Manage my plan

There are a few ways you can file a claim.

Your provider submits the claim directly.
Pharmacy claims: Present your benefits card at the time of purchase and your pharmacist will send your claim electronically. If your pharmacist is unable to submit your claim electronically, the pharmacist can call the pharmacy helpline at 1-866-773-5467 (toll-free).

Dental, paramedical and vision offices with the ability to submit electronic claims can submit your claim directly. You may be asked to pay for the service upfront, depending on the practitioner’s arrangement

Submit your claim online
You can submit through the online claims portal.
Access the portal

You will receive a confirmation number, and your claim form and receipts will be filed in the Filed Plan Benefits folder in the Communications Centre. For audit purposes, original receipts may be requested at any time. Please keep your receipts for seven years. Once processed, an Explanation of Benefits statement will be filed in the Plan Benefits folder in the Communications Centre.

Submit your claim by mail
Download the claims form to submit your claim by mail. Make sure your claim form is complete, including your certificate number (ID#). Remember to sign each claim form. Please submit claims as directed on the form.

Claim submission tips

• Submit your claim as soon as possible, so you don’t forget. All claims must be submitted no later than six months from the date in which the expenses were incurred.
• Claims for items (e.g., eyeglasses) will apply toward the maximum in the year the item was paid in full. Claims for services (e.g., chiropractor, physiotherapist) will apply to the maximum in the year the service was rendered.
• Keep copies of your receipts. Photocopies of receipts are acceptable. Cash register and credit card receipts are not acceptable. File your receipts after you’ve submitted the claim and keep them for at least seven years.
• Receipts must contain the patient’s name, the vendor or provider’s information, the date of service or purchase, a description of the item purchased and a breakdown of charges. Please note that the patient account statement does not contain the information required.
• If a plan is cancelled, all claims must be submitted within 90 days of the cancellation date.

If you are covered under more than one insurance plan simultaneously, you can coordinate benefit payments from all plans. The total reimbursement cannot exceed the actual expense incurred.

Your claims should generally be submitted first to this plan. Your spouse’s claims should be submitted first to their plan, and your dependent children’s claims should be submitted first to the plan of the parent whose birthday (i.e., month and day) occurs earlier in the calendar year.

Please contact us to verify which plan pays first. If the other plan does not have a coordination of benefits provision, claims should be submitted first to that plan. If priority cannot be established by those means, benefits will be prorated between the plans.

A copy of the explanation of benefits from the other insurance carrier, a completed Extended Health Care Claim Form and photocopies of all receipts are required for consideration of the claim balance.

For extended health plan members

If you have an emergency while travelling, call Global Excel Management immediately before seeking treatment. If you can’t call yourself, have someone call on your behalf, or call as soon as medically possible. They’re available 24/7. The numbers are on your benefits card.

• From Canada and the United States, call 1-877-346-1467
• From Mexico, call 800-062-4728
• From anywhere else in the world, call COLLECT + 819-780-0647

The agent you speak to will provide all the information required to file a claim. A claim will be opened, and they’ll give you instructions on how to access the online claimant portal to submit further documents, and review the status of your claim. As with all other claims, it’s essential to keep your documentation. Full coverage and claim details are included in your Group Travel Insurance booklet.

Contact us with questions about your coverage or to change or add to your coverage.

• Complete the intake form on the CloudMD site for plan members. 
• You will be contacted by a nurse care coordinator to gather all the medical information and answer questions/concerns.
• The medical information will be gathered and sent to a specialist to review the diagnosis and provide a second opinion.
• The nurse care coordinator will schedule an appointment with the specialist (virtual/in-person) for you to discuss the second opinion.

Here’s what to do before your set up your account and transfer your prescriptions for maintenance medications to Express Scripts Canada Pharmacy:

• Ensure you’re already a member extended health plan.
• Make sure you have a 30-day supply for each maintenance drug you take. If you don’t have a 30-day supply, refill your prescription from your current pharmacy before joining Express Scripts Canada Pharmacy.
• Make sure you have at least one refill for each of your maintenance drugs on file at your current pharmacy to do the transfer. If not, renew your prescription at your current pharmacy before doing the transfer.
• Have your benefits card and also have your spouse’s benefit card if you are covered as a dependant on their plan.
• Gather all maintenance medications you are currently taking. The information you need to transfer your prescriptions is on the medication labels.

How to join

• Go to the Express Scripts Canada Pharmacy page and enter the VIP code: RTOERO. Or, download the Express Scripts Canada Pharmacy mobile app and register through the app. Select the option to enter a VIP code. Skip the ‘See my prescriptions’ step and continue filling in your information.
• Once your account is active, you can begin transferring prescriptions following the Transferring Prescriptions guide available in your account.
• An Express Scripts Canada pharmacist will contact you for a consultation to ensure everything is taken care of and answer any questions you have.

Need help? Call: 1 855 550-MEDS (6337). Residents of Québec, please contact PharmaGO toll-free at 1 855 333-3977