Call us 24/7 from anywhere in the world for help during a medical emergency.
If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms. If you have coverage through an advisor, use our personal insurance forms.
Use this form to make a claim for medical expenses you incurred while travelling outside Canada or while more than 500 kilometres from your home within Canada.
These are the forms to use if you are a Freedom to Choose health and dental insurance customer.
Questions? Call us at 1-866-430-2863.
Alberta Health requires all claim documents be received within 12 months from the date the medical treatment was provided.
In addition to the Out-of-Country M5975(IHP) claims form, British Columbia residents are required to submit the following 3 forms to Canada Life:
- #2814 (out-of-country claim)Opens a new website in a new window
- #2806 (Schedule A; medical travel assignment of payment)Opens a new website in a new window
- #2807 (Schedule B; authorization to provide medical information)Opens a new website in a new window
These Medical Services Plan (MSP) Forms should be downloaded from the official websiteOpens a new website in a new window of the Government of British Columbia, completed in full, and submitted as part of your claim. The MSP of British Columbia requires all claim documents be received within 90 days from the date of service, except for in-patient hospital services, which must be received within six months from the date the medical treatment was provided.
Manitoba Health requires all claim documents be received within 6 months from the date the medical treatment was provided.
The New Brunswick Medicare Plan requires all claim documents be received within 12 months from the date the medical treatment was provided.
In addition to the Out-of-Country M5975(IHP) claims form, Newfoundland and Labrador residents are required to submit the out-of-province claim form available from the Government of Newfoundland and Labrador websiteOpens a new website in a new window.
Newfoundland and Labrador requires all claim documents be received within 12 months from the date the medical treatment was provided.
The Nova Scotia Medical Services Insurance Plan requires all claim documents be received within six months from the date the medical treatment was provided.
The Ontario Health Insurance Plan (O.H.I.P.) requires all claim documents be received within 12 months from the date the medical treatment was provided.
The Health and Community Services Agency of Prince Edward Island requires all claim documents be received within 6 months from the date the medical treatment was provided.
The Régie de l’assurance-maladie du Québec (RAMQ) requires all claim documents be received within 1 year from the date the medical treatment was provided, except for in-patient and out-patient hospital services, which must be received within 3 years from the date the medical treatment was provided.
Quebec residents are also required to provide a completed Application for reimbursement formOpens a new website in a new window.
Saskatchewan Health requires all claim documents be received within 1 year from the date the medical treatment was provided.
Log in to your Canada Life online account to submit your completed claim form. We’re not able to process these claims on the app right now.
When you’ve logged into your account, click Make a claim, and then follow the steps under Start a paper claim.