Detailed Claim Submission Guide

We cannot use a till-tape or credit card slip as it does not give us any of the information above. We need the detailed invoice for your claim submission.

What to submit when you have insurance

You must submit your expenses to all eligible insurance carriers first before using the spending account. We are the last payer. 

Any time there is insurance coverage involved we require their "Explanation of Benefits," the detailed document that confirms how much the insurance carrier has paid towards an expense (even if it is 0). If you do not have your copy, contact your insurance carrier directly to obtain it. Please note, online printout copies are acceptable. Summary documents are not acceptable.

More details found here.

What to submit when you have dental coverage

The Standard Dental Claim Form is filled out by the dental office and includes information that does not typically appear on a regular dental invoice. Most commonly missing from other documents is a listed treatment date. While the billing date may be the same as the treatment date, this is not always the case. As dental claims are processed by the treatment date specifically, we do require clear confirmation. 

If you have no other coverage, we ask that you request a Standard Dental Claim Form from your dental office for each treatment.

Sample Form:

What to submit if you have orthodontic coverage

For orthodontic treatment expenses submit a copy of each payment receipt. The payment receipt must clearly indicate the expense is for Orthodontics and what kind of expense it is (Deposit/Initial Payment/Monthly Installment). The receipt must include the patient name, amount and the date of the payment.

IMPORTANT: If you have any insurance or other coverage for orthodontic treatment, you must provide additional documentation. Your first orthodontic claim must include the Orthodontic Treatment/Financial plan, which shows the patient name and payment schedule you have arranged with the dentist. We will keep this plan on file so you will need to submit it only once.

When there is any insurance or other coverage for orthodontic treatments, you must submit the expenses to them first. They will process the claim according to the payment schedule and provide you with an Explanation of Benefits document (EOB, also sometimes called a Claim Statement). We require the EOB document for each payment you are claiming when other coverage has been involved.

You can click the link below to see more information about this required document. 

Explanation of Benefits (detail)

Regarding lump-sum payments, please be aware that we cannot reimburse lump sum payments if there is any other coverage involved with your orthodontic claim. If you have other coverage, you must make payments according to the payment plan that your insurance company is following.

What to submit if you have travel medical coverage

In order to claim expenses related to travelling for a medical appointment more than 80km from your home, you must provide the following:

1. A doctor's letter confirming (as per CRA guidelines) that “substantially equivalent medical services are not available near your home and that under the circumstances, it is reasonable for you to travel to that place for those medical services.”
2. If you are claiming any travel companion expenses, you will also need the doctor's letter to certify that you were not able to travel alone to get medical services. This would allow you to claim their expenses, as well.
3. Proof of your medical appointment. Preferably a detailed invoice, but a letter from the provider will suffice if you are not claiming the appointment cost itself.
4. The completed Travel Expense Form, which you can download here.

How to claim an expense in any currency other than CAD

In order to submit an expense in a currency other than CAD, you must include the following:

1. The original invoice.
2. A translation of the invoice to English (if applicable). Please ensure the details include the provider name, patient name, service details including service date, and the full cost of the service.
3. Confirmation of payment and exchange rate to CAD. If you paid by credit or debit card, you can include the line from your statement showing the amount paid in CAD and the date of payment. If you paid with cash, you can go to www.x-rates.com to obtain the conversion of what you paid on that date. Please include the information from x-rates.com, as well as a note stating you paid by cash and have no further documentation to provide.