How can we help you?

We need to approve certain drugs for coverage before you get your prescription filled. To apply for prior authorization, print and complete the Drug Prior Authorization form.

Firstly, we would like to state that every group benefits plan is unique to each employer and insurer. The information we provide here is therefore general in nature, and subject to the terms and conditions of each individual plan.

Spouses may have separate benefits plans through their separate employers. If they are set up on their plans as having coordination of benefits with each other, they can make group benefits claims to their own and each other’s plans, provided they are cited as spouses of the other on their account. Manulife has published a page on coordination of benefits. This resource explains how to make a claim for yourself, how your spouse can make a claim, and how to make a claim for a child.

In practice, when one person needs to make a claim, they will submit the claim to their employer’s group benefits provider first. Then, once that claim’s completed, if there are any outstanding amounts, they can submit that amount to their spouse’s employer’s plan. In this way, a plan member may be reimbursed up to 100% of the cost for the service or item. 

Once a couple becomes registered on each other’s group benefits plans, claim payments involving both plans may start to happen automatically. For example, for regular dental appointments, once the dentist has your particulars, they may submit claims immediately to your provider, and then to your spouse’s provider, without you needing to take any independent action.

Download Manulife Mobile today :

For easier group benefits plan management, anytime, anywhere, consider downloading the Manulife Mobile app. Available through the Apple App Store or the Google Play ™ store for Android™, it’s the only app you need to manage your group benefits plan. Through the app you can submit your claims, review statements, check benefits balances, find health care providers near you, and more.

Apple and App Store are trademarks of Apple Inc., registered in the U.S. and other countries and regions.

Firstly, we would like to state that every group benefits plan is unique to each employer and insurer. The information we provide here is therefore general in nature, and subject to the terms and conditions of each individual plan.

‘Reasonable and customary’ (R + C) describes the amount a group benefits provider (i.e. insurer) would expect a health, dental or extended health care provider to charge one of their members for a service. The insurance company establishes those amounts – considered a ‘realistic and expected’ charge for a service – as a starting point for settling claims.

Based on what that R + C amount is, the insurance provider then determines how much of what a member is claiming will be covered, according to that member’s plan.

Expense amounts are subject to R + C limitations because fees across different geographical locations vary. In addition, some health care providers charge more than others for the same service, due to individual fee schedules

Insurance companies adjudicate claims based on what they determine as the standard amount charged for a particular service, according to:

• the prevailing rate for that service provincially
• fee guides for a specific profession under its regulatory body (e.g., dental fee guide, medical association guide)

Download Manulife Mobile today:

For easier group benefits plan management, anytime, anywhere, consider downloading the Manulife Mobile app. Available through the Apple App Store or the Google Play™ store for Android™, it’s the only app you need to manage your group benefits plan. Through the app you can submit your claims, review statements, check benefits balances, find health care providers near you, and more.

Apple and App Store are trademarks of Apple Inc., registered in the U.S. and other countries and regions.

Provincial or territorial government health insurance plans may pay only a small portion of medical expenses incurred abroad. They might not pay for ambulance services, prescription drugs, fees charged by private hospitals or facilities or emergency dental treatment. In addition, many hospitals abroad may require immediate cash payment or proof of insurance, which our assistance centre would help coordinate.

Yes, most plans may be purchased up to and including the date of departure. However, our Cancel For Any Reason Rider, which is an add-on available when purchasing a plan with Trip Cancellation and Interruption coverage, must be purchased within 7 days of booking your trip. 

For Trip Cancellation and Interruption protection, we recommend maximizing your length of coverage and purchasing as soon as possible, in the event you need to cancel your trip. Same recommendation applies when purchasing our Government Health Travel Advisory Rider. This is so you are protected for emergency medical expenses related to a specific virus or disease if the government issues a “Avoid non-essential travel” advisory before your departure date. This add-on is available when purchasing a plan with Emergency Medical coverage.