Making a Claim
Dental Claims
Many dentists will bill Medavie Blue Cross directly and send you a bill for any remaining balance. However, in those instances where you do need to submit a claim, your dentist should complete the Medavie Blue Cross Standard Dental Claim Form.
Send your claim form to Medavie Blue Cross along with your receipts within 12 months. Write your name, policy number and group identification number on the receipts. Be sure that your Benefits Administrator has your current address.
Send all claim forms and original receipts to:
Medavie Blue Cross
PO Box 2200
Halifax, Nova Scotia
B3J 3C6
For your convenience, you can also call Medavie Blue Cross’ customer enquiry centre with questions about your dental claims. Just call 1-800-667-4511 and give them your plan and identification number which is shown on your Medavie Blue Cross Card.
Health and prescription drug claims
You typically do not have to submit claims for drugs. You will be given a card to pay your "co-pay" amount at the pharmacy. The pharmacy submits for the remainder of the claim.
For some health supplies and services, you will need to submit a claim form along with your original paid-in-full receipts to Medavie Blue Cross. Write your name, policy number and your group identification number on the receipts. Be sure your Benefits Administrator has your current address.
You must submit all claims to Medavie Blue Cross within 24 months of the date the supply and/or service was provided.
Claim forms are necessary to be reimbursed for these services:
- Vision care
- Private duty nursing or VON services
- Treatment for an accidental dental injury
In most cases, your healthcare provider will be able to provide you with the applicable Medavie Blue Cross claim form.
Send your claim form and original receipts to:
Medavie Blue Cross
PO Box 2200
Halifax, Nova Scotia
B3J 3C6
For your convenience, you can also call Medavie Blue Cross' customer enquiry centre with questions about your health or prescription drug claims. Just call 1-800-667-4511 and give them your plan and identification number which is shown on your Medavie Blue Cross Card.
Canadian insurance companies follow a process called Coordination of Benefits (CoB) when both partners have family coverage. CoB ensures you receive the maximum benefit available from your health and dental policies. In fact, two policies can be combined to give you up to 100% reimbursement of eligible claims.
Here's how Coordination of Benefits works:
Submit your medical, dental, and prescription drug expenses first to your Health Association benefits program (either by using your Medavie Blue Cross card or by submitting your paper claim form). You can then submit any unpaid portion of your claim to your spouse’s plan.
Submit your spouse’s medical, dental, and prescription drug expenses first to your spouse’s benefits program. You can then submit any unpaid portion of your spouse’s claim to your Health Association benefits program.
If your dependent children are covered under your and your spouse’s benefit programs, you must submit their medical, dental and prescription drug expenses first to the benefit program of the parent whose birth date falls earliest in the calendar year (the month, then day). Any remaining balance can then be reimbursed from the other plan. When parents are separated or divorced, the custodial parent claims under his or her plan first.
When you submit a claim for an unpaid balance from another insurance company, Medavie Blue Cross will need a copy of the receipt and a copy of the statement showing the portion of the claim paid by the other company. Although you have 12 months to claim any remaining balances, your receipts should be submitted as soon as possible.
If you need help determining the order in which your claims should be submitted, call Medavie Blue Cross toll-free at: 1-800-667-4511.
Health Spending Account
How to make a claim:
A) If you are covered by the Acadia Group Health plan...
1. Complete a Health Spending Account Claim Form (pdf format)
2. Attach original receipts
3. Attach original claim form completed by your provider (i.e. dentist, optometrist, etc.)
B) If you have Health Coverage insurance elsewhere and have only the Health Spending Account with Acadia...
1. Take copies of your claim form and receipts
2. Submit claim form and receipts to your insurance carrier.
3. Your insurance carrier will provide you with an "Explanation of Benefits" statement which you must attach to the HSA claim form
4. Attach copies of your provider's claim form and receipts which you originally sent to your insurance carrier.
NOTE: All claims must be submitted directly to Medavie Blue Cross
The amount of the receipt paid will be deducted from the balance in your HSA. The HSA can be used for items and services not covered, or not covered in full, under your current health plan, including dental charges.