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Submitting Claims


Health and dental claims: insurance provider, policy number

Insurance provider: Manulife Financial    Contact: 1-800-268-6195

Policy number: 85210


Claims submission deadline- health and dental claims

 

The benefit year is January 1 to December 31. All claims must be received by our insurer within 90 days of the end of the benefit year — that is, by March 31st.

Claims received after this date will not be eligible for consideration.


Submitting your claims to Manulife.  Submit certain health practitioner claims online!

 

Submit your health practitioner claims online!

You can submit claims online on Manulife's website for certain health practitioners that do not require a doctor's referral.  To do so, log in to the Manulife  Plan Member Secure site .   You will need to keep your receipts for at least one year. If you have questions about the online claims submission process, contact Manulife directly at 1-800-268-6195.

Your health practitioner can also submit online: Health care providers, such as physiotherapists and chiropractors, can submit plan member claims directly to Manulife right at the point of care. In many instances, plan members will only have to pay the amount not covered by the plan for approved claims. For more details and a list of eligible health care providers near you, go to Manulife Provider eClaims  

You can manage your benefits on your smartphone or tablet. It’s available in all app stores for all smartphone devices (Apple App StoreSM, Google PlayTM, BlackBerry® WorldTM and Windows® Store).With the app, you will be able to:

  • Submit claims from your smartphone
  • View your most recent claims
  • Explore claim details

Mail: 

Mail your claim to the Manulife address indicated on the claim form.

Deliver in person: 

Bring your claims to the Manulife drop off location at: 2000 Mansfield, 2nd floor reception (Montreal).

 


Health and dental claim forms

 

You can print claim forms directly from the Human Resources website.

You can also obtain claim forms from the HR Service Center at 688 Sherbrooke St. W., 15th floor, Rm 1520 or by calling 514-398-4747.


Direct deposit of health & dental claim payments

Your health and dental claims payments will be automatically deposited directly into your McGill payroll designated bank account.  

How will it work?

Automatic Registration: McGill will provide Manulife with the required information so that you will be automatically registered for direct deposit of your claims  payments.                                                                                                                                                                                                 

You will receive claim payments faster -in most instances- within 48 hours.

Manulife will send you an e-mail advising when your claim has been processed.

Your claim statements will be available on-line at Manulife’s Plan Member Secure Site.   In addition to viewing your claim statements, this site will allow you access to view the status of your most recent online submitted claims, a detailed view of your claims history, and ability to print a personalized benefits card at any time.

To view your claim statements and claims history, you will need to register for Manulife's Plan Member Secure Site.:

Click on the 'Sign In' button, under Group Benefits select 'Participant' and then follow the steps.

 

 Questions?

Visit the FAQ section.

Manulife Plan Member Secure Site

Once you have registered for the Plan Member Secure Site, Manulife will send you an activation key to 'activate' your account. 
With your activation key, follow the instructions on the Manulife website to gain full access to the Plan Member Secure Site and your benefits information.
If you encounter any problems during this process or do not receive your activation key, contact Manulife directly at 1-800-268-6195.
 

With the Manulife Plan Member Secure Site you can:

Quickly view the status of any online submitted claims.
Access details of your claims history. 
Print a Benefits card from anywhere in the world as long as you have internet access.
 
 

Supplemental Health Claims (including Private Duty Nursing and Emergency Out of Province)

 

A. Hospital Claims                                                                                                                         
B. Drug Claims
C. Private Duty Nursing
D. Orthotics and Orthopaedic shoes 
E. Health Practitioners
F. Medical Services and Supplies
G. Electronic Claims Submission
H. Emergency Out of Province Claims


Hospital claims

 

 If the hospital will bill the insurer directly:                                                                                                                                           
  • Advise the admitting clerk that you are covered under plan contract number 85210 with Manulife Financial
  • Give them your McGill identification number
  • The hospital will bill the insurer directly.
If the hospital requires that you pay the bill:
  • Obtain the completed hospitalization claim form from the hospital (keep a copy for your personal records)
  • Forward the completed hospital form directly to Manulife Financial with your policy and ID number indicated; or attach the hospital form to a Manulife claim form and forward both directly to Manulife Financial.

Drugs claims

 

  • If you use your deferred drug card to purchase medication, your claim is processed via your pharmacist's computer system. There is no need to submit a paper claim to Manulife Financial. You will automatically receive a reimbursement cheque in the mail.
  • If you do not use your drug card to purchase medication, you may submit a paper claim to Manulife Financial. Follow the same instructions as outlined below "For other claims".

Private duty nursing services

You must submit a Pre-Determination to Manulife Financial before nursing services can begin; otherwise, your claim could be refused or reimbursed at a lower level. Please refer to: Private_Duty_Nursing_Guidelines  Attach all necessary information to a Manulife Supplemental Health claim form.

Orthotics and orthopaedic shoes

In order to be eligible for payment, your orthotics and/or orthopedic shoes must be:

  • Custom made
  • Prescribed by a medical general practitioner or specialist, podiatrist or chiropodist, and
  • Supplied by an orthotist, pedorthist, podiatrist or chiropodist.

For each claim and/or predetermination for orthotics and orthopaedic shoes,you must supply a detailed prescription from the prescribing medical practitioner indicating all of the following:

  • A diagnosis of the condition (symptoms alone will not suffice),
  • A list of symptoms and the chief complaint,
  • A description of the physical findings from the clinical examination,
  • A brief narrative description of the gait abnormality with the diagnosis,
  • A detailed receipt from the supplier indicating:
    • The provider's qualifications, and
    • Confirmation that the orthotics or orthopedic shoes have been custom made.

 

Health Practitioners

Electronic claims submission:

You can enter your claims online on the Manulife website for certain health practitioners that do not require a doctor's referral.  To do so, log in to the Manulife  Plan Member Secure site .                         
You will need to keep your receipts for at least one year.
If you have questions about the online claims submission process, contact Manulife directly at 1-800-268-6195.
Health practitioners - online claim submission
Health care providers, such as physiotherapists and chiropractors, can submit plan member claims directly to Manulife right at the point of care. In many instances, plan members will only have to pay the amount not covered by the plan for approved claims. For more details and a list of eligible health care providers near you, go to Manulife Provider eClaims  
There's an app for that!
You can manage your benefits on your smartphone or tablet. It’s available in all app stores for all smartphone devices (Apple App StoreSM, Google PlayTM, BlackBerry® WorldTM and Windows® Store).
With the app, you will be able to:
  • Submit claims from your smartphone
  • View your most recent claims
  • Explore claim details
Visit your favourite app store to download it now and enjoy the convenience of managing your benefits on the go.
Watch a tutorial at MobileDemo

Paper claim submission:

  • Complete the appropriate sections, being sure to include
    • The plan member certificate number (your McGill ID number)
    • The name and date of birth of claimant
    • The total amount submitted
    • Referral or prescription from the treating physician were necessary (consult the Supplemental Health Plan as to whether the service you incurred requires a referral/doctor's prescription)
  • Attach the original receipt(s) and keep a copy for your personal records
  • Sign, date and forward the completed form directly to Manulife Financial. Their address is indicated on the form.
    

Medical Services and Supplies

Obtain a Manulife claim form:

  • Complete the appropriate sections, being sure to include
    • The plan member certificate number (your McGill ID number)
    • The name and date of birth of claimant
    • The total amount submitted
    • Referral or prescription from the treating physician were necessary (consult the Supplemental Health Plan as to whether the service you incurred requires a referral/doctor's prescription)
  • Attach the original receipt(s) and keep a copy for your personal records
  • Sign, date and forward the completed form directly to Manulife Financial. Their address is indicated on the form.
  • If your claim is for an eye exam performed by an opthamologist who is registered with Medicare, a detailed explanation of the services rendered, as well a separate charges, must be indicated on the receipt.

Electronic Claims Submission

You can enter your claims online on the Manulife website for certain health practitioners that do not require a doctor's referral.  To do so, log in to the Manulife  Plan Member Secure site .                         
You will need to keep your receipts for at least one year.
If you have questions about the online claims submission process, contact Manulife directly at 1-800-268-6195.
 
Provider eClaims - health care providers online claim submission
Health care providers, such as physiotherapists and chiropractors, can submit plan member claims directly to Manulife right at the point of care. In many instances, plan members will only have to pay the amount not covered by the plan for approved claims. For more details and a list of eligible health care providers near you, go to Manulife Provider eClaims  
There's an app for that!
You can manage your benefits on your smartphone or tablet. It’s available in all app stores for all smartphone devices (Apple App StoreSM, Google PlayTM, BlackBerry® WorldTM and Windows® Store).
With the app, you will be able to:
  • Submit claims from your smartphone
  • View your most recent claims
  • Explore claim details
Visit your favourite app store to download it now and enjoy the convenience of managing your benefits on the go.
Watch a tutorial at MobileDemo

Emergency out of province claims

In case of a medical emergency, contact Manulife's emergency travel assistance provider, Allianz Global Assistance, immediately. Be sure to quote the ManuAssist Plan ID number & your Manulife Plan Contract Number 85210.  For more information, go to Emergency Travel Assisitance - Active or Retirees 

  • Keep all receipts
  • Obtain a fully itemized bill for any hospital treatment provided

For expenses of $200 or less

You must file a claim first with your provincial health care plan (eg. RAMQ in Quebec) and then with Manulife for the balance:
  • Attach the original receipt(s) to the appropriate provincial health plan claim form for your province of residence. Keep a copy of all documents to send to Manulife once you receive settlement from the provincial health care plan.
  • Sign, date and forward this form along with the original receipts to your provincial health plan (e.g., RAMQ — Régie de l'assurance-maladie du Québec)
  • Once you receive payment from your provincial health plan, submit any unpaid balance to Manulife. Attach copies of the receipts and the Statement of Expenses indicating amounts considered and paid under your provincial health care plan.

For expenses in excess of $200

Allianz Global Assistance immediately or soon as possible after emergency medical services have been incurred.  Allianz will assume responsibility on your behalf for obtaining reimbursement of eligible medical expenses from your provincial health care plan and from Manulife. 

For further details, go here

 

 


Dental claims

 

Pre-determination

If the total treatment is expected to cost more than $400, it is recommended that you submit a treatment plan to Manulife Financial before the treatment begins - to avoid surprises.

Electronic claims submission by your dentist

Some dentists have the ability to submit dental claims electronically to Manulife Financial, in which case no paperwork is required. Simply provide your dentist with your Manulife policy number 85210 and your plan member certificate number (your McGill ID number).

Paper claim submission

  • Before visiting your dentist, obtain a Manulife Financial dental claim form
  • Complete Part 2 of the form
  • Have your dentist complete Part 1 of the form
  • You can assign your benefit payment directly to your dentist by signing in the appropriate box on the claim form
  • Otherwise, sign, date and forward the completed form directly to Manulife Financial. The address is provided on the form. (Keep a copy for your records)

Dental claims as a result of an accident

Submit a pre-determination under the McGill Supplemental Health Plan using a health claim form.  Include from your dentist: xrays, details of treatment, including procedure codes, tooth #, tooth services and fees and details of the accident.  Once the estimate is approved, the claim must be sent in and not submitted electronically.


Coordinating health and dental payments

 

If both you and your spouse have Health and/or Dental coverage under another employer-sponsored benefit program, you can coordinate your claims (claim expenses under both plans). This process may allow you to recover some of the costs not covered under the plan — things like deductibles, co-insurance payments, or expenses in excess of the plan limitations or restrictions (but not more than 100% of actual expenses).

To co-ordinate benefits, please follow this process:

If

Then

You incur the expense

You must submit your claims through the McGill plan first. If the McGill plan doesn't cover the full expense, your spouse can submit the unpaid portion through his/her plan.

Your spouse incurs the expense

Your spouse must submit claims through his/her plan first. If that plan doesn't cover the full cost of the service or procedure, you can claim the remaining expense through the McGill plan if you have family coverage.

The expense is for a child

If both you and your spouse have family coverage, claims for children are to be submitted first to the plan of the parent whose birthday falls earlier in the year. If you were born in March, for example, and your spouse was born in July, you would submit claims to the McGill plan first. Again, any uncovered expenses could, in turn, be submitted to your spouse's plan as the secondary payer.


Life insurance and accidental death claims

 

Your beneficiary or the executor of your estate should contact the HR Service Centre at 514-398-4747 as soon as reasonably possible to advise of your death. A representative will help them complete the claims process.


If you leave the University before retirement

 

You have 90 days from the day you terminate employment to submit any outstanding claims for charges incurred prior to your termination date.



Claiming expenses under the provincial plan replacement coverage benefit

 

For all details, go to refer to the Provincial Plan Replacement (PPR) Coverage section of this website.


 

FAQs

Questions?

Visit the FAQ section.