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 1-800-361-9888 (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.

As part of the Extended Health Care plan, you and your dependents have free access to Novus Health’s thorough resources and a team of health information specialists and nurse case managers who provide trusted guidance so you can make informed decisions about your care and the care of your loved ones.

All services are confidential, bilingual (English and French), and delivered entirely within Canada. Your personal health information is protected under Canadian privacy laws (PIPEDA, PHIPA, and Quebec’s Law 25).

Who can benefit

This service is designed for plan members and dependents who:

• Want a second opinion on a medical diagnosis or treatment plan
• Need help finding a family doctor, nurse practitioner or specialist
• Would benefit from health coaching to support a new or existing complex health condition
• Would like support understanding test results, treatment options or next steps

Services are available online 24/7 or you can reach a health information specialist by phone Monday to Friday from 8 a.m. – 8 p.m. ET.

Full details are included in your insurance plans booklet.

How to get started

1.  Contact Novus Health: Call 1-833-787-7156, or visit the health navigation platform at ententeplus.mynovushealth.com to begin. Select ‘Sign up’ and enter the group code: ENTENTE.
2. Connect: A health information specialist will review your information and understand your concerns.
3. Coordinate: Your health information specialist will gather the necessary information to support your inquiry.
4. Review: You’ll receive a detailed report and the opportunity to ask questions with your health information specialist. You can discuss the findings with your physician.

GreenShield Pharmacy™ is a convenient, integrated online pharmacy that lets you manage your prescriptions from home or anywhere in Canada.* This voluntary service is available to Extended Health Care plan participants and dependents under the Entente Plus Group Insurance Program.

Member benefits

• Higher reimbursements of the drug ingredient cost — 100% for generic drugs or 90% for eligible brand-name drugs**
• Free delivery of your prescriptions to anywhere you are in Canada*
• Personalized care from the privacy and comfort of your home — GreenShield pharmacists are available to discuss your medications or a dependent’s medications

Pharmacists are available by phone or video chat Monday to Friday, 9 a.m. to 5 p.m. ET.

Integrated pharmacy experience in the Entente Plus app and portal

• View and order all your medications, including an auto-refill option so you never run out.\
• Book pharmacist consultations for:
  • Questions about medications
  • Support with chronic disease or medication management
  • Concerns with side effects
  • Prescribing for minor ailments, such as eczema or allergies
• Use caregiver functionality to manage a dependent’s medications.
• Family members can create their own separate pharmacy accounts.
• Access live translation services in any language, including American Sign Language (ASL).

How to get started

Access the GreenShield Pharmacy™ from the Entente Plus portal or app.

If you need help or have questions, contact Entente Plus Assistance:

• Phone: 1-800-361-9888
• Email: assistance@ententeplus.ca

* Available through GreenShield Pharmacy™ partner Pharmacie Sonia Boutin inc., Medzy in Quebec.

**Not available in Quebec.