How to submit a healthcare spending account claim
Once a health care service has been provided, the expense can be submitted under your health and dental plan for reimbursement.
If you have one, use your healthcare spending account (HCSA) to submit the portion of your expense that exceeds any plan limits. You can also use your healthcare spending account to cover the costs that aren’t covered by your workplace benefit plan but that qualify for a medical expense tax credit under the Income Tax Act.
Claims can be submitted by either:
- Online – Sign in to My Canada Life at Work™ to complete a claim.
- Paper – Complete and submit the appropriate healthcare spending account claim form.
What are the submission timelines?
For most HCSA expenses, you must submit the claim within 31 days after the end of the prior plan year. The quickest way to check how long you have is to sign in to the healthcare spending account coverage and balance section of mycanadalifeatwork.com. Or you can refer to your booklet or ask your plan administrator.
I’ve submitted my claim. Now what?
Once all information for your claim is received, we’ll adjudicate your claim.
If there’s any missing information required to assess your claim, we’ll contact you through My Canada Life at Work or by mail.
You can respond to any missing details for your claims online by signing in to My Canada Life at Work and going to the contact us section.
When will a decision be made about my claim?
If you submitted your claim online through My Canada Life at Work, most HCSA claims will have instant claims payment details.
For more complex claims, or claims submitted by mail, a decision will be made 7 calendar days from the date we receive all necessary information.
Please note: This timeline is intended for standard plans only. Actual timelines might vary based on plan design and claim complexity. Missing information or incomplete applications for benefits may impact processing timelines. We may need to extend the timeline if additional review is needed.
How will I find out if my claim has been accepted?
We’ll provide you a response either electronically or by a letter in the mail, depending on your communication preferences.
How to appeal a decision
Appeal level 1
- Details – Prior to submitting an appeal please refer to the Canada Revenue Agency (CRA) to ensure the claim is eligible as per the medical expense tax credit definition. You can appeal by resubmitting the claim and indicating it is an appeal. Please tell us why you disagree with our assessment.
- Timeline – Canada Life aims to process all appeals within 7 calendar days of receipt.
- Communication – If the appeal is accepted, we'll provide you a response either electronically or by mail, depending on your communication preferences. If the appeal decision is maintained, we'll respond by sending a detailed letter with an explanation for the decision.
Appeal level 2
- Details – If you aren’t satisfied with the first appeal decision you may send us in writing all claims details with any additional information we may not already have for review.
- Timeline – Appeals will be reviewed within 10 calendar days.
- Communication – We'll respond by sending a detailed letter with an explanation for the decision.
Complaints
After Appeal level 2, you can ask to have your concerns escalated further. This would flow into our customer complaint process.