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No more deductible for PSHCP members

Canadian Armed Forces members no longer have to pay a deductible as of January 1, 2015 to cover eligible dependants, under the Public Service Health Care Plan (PSHCP). Meaning any medical expense, including prescriptions incurred on or after the first of the year will not be subject to a deductible.

The PSHCP is sponsored by the Government of Canada, and its members include public servants and other employees of the federal public administration, parliamentarians, federal judges, and pensioners receiving an ongoing pension benefit based on service in one of these capacities.

“This elimination of the deductible is a fair and reasonable agreement, resulting in benefits for employees, retirees, and the Canadian taxpayer,” said Minister Tony Clement, president of the Treasury Board of Canada. “Our work to modernize the public service is part of our commitment to strong financial management and spending restraint.”

With the elimination of the deductible claimants will only be responsible for paying the 20 per cent co-payment and any costs exceeding the reasonable and customary charges or the maximum eligible expenses stated for each benefit through Sun Life.

If in 2015 members submit a claim for expenses incurred in the previous year and have not yet paid the 2014 deductible, the deductible will be applied to that claim. In order to be eligible under the PSHCP,  claims for expenses incurred in 2014 must have been received by Sun Life no later than December 31, 2015.

“A deductible is basically the amount a beneficiary contributes out-of-pocket before health plan benefits commence. Deductibles have been a part of the insurance contract for years and represent a sharing of the cost between the insurance company and the policyholder,” explained Mark Freeman, certified financial planner, D.S. Curry Insurance.
Prior to 2015 the annual deductible of $60 for members with single coverage and $100 for members with family coverage. The deductible was applied to the first expenses claimed for the calendar year.

According to www.pshcp.ca, the Public Service Health Care Plan is one of the largest private health care plans in Canada, providing benefits to over 600,000 Plan members and their dependants.

The purpose of the PSHCP is to reimburse plan participants for the reasonable and customary costs they have incurred for eligible services and products as described in the Plan Document. Plan members receive their reimbursement after they have taken advantage of the benefits provided by their provincial or territorial health insurance plan.

The PSHCP also provides coverage to members who reside outside of Canada for basic health care services equivalent, as much as possible, to the services covered by provincial and territorial health care plans.

For further information on the Public Service Health Care Plan please visit their website.

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Vicki L Morrison

Thanks to her husband's military career Vicki reinvented herself as a writer so she could work from home, while taking care of their three kids. A former MFRC executive director Vicki is a passionate advocate for military families who loves telling their stories.

6 Comments

  1. Nice to see the deductible gone but wait for the other shoe to drop. Mr. Clements is also negotiating to change your share that you pay for having Sun Life from 1/3rd to 50%. Thus our payments to Sun Life will double.

  2. I am pretty certain that the insurance company is not going to loose money. If my mth payments are gong from 20% to 50% I’m guessing annually that will be more then my annually deductible. Time will tell.
    Thanks for the info.

  3. Good news, I wish they would fix the issues with glasses. still have to pay and submit unlike everything else being billed directly and we only have to pay the 20%.

  4. “effective April 1, 2015, the cost sharing ratio for retired members will change from the current 25:75 (retired member: employer) to a 50:50 model over a four-year phase-in period. Starting April 1, 2015, and each April thereafter, the contributions paid on a monthly basis by retired members for their Public Service Health Care Plan (PSHCP) Supplementary coverage will gradually shift, as follows, until an equal cost sharing arrangement is achieved:”

    Its not 25:75, its 36:64 (as of 2013)

    Level 3 is going up 8.85 / mo and level 2 up 23.27 / mo and level 1 up 31.55 / mo for the retired (based on the 2013 rates). So I’ll pay the deductible for 2 married, 1 single member plus myself. And they make an extra 18.60 a year to boot.

    The last time I looked, Reg Mem paid $4.00 for level 3, I pay $42.76 for level 1, now it going up to 74.31. Its bad enough a retired service member had to pay the working classes way, now we have to pay for the deductible as well. I might as well pay another $8.00 and jump to level 2.

    I should submit a claim against the VA Office for sore *&$% for having being kicked so many times. Oops they gave all their money back to the Tres Board. Money that could have been used to help offset the high cost of health insurance.

    1. I am just registering for the PSHCP based on the fact it is cheaper than my present plan with Manulife. I pay 88.17 for level 111. Based on what you say, that is going up to 97.02. Is that correct? What about Dental?

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