Frequently asked questions

Your certificate number is located on the front of your ID card. If you have an older card, this may show as contract number.

We accept photocopies of receipts for all claims, except travel claims.

There is no maximum to the number of emergency ambulance trips you can take. If you have emergency ambulance coverage, it is covered at the coverage per cent indicated by your plan and subject to the usual & customary rates in place for the region of service.

* This does not include Out of Province ambulance and Medical Transfer benefits. These benefits are separate and subject to their own exclusions and limitations.

Usual, customary, and reasonable charges refer to the range of charges by individuals of similar training and experience providing the same services or supplies within a specified location/province. These may also include charges considered justifiable under special circumstances by the provider's professional association.

If your provider charges more than the reasonable and customary limit (including more than one visit in a day), you will be responsible for paying the difference. Shopping around for health care products and services helps members reduce out-of-pocket expenses and helps employers reduce benefit plan costs.

You are covered anywhere outside of Manitoba, unless the Government of Canada has placed an "avoid all travel" advisory on your destination. View travel advisories on the Government of Canada website.

A Health Spending Account (HSA) is a tax-free allocation of credits that an employer may offer to employees to provide reimbursement on a wide range of out-of-pocket health expenses. In general, expenses are considered eligible if they qualify as a medical expense tax credit under the Income Tax Act of Canada and have not been 100 per cent reimbursed by another benefit plan. Deductible amounts and co-insurance also qualify.

An HSA is administered in accordance with Canada Revenue Agency guidelines, and is always last payer (after government, employer, individual, student, and spousal plans).

There are a number of ways to maximize your drug coverage:

• Check with several pharmacies to find out who has the lowest dispensing fees and mark-up. Pharmacies have their own practices and costs, resulting in various prices for the same prescription. Dispensing fees can range from $4 to $20 or more per prescription across different pharmacies. You have the option to shop around.
• Reduce your dispensing costs by purchasing the maximum supply of a prescription drug at one time (100-day supply).
• Choose generic wherever possible. Generic drugs are strictly regulated in Canada and must contain the same active ingredients, provide the same strength per dosage, and be administered the same way as their brand-name counterparts. If prescribed a brand-name medication, ask your doctor about a generic alternative. You can also ask your pharmacist to substitute a generic version when filling your prescription.

Vision coverage frequency varies by plan. Visit Coverage in mybluecross® and view your vision eligibility to find out when you are eligible for your next eyeglass or lens purchase, or contact us.

The Employee Assistance Program (EAP) is a comprehensive, voluntary program that provides confidential counselling to assist in identifying and resolving concerns affecting you and your family's health and well-being.

To submit a claim that has been partially paid by another carrier or the government program:

• Respond "Yes" to the question: "Has a portion of this expense been paid by another policy or a government program?". This field is required even if the amount paid was zero.
• Enter the amount paid by the other plan(s) under "Other Plan(s) Paid", "Government Paid", or both, depending on who paid a portion of your claim. The amount entered should reflect what is shown on the Explanation of Benefits (EOB) provided by the other plan.

Click the Back button to go back to make any corrections. Ensure all information is correct before submitting your claim.

If the Paid Amount is $0.00, please review the claim details.

If the claim status is Processed and a Paid Amount is indicated, a payment will be direct deposited with 1-3 business days from the Processed Date. Cheque payments are issued weekly.

Only specialty claim forms are required.

Queued means your claim is being held for processing. This has happened because you have a claim in Audit status. When a claim is selected for audit, the system places a temporary hold on all subsequent claims. Once Manitoba Blue Cross receives the requested receipt(s) for your Audited claim, all Queued claims will be released for processing.

Manitoba Blue Cross is committed to protecting your benefits from fraud and abuse. One of the ways we do this is by auditing claims to confirm the accuracy of information provided.

Visit Insurance Fraud and Abuse to learn more.

Claims are processed in the order in which they are received.

We are located at 599 Empress Street, Winnipeg MB. Our office hours are Monday through Friday 9 a.m. - 4 p.m. For additional contact information please visit our Contact us page.

Claims are processed in the order in which they are received.

For faster processing, register for direct deposit under Manage Account and payment will be transmitted as soon as your claim is processed. As an added benefit, you'll also be able to submit claims online through mybluecross. An EFT payment will be deposited to your bank account within 1-3 business days from the processed date.

Manitoba Health will cover the full patient cost of inter-facility transports when:

• the patient is a resident of Manitoba with a valid Manitoba Health card
• the patient medically requires transportation by ambulance as determined by a physician
• the patient is being transferred between designated health-care facilities for diagnostic tests or treatments, or from a more specialized level of care to another facility closer to home for rehabilitation or recovery.

We allow direct billing from all qualified service providers. Direct billing is free to set up with Manitoba Blue Cross. However, the decision to offer this is at the discretion of the provider.

Each country has its own documentation requirements. Before travelling, we recommend you visit the Goverment of Canada website for information on the country you're visiting. Be sure to travel with your Manitoba Blue Cross certificate or policy, which includes contact information for International Travel Assistance.

Health Spending Account credits are deposited into your account as directed by your employer. Visit Coverage in mybluecross® to view your HSA coverage information, including credits accrued and credits used.

Based on coordination of benefits' guidelines, you must submit prescription drug claims under your own plan first, even if your spouse has BlueNet.

*This coordination of benefits guideline also applies to dependents. When making claims for eligible dependents, you must first claim under the plan of the parent with the earlier birth month in the calendar year.

For faster processing, register for direct deposit and gain access to submit claims online. This convenient service allows you to bypass the manual processing wait times by processing prescription drug claims in real time. As an added benefit, payment will be transmitted to your bank account as soon your claim is processed.

At the start of the orthodontic treatment, your orthodontist will prepare a written outline of the proposed treatment. This is called a treatment plan. Prior to service, your orthodontist should submit this treatment plan to Manitoba Blue Cross. Manitoba Blue Cross will in turn generate a pre-authorization.

Orthodontic claims are paid monthly based on the treatment plan outlined by your provider. You must submit a claim for each month's visit. If you elect to pay the entire amount upfront, you may submit the full receipt and Manitoba Blue Cross will reimburse monthly according to the length of your treatment plan, until the treatment plan ends or you've reached your yearly or lifetime maximum (whichever comes first).

No. Only sunglasses that contain corrective lenses are eligible for coverage.

All family members (including spouse and dependents) are covered under the plan.

Ensure the claim has been submitted under their primary plan first. Then, when adding an expense:

• Respond "Yes" to the question: "Has a portion of this expense been paid by another policy or a government program?". This field is required even if the amount paid was zero.
• Enter the amount paid by the other plan(s) under "Other Plan(s) Paid", "Government Paid", or both, depending on who paid a portion of your claim. The amount entered should reflect what is shown on the Explanation of Benefits (EOB) provided by the other plan.

To submit a claim that has been partially paid by another plan or government program, please upload your Explanation of Benefits or government statement along with your claim.

If the Total Paid Amount is $0.00, select "View this claim" to review claim details.

‍

To resolve an Audited claim, use Claim Search to find your claim and submit your receipt(s).

Important: If you prefer to mail your receipt(s), you must include the Reference Number of your audit, which you will find under Claim Details.

Only processed claims will appear in results. Most claims are processed in real-time by our system. However, claims that include document uploads are manually reviewed and will be processed in the order in which they are received. Note: Travel and Employee Assistance claims are not available for viewing in your Claim History. Contact us for information on these claims.

Select View or request an ID card, under the user account menu. Here, you can print a card for temporary use, request a new permanent card or immediately display the electronic version to your service provider.

Cheques are mailed weekly (this does not include the time needed by Canada Post to deliver your claim or Explanation of Benefits statement). Busier periods or complex claims may require additional processing time.

For faster reimbursement, register for direct deposit by selecting Manage Direct Deposit under the account dropdown. It's safe, secure and eliminates the risk of lost or stolen cheques. Plus with direct deposit, payments will be transferred directly into your bank account (and not subject to mail delays like cheque payments) so you'll gain access to your money sooner.

If any part of the trip is outside of Manitoba, the trip would be considered under the Out of Province Ambulance benefit and subject to any maximums that may apply.

Visit Coverage in mybluecross® to view the details of your coverage.

In the event that any portion of the travel outside of Manitoba falls after the 31st week of gestation, charges associated with the required confinement of the mother and newborn infant due to childbirth and delivery will be denied by Manitoba Blue Cross. However, in the event of unexpected, pre-mature delivery prior to 31 weeks gestation, the coverage terms of the Policy will extend medical, hospital and necessary transportation costs for the mother and pre-mature infant.

You may request reimbursement for any CRA-approved medical expense or service by an approved practitioner that has not already been 100 per cent reimbursed by another plan. Deductible and co-insurance amounts also qualify.

To determine if a medical expense is tax deductible, refer to the Canada Revenue Agency. For exclusions or exceptions specific to your group plan, refer to your benefit booklet or contact us.

Drugs not eligible under Manitoba Pharmacare (e.g. over-the-counter drugs) are generally not included as benefits of a prescription drug plan. Visit Coverage to view the details of your coverage or contact us.

• Basic Services covers basic diagnostic and preventative services. This includes examinations, radiographs, basic restorations, periodontal cleaning, maintenance of dentures, and extractions.
• Major Services cover major restorative procedures such as crowns, onlays, veneers, bridgework and dentures.
• Orthodontic Services cover treatment used to straighten teeth and align the bite.

* This information is based on a standard plan. Manitoba Blue Cross has many non-standard plans. For specific information regarding your plan, refer to your benefit booklet or contact us.

Some plans allow reimbursement toward laser eye surgery in lieu of vision benefits (at the same benefit level and maximum). Visit Coverage in mybluecross® to view the details of your coverage or contact us.

Areas of personal counselling include marital and family counselling, addictions, emotional/behavioural concerns, occupational stress, adjustment, and financial counselling. For active mybluecross® members, visit Coverage to view your benefit details or contact the Employee Assistance Centre at 204.786.8880 (within Winnipeg), 1.800.590.5553 (toll-free), or 204.775.0586 (TTY) to find out how we can help.

If your provider is not listed:

• Verify the name of the service provider entered matches the service provider shown on your receipt
• Try limiting your search to only one or two fields
• Try entering a partial name, using only some letters of each word per field

If you still cannot find your service provider, select "Can't find my provider" and upload your claim instead.

If a person is a member of more than one plan, the adjudication priority is as follows:

• The employer plan where the member is an active full-time employee
• The employer plan where the member is an active part-time employee
• The employer plan where the member is a retiree
• The individual plan that a member has purchased on their own
• The plan where the person is covered as a dependent

Some plans require a medical prescription for services or products to be eligible for coverage. You may upload your medical prescription at any time.

Important: If you prefer to mail your medical prescription, you must include your certificate number.

‍

If your pharmacy is not listed:

• Verify the name of the pharmacy entered matches what is shown on your receipt (e.g.: Loblaws Pharmacy, Drugstore Pharmacy, etc.)
• Try limiting your search to only one or two fields
• Try entering a partial name, using only some letters of each word per field

If you still cannot find your pharmacy, select "Can't find your provider?" and upload your claim instead.

‍

To understand the reason for a partial payment, select "View this claim" to review claim details.

‍

If you do not submit receipts for an Audited claim, we will be unable to process that claim or any future online claims.

• If you have benefits through an employer or group, it is recommended that you contact your plan administrator to update your address.
• If you have purchased benefits through Manitoba Blue Cross or an agent, please contact us to update your address.

Coverage details vary by plan. Visit Coverage in mybluecross® to view the benefits you are covered for, benefit eligibility, dollar maximums and frequency limitations of your plan.

• An emergency ambulance is an ambulance that is dispatched from a 911 call to provide immediate care and transport to a person with an acute illness or injury.
• A non-emergency ambulance is an ambulance that provides non-emergency transport by stretcher to a person who is medically stable but requires transportation by ambulance as determined by a physician (a non-emergency ambulance provides a higher level of care than a medical transfer).
• A medical transfer is a private company (Medi-Van, etc.) that provides non-emergency transport by stretcher to a person who is medically stable.

* Manitoba Blue Cross will only pay non-emergency ambulance or medical transfer claims when a medical doctor specifies a patient is non-ambulatory and cannot be transported by any other means (e.g. regular vehicle).

Some plans require a medical referral for services or products to be eligible for coverage. Review the coverage summary under Coverage to determine whether your plan requires a medical referral for the products or services being claimed. You may upload your medical referral at any time.

• If you have purchased benefits through Manitoba Blue Cross or an agent, visit our travel plans for detailed information regarding travel and pre-existing conditions.
• If you have travel coverage through an employer or group, consult the coverage provisions within your benefit booklet or contact us.

Irrespective of pre-existing conditions, travel health benefits will never cover:

• any person travelling for the purpose of seeking medical or hospital services of any kind
• any person aware of requiring medical or hospital services
• any person travelling against medical advice.

‍

If you have an automatic claim payment plan, you do not need to request reimbursement. Manitoba Blue Cross will automatically pay balances remaining from previously submitted claims with the payment of a health or dental claim or when you reach the minimum payment threshold. If you have unpaid balances with another carrier, add an Explanation of Benefits (EOB) from that carrier to your claim on mybluecross®. Or, if you have unclaimed expenses, be sure to submit your claim on mybluecross.

If you have an on request claim payment plan, you will need to request reimbursement for unpaid balances:

The easiest time to do this is during initial claim submission to your health or dental plan. When completing your online or paper claim, check Yes where it says "Pay remainder from Health Spending Account."

To request reimbursement after a claim has been submitted to your health or dental plan, use the Request HSA payment feature within mybluecross®. This web-based application allows you to quickly request reimbursement for outstanding balances previously submitted to your health or dental plan.

If you have unpaid balances with another carrier, please submit an Explanation of Benefits (EOB) from that carrier on mybluecross® so we may add these outstanding expenses to your account. Or, if you have unclaimed expenses, be sure to submit your claim on mybluecross.

The Pharmacare drug benefits list is divided into three categories:

• An EDS I or Part 1 drug is a drug that is allowed by Manitoba Pharmacare under all prescribed circumstances.
• An EDS II or Part 2 drug is a drug that is allowed by Manitoba Pharmacare only when a doctor specifically indicates it is medically necessary and "Meets EDS."
• An EDS III or Part 3 drug is a drug that is not ordinarily prescribed or administered in Manitoba or a drug that is ordinarily administered only to hospital in-patients. In order to be covered for an EDS III drug, your doctor must receive approval from the Manitoba Drug Standards and Therapeutics Committee and a copy of the approval must be provided to Manitoba Blue Cross prior to prescription fill.

Contact Pharmacare for more information on these definitions. Or, confirm which category your drug belongs to by entering the Drug Identification Number (DIN) under the Manitoba Drug Formulary Lookup.

Ask your dental provider if they charge in accordance with the Dental Fee Schedule. Manitoba Blue Cross pays dental claims based on the Fee Guide set by the Manitoba Dental Association. Your employer group determines the fee guide year upon which your coverage is based. If your dentist charges more than the dental fee guide for a service, you will be required to cover the difference.

Coverage for safety glasses varies by plan. Visit Coverage in mybluecross® to view the details of your coverage or contact us.

To accommodate work schedules and concerns about confidentiality, we provide flexible scheduling. Appointments can be scheduled for days, evenings and weekends.

View account details under Manage account to confirm all eligible dependents were added during enrollment, or upon date of eligibility (e.g. marriage date, birth date).

*For over-age dependents to be considered eligible, we must receive confirmation of full-time enrollment.

‍

Manitoba Blue Cross is committed to protecting your benefits from fraud and abuse. One of the ways we do this is by auditing claims to confirm the accuracy of information provided. Visit Insurance Fraud and Abuse to learn more.

To resolve an audited claim, simply upload your receipt(s) and any related documents (e.g. prescription, claim statement from another carrier).

Important: If you prefer to mail your receipt(s), you must include the printed claim showing the Reference Number.

‍

To request payment from your Health Spending Account, select "Yes" where it says "Pay remainder from Health Spending Account."

• Visit Documents in mybluecross® to view your Explanation of Benefits statements online.
• Visit Claim history in mybluecross® to view the details of your claims.

Visit Payments history once your claim is processed to view the details of your claim payment.

To resolve an Audited claim, click the Audited claim to submit your receipt(s) and any related documents (e.g. prescription, claim statement from another carrier).

Changes to account information must be requested in writing by the member.

• If you have benefits through an employer or group, it is recommended that you contact your plan administrator to update your information.
• If you have purchased benefits through Manitoba Blue Cross or an agent, please submit your written request and appropriate supporting documents to Manitoba Blue Cross.

You may submit any claim as long as the expense:

• was incurred in Canada
• is payable to you
• is for you, or
• is for your spouse or dependents (provided they have already claimed through their primary plan, if applicable).

If a portion of your trip was outside of the province, the claim is processed under the Out of Province ambulance benefit and subject to any maximums that may exist under your plan.

Visit Coverage in mybluecross® to view the claim submission requirements for an individual benefit or contact us.

In the event of a medical emergency, contact International Travel Assistance as soon as possible and have your policy number ready. Failure to contact International Travel Assistance prior to receiving treatment may invalidate coverage.

In accordance with Canada Revenue Agency guidelines, proper receipts must support all amounts claimed as qualifying medical expenses. A receipt should indicate the purpose of the payment, the date of the payment, the patient for whom the payment was made and, if applicable, the medical practitioner, dentist, pharmacist, nurse, or optometrist who prescribed the purchase or gave the service. A cancelled cheque will not be accepted as a substitute for a receipt.

An EDS II or Part 2 drug is a drug that is allowed by Manitoba Pharmacare only when a doctor specifically indicates it is medically necessary and "Meets EDS."

One unit of scaling or polishing (as part of a dental cleaning) is equivalent to 15 minutes of time. Make a note of how long it takes to get your teeth cleaned (excluding the time it takes for your examination, X-rays and fluoride). Discuss any discrepancies about the number of units billed with your dental office and contact Manitoba Blue Cross if you have any unresolved issues.

The Manitoba Seniors Eyeglass Program provides financial assistance towards the purchase of eyeglasses for eligible Manitoba residents aged 65 years and over. Benefits are based on a fixed fee schedule and one pair of eyeglasses may be claimed every three years (more often if a medical practitioner or optometrist diagnoses a change in vision). There is a $50 deductible on eyeglass reimbursements. If two family members aged 65 and over require glasses between April 1 and March 31, only one $50 deductible is applied. For more information about this program, contact Manitoba Health.

If you are age 65 or older, you will need to submit your claim to Manitoba Health first. Then, submit the Manitoba Health statement to Manitoba Blue Cross to claim the balance.

Employee Assistance coverage is 100 per cent — there is no deductible or co-insurance.

Changes to account information must be requested in writing from the member.

• If you have benefits through an employer or group, it is recommended that you contact your plan administrator to update your account.
• If you have purchased benefits through Manitoba Blue Cross or an agent, please submit your written request to Manitoba Blue Cross.

*Provided the change is submitted within 30 days, coverage will be effective as of date of eligibility (e.g. marriage date, birth date). If the change is submitted outside this time frame, coverage will become effective after three full months in accordance with the enrollment rules of your plan.

‍

If your claim submission is successful, the final screen will confirm payment details. You will receive an email notification when payment is processed. Your bank account should reflect payment within 2-3 business days.

Changes to account information must be requested in writing by the member.

• If you have benefits through an employer or group, contact your plan administrator to update your information.
• If you have purchased benefits through Manitoba Blue Cross or an agent, please submit your written request to Manitoba Blue Cross.

Provided the change is submitted within 30 days, coverage will be effective upon date of eligibility (e.g. marriage date, birth date). If the change is submitted outside this time frame, coverage will become effective after three full months in accordance with the enrollment rules of your plan.

The claim limitation period indicates the deadline to submit health or dental claims for the prior benefit year and can vary based on your plan. Refer to the Claim Submission Deadline in Coverage.

*The health spending benefit has a separate limitation period.

If you are required to pay for the services, upload your itemized receipt via mybluecross® along with a completed Ambulance/Medical Transfer claim form for reimbursement.

Note: Non-emergency ambulance and medical transfer claims must include the name of the referring physician.

Benefit eligibility, dollar maximums, and frequency limitations vary by plan. Visit Coverage to view the benefits covered by your plan.

International Travel Assistance provides Manitoba Blue Cross travellers with access to multilingual coordinators world-wide, 24 hours a day. In the event of a medical emergency, it is essential you contact International Travel Assistance as soon as possible. They will help you locate the nearest medical care, help coordinate coverage verification, and even arrange emergency evacuation (when deemed medically necessary).

Minimum payment refers to the lowest dollar amount that can be reimbursed at a time. This threshold is set by the employer.

• If the amount requested is less than the minimum payment, payment will be held and expenses will continue to accumulate until this threshold is met.
• If the threshold is never met, Manitoba Blue Cross will pay all pending expenses at the end of the group's claim limitation period following your benefit year.

Visit Coverage in mybluecross® to view your Health Spending Account (HSA) plan information including minimum payment amount, claim limitation period, and benefit year.

*The minimum payment threshold applies to any outstanding HSA claim that has not been paid. If an HSA balance is requested at time of your initial health or dental claim under the same certificate and claim is payable to you, the minimum payment threshold will be bypassed and the HSA payment will be included with this payment. In addition to this, all pending HSA payments accumulating in the account will attach to this request and be included with the HSA payment.

*Your Health Spending Account (HSA) is considered last payer (after government, spousal, and student plans, etc.). If you have coverage with another carrier, you must submit an Explanation of Benefits (EOB) from that carrier before outstanding expenses can be processed through your HSA.

An EDS III or Part 3 drug is a drug that is only allowed by Manitoba Pharmacare under special circumstances. In order to be eligible, your doctor must receive approval from the Manitoba Drug Standards and Therapeutics Committee and a copy of the approval must be provided to Manitoba Blue Cross prior to prescription fill. EDS III drugs usually fall into one of the following categories:

• The drug is ordinarily administered only to hospital in-patients but is being administered outside of a hospital because of unusual circumstances.
• The drug is not ordinarily prescribed or administered in Manitoba, but is being prescribed because it is required in the diagnosis or treatment of an illness, disability, or condition rarely found in Manitoba.
• Evidence, including therapeutic and economic evidence, is provided to the Health Minister in accordance with established criteria and supports a specific treatment regime which includes use of the drug.

No, a pre-authorization is not required for claim approval; however, to avoid unexpected costs associated with a product or service, ask your provider to send in a detailed description of the service or product with the estimated charges. Manitoba Blue Cross will then provide pre-authorization based on benefit eligibility, frequency limitations, and maximums of your plan.

• For online purchases, submit a Vision claim via mybluecross®, and include the order form and paid receipt. These are typically provided to you by email, or on the package the order came in.
• For purchases outside of Canada, provide the paid receipt and make sure that it indicates the currency of the receipt.

* All receipts require the name of the patient, the dollar amount paid, and the detailed item/service provided.

Our professional intake is available via phone 24 hours a day, 7 days a week. Contact the Employee Assistance Centre at 204.786.8880 (within Winnipeg), 1.800.590.5553 (toll-free), or 204.775.0586 (TTY). You can also reach us online.

* Calls after 7:00 p.m. will be picked up by an answering service. In the event of a crisis, you will be promptly connected with a qualified and experienced professional.

Ensure all certificates have been added to your online account. Visit Add certificates in mybluecross® to add a missing certificate to your account.

If you are covered under our National plan, your certificate is not eligible for claim submission through this application.

Visit Update Direct Deposit in Manage Account to add or edit your bank account information.

The deadline to submit claims once coverage has been terminated is determined by your employer. Refer to Coverage.

A private room is a room with one bed in a public general hospital. A semi-private room has no more than two beds. Upon discharge, ask to see a copy of the accommodation charges to verify that they are charging you for exactly what you received.

You should only be charged if you have requested the room and signed for such accommodation. You should never be charged for hospital ward accommodation (three or more beds in a room), Intensive Care Unit (ICU) beds, Critical Care Unit (CCU) beds, or Outpatient beds (used for day surgery). Additionally, if your doctor requests that you have a private or semi-private room for medical reasons, neither you nor Manitoba Blue Cross should be billed for the room charges.

* Manitoba Blue Cross will not cover the cost of the room for panelled patients or for hospitalization due to cosmetic reasons.

Bills will be paid directly to the hospital whenever possible. In the case of a visit to a doctor's office or clinic (when coverage cannot immediately be confirmed or a facility does not bill directly), the client would pay upfront and claim for reimbursement. In the case of hospital admission (requiring a guarantee of payment, surgeries, or repatriations), most costs can be billed direct. If you are in doubt, check with the facility and be sure to engage International Travel Assistance as they will work with the hospital to coordinate this.

Automatic and requested Health Spending Account (HSA) payments may be released with payment of a health or dental claim or when the minimum payment threshold is met:

• When an HSA balance is requested with a health or dental claim that is payable to the member, HSA payment is included with claim payment (minimum payment threshold is bypassed).
• When an HSA balance is requested on its own, payment is released once the minimum payment threshold is met. The minimum payment threshold is set by your employer. If the amount requested is less than the minimum payment, payment is held and expenses will continue to accumulate until this threshold is met. If the threshold is never met, Manitoba Blue Cross will pay all pending expenses at the end of your group's claim limitation period following your benefit year.

Visit Coverage in mybluecross® to view your Health Spending Account (HSA) plan information including minimum payment amount, claim limitation period, and benefit year.

* When a member requests HSA reimbursement alongside a health or dental claim, all pending HSA payments will be released, including pending HSA balances accumulating in the account.

Many drug plans follow the Manitoba Pharmacare Drug Formulary, which means prescription drugs must be eligible under Pharmacare to be covered under these plans.

Some drugs are only allowed by Pharmacare under special circumstances (Exception Drug Status). To obtain approval, your doctor must apply to the Exception Drug Status office on your behalf. You will be notified in writing of their decision.

Visit Coverage in mybluecross® to verify if the lifetime orthodontic maximum is combined with the annual maximum for all dental work or contact us. If it is combined with the annual maximum, this means that all dental work, including orthodontic work, is limited to the annual maximum. In the next benefit year, the annual maximum will reset, but the lifetime orthodontic maximum will not.

Your coverage may be subject to a usual and customary fee for an eye exam or a per visit maximum. If this is the case, your claim is cut back to the allowable fee and then processed at the per cent level of your coverage.

Visit Coverage in mybluecross® to view the details of your coverage or contact us.

Information that could identify any individuals seeking Employee Assistance services will not be provided to an employer. Only general statistical information regarding the number of individuals utilizing the Employee Assistance Program is sent to employers.

Yes. You may submit a claim for a spouse or dependent with coverage under another plan through mybluecross® as long as they have submitted the claim under their primary plan first.

Direct deposit is safe and secure. It eliminates the risk of lost or stolen cheques and gives you quick access to your money. Unlike cheques, direct deposit payments are transferred directly into your chequing or savings account, and not subject to mail delays. No need to worry about when your cheque will arrive or when you can get to the bank — your money is there when you need it.

Visit Update Direct Deposit in the account dropdown to sign up for direct deposit.

Yes. Coordinating benefits can provide coverage up to 100 per cent of the expense. To coordinate, first claim under the plan for which you are the primary member, then claim any amount not reimbursed under your spouse's plan.To claim under the second plan, submit your statement from the first carrier showing payment or denial of your claim. The statement must include the service date, service provider name, type of service provided, and patient name. If this information is not included on the statement, include your receipts.* When making claims for eligible dependents, you will need to first claim under the plan of the parent with the earlier birth month in the calendar year.

Your hospital bill will indicate the type of room for which you were billed. If your plan has semi-private coverage, and you were billed for a private room, you will be responsible for the difference. If you stayed in a semi-private room (no more than two beds) but were billed for a private room, contact the hospital you were admitted to for more information.

Visit Coverage with mybluecross to verify what your plan allows or contact us.

* If you are a resident of another province, your plan may only allow the semi-private room charge at Manitoba rates.

This information can be found on the Manitoba Government website.

If the balance remaining is less than the minimum payment, payment will be held and expenses will continue to accumulate until this threshold is met. Minimum payment refers to the lowest dollar amount that can be reimbursed at a time. This threshold is set by your employer. Visit Coverage in mybluecross® to view your Health Spending Account (HSA) plan information including minimum payment amount, claim limitation period, and benefit year.