Filing a Health Insurance Claim

So you’ve decided on a health insurance plan that fits your needs, what now?

You will receive your ID card in the mail that has all of the information necessary that your health service provider will need to process your claim.

Individual claims must be submitted within 12 months of the service charge. Once the insurance company receives your claim it shouldn’t take more than 5 business days to process your claim and another 24hrs after processing to send out your re-imbursement. Make sure to include all necessary information including original receipts, for prompt processing and payment.

Many health care providers, hospitals, pharmacies dentists and optometrists most likely will bill your insurance provider right from the office, eliminating the process of having to fill out and send a claim form. If your health care provider does not bill your insurance provider directly, you are then required to pay the initial cost in full and then submit your claim yourself. You would then receive your re-imbursement by mail. You can use your receipts for tax purposes so make sure to retain the top portion of the cheque for verification.

Medical Marijuana Coverage

In June 2013 Health Canada introduced regulations to permit larger-scale medical marijuana production facilities. As a result, 15 companies are now fully authorized to produce and sell the product. Eight other companies are authorized to produce, but not to sell.

There is a very strict application process in which a company must meet Health Canada’s criteria in order to be considered. 

Consideration is given to the following:

• Storage
• Location
• Human Resources
• Pest Management
• Packaging/Inventory
• Record Keeping
• Sales and Marketing
• Quality Assurance

There are 3 steps when applying to Health Canada for an Authorization to Possess Marihuana for Medical Purposes and for a legal source of supply under the Marihuana Medical Access Program (MMAP):

Consult your Medical Practitioner

Before you apply to the MMAP your doctor must provide a letter declaring that other avenues of treatment have been used and have not been effective.  If you and your doctor agree you should apply to the MMAP to obtain marihuana for your condition and/or symptoms, you must choose a source of supply. As of March 31, 2014 you   would no longer be permitted to access Health Canada supply of medical marijuana, you will need to register with a licensed producer.

Is my medicine covered by my medical plan?

Because medicinal cannabis doesn’t at this time have a Drug Identification Number (DIN) it isn’t covered by any Federal, Provincial or private health insurance. If you are a veteran you may be covered by the Veterans Affairs of Canada or there is the option to declare it as a medical expense on your personal taxes providing you have valid receipts.

For any other questions about drug coverage go to http://www.caahealth.ca/