Skip to main content

Your web browser is out-of-date. For the best experience, please update to a modern browser like Chrome, Edge, Safari or Mozilla Firefox.

Resumption of service for claims from outside of Canada.

MSH International has resumed services, including the MSH PSHCP Member Portal and claims processing. Sign in to your MSH PSHCP Member Portal account to submit claims online. Learn more.

Home

Effective July 1, 2023, prescription drugs under the Public Service Health Care Plan (PSHCP) are subject to mandatory generic substitution. This means that if you are taking a brand name drug, the PSHCP will only provide coverage at 80% of the lowest-cost generic drug equivalent, when a generic drug equivalent is available. Generic drugs are approved by Health Canada and are pharmaceutically equivalent to the brand name drug as they contain identical medicinal ingredients.If you were taking a brand name drug before July 1, 2023, the PSHCP will provide a legacy period ending December 31, 2023. During the legacy period, prescribed brand name drugs will still be reimbursed at 80% of their cost for those with existing prescriptions.

You can continue taking a brand name drug, however, you will need to pay the difference between 80% of the lowest-cost generic and the brand name drug out-of-pocket.

Exceptions will be granted based on medical necessity. To request an exception for your brand name drug, ask your doctor or nurse practitioner to complete a PSHCP Request for Brand name drug coverage form, available on the Your forms page on the PSHCP Member Services website. 

Any fees that your doctor or nurse practitioner may charge for providing this information will not be reimbursed. 

Submit the completed form to Canada Life at the mailing address, email address or fax number on the form. Please allow us 7 to 10 business days to complete a review of the medical information provided. Canada Life will send a letter outlining the decision.

You can decide to take the brand name drug under the Public Service Health Care Plan (PSHCP) even if you are not approved for an exception, but you will be responsible for the difference in cost between the brand name drug and its lowest-cost generic drug equivalent. This means you will have a higher out-of-pocket expense.

For example, a brand name drug costs $100 and the generic drug equivalent costs $80. If you purchase the generic drug, the PSHCP will cover 80% of the $80 charge, which is $64. Your out-of-pocket amount is $16. If you choose to purchase the brand name drug, the PSHCP will still cover $64, but your out-of-pocket amount will be $36.

If your prescribed brand name drug does not have a generic drug equivalent available, then the Public Service Health Care Plan (PSHCP) will continue to reimburse you for the brand name drug at 80% of its cost. No action is required from you or your doctor or nurse practitioner.

You can find more details about the improvements and changes to the Public Service Health Care Plan (PSHCP) here:

Please check with your pharmacy if there are other generics available.

Pharmacies are responsible for checking all available suppliers for stock or obtaining another generic interchangeable product if one is available. 

If all generic versions of a brand name drug are not available due to shortage or backorder, the Public Service Health Care Plan (PSHCP) will reimburse the brand name drug at 80%. This occurs automatically during a shortage, so you do not need to make a special request to Canada Life.  

Once a generic drug is available, reimbursement will be limited to the cost of the generic version.

We continue to receive higher than expected call volumes.

Here are a few examples of how we are working to make this right:

  •  We have increased the number of PSHCP Member Contact Centre agents to serve you better.
  • Until we meet our service levels, every week we are training and adding new PSHCP Member Contact Centre agents who are receiving required security clearance.
    • Our goal is to be able to achieve an average wait time of between 5 to 10 minutes by December 
  • We have extended our hours of operations to temporarily open 7 days a week from November 1 through December 17, 2023. Monday to Friday from 8 am to 5 pm, your local time or Saturday and Sunday between 9 am to 5 pm ET.
  • Note: Towards the end of each business day, we may, if necessary, not let further calls in to avoid disappointment of a wait time exceeding our business hours of operation. Rest assured, you will be advised on the call if this becomes the case.

Before you call, we invite you to check back again here, on the PSHCP Member Services website, for answers to your questions, as updates are being made regularly.   

No – please do not resubmit your claim.

If a claim is submitted more than once, it creates an extra step on our side to match and cancel out one of the claims, slowing down the process and reimbursements.

 Most claims submitted electronically are automatically processed within 2 business days. Claims that require manual review by a claim’s examiner, such as those submitted by paper, may take longer. We apologize for the inconvenience this may cause. 

Submitted claims can be viewed through your PSHCP Member Services account on My Canada Life at Work. Your account provides status updates for all claims. The only exception is if you have visited a provider that needs to have their credentials reviewed. Please do not submit claims for the same service more than once.

If you believe the information you have received about your claim through your Explanation of Benefits statement from Canada Life is inaccurate, please refer to the Plan Directive as a first point of reference. There have been a number of improvements and changes implemented effective July 1, 2023, following negotiations with the PSHCP Partners Committee, comprised of Employer, Bargaining Agents and pensioner representatives, that may mean some claims may be paid differently than before. The following links provide more information:

Sometimes Canada Life will require additional information from you to process your claim according to the terms of the PSHCP.  To avoid further delays in claim adjudication, please check to ensure all information required has been included in your claim submission and is accurate. If sending in a paper claim form, please ensure that you have signed this ahead of mailing. We will contact you when this is required and will reassess your claim once all additional information is provided. 

Where Canada Life is both the primary insurer under the PSHCP, and Canada Life is also the secondary insurer (spouse/common-law partner is also a PSHCP participant OR the spouse/common-law partner’s employer has Canada Life coverage) only one claim needs to be submitted under the primary plan. If the coordination of benefits information is provided with the claim, the secondary plan adjudication will happen automatically without the need for another submission.  


If Canada Life is not the secondary plan provider, submit your primary plan claim to Canada Life, and use our Explanation of Benefits Statement to submit your secondary claim to your secondary provider.


Finally, if the PSHCP is the secondary plan to your spouse/common-law partner, and their coverage is with another carrier, please submit to the spouse/common-law partner’s plan first and then to the PSHCP.

To submit an electronic claim under the Public Service Health Care Plan (PSHCP) to Canada Life, you must first register for a PSHCP Member Services account through My Canada Life at WorkTM

Submitting a claim online is the easiest and fastest way to get a claim processed and reimbursed. To make a claim, please sign in to your account through My Canada Life at WorkTM and follow these instructions:

  1.  Sign in through My Canada Life at WorkTM
  2. Go to Submit a claim.
  3. Choose the appropriate claim type and follow the steps to complete the transaction.

Other web features:

  • Coordination of benefits: You may submit coordination of benefit claims between 2 Canada Life plans or submit the remaining balance of a claim already processed by another benefit plan.
  • Positive enrolment: You may complete or update your positive enrolment information, including direct deposit information.
  • Drug look-up: You can use this search feature to look up drug information by entering a drug name, or drug identification number (DIN). This includes whether or not a drug requires prior authorization. 
  • File submission: You must submit copies of receipts for all medical expenses. You can do so by submitting photos or electronic files. You can also provide electronically any supporting documentation requested by Canada Life, such as physician referrals and medical questionnaires.

Where possible, Canada Life adopted the Reasonable and Customary Charges you were previously accustomed to.

However, there may be some instances where the Reasonable and Customary Charges could be different as these are aligned with industry standards. Just as Reasonable and Customary Charges will be assessed from time to time by Canada Life and adjusted as needed, some changes should be expected from the prior administrator.

In some cases, Canada Life has higher values. If you come across a Reasonable and Customary Charge that looks lower than what you were charged, please call the PSHCP Member Contact Centre at 1-855-415-4414, Monday to Friday from 8 am to 5 pm, your local time, Saturday to Sunday between 9 am to 5pm ET., with your expense details.

Canada Life has moved aggressively to hire and recruit new agents for the PSHCP Member Contact Centre. 

The process of onboarding and training new call centre agents is lengthy for three reasons:

  1.  We are handling sensitive health and medical information, and agents must obtain security clearances as required by the Government of Canada.
  2. We are committed to providing rigorous training for insurance benefits, which is more complicated than most call centre agent roles. 
  3. There is a tight labour market pool for call centre agents.

Wherever possible, we have streamlined our processes to get more agents on the phones, faster. 

The PSHCP Partners Committee, comprised of Employer, Bargaining Agents and pensioner representatives negotiated benefit improvements and changes to the PSHCP. These came into effect July 1, 2023

The following links provide more information:

Changes to the PSHCP are not decided by Canada Life and are unrelated to the change in plan administrator. Canada Life administers your coverage based on the Plan Directive.

If your claim says pending, then it is in progress.  If your claim is within those handling times, we ask that you check back later to see if the status has changed to “paid”. 

If additional information is required for a manual claims assessment, we will contact you directly and reassess your claim once that information is received.

We apologize for any challenges you may have experienced in accessing your PSHCP Member Services account through the My Canada Life at Work™.

If you do experience an error message, please refresh your browser, and attempt to log in again. Most errors are solved by exiting the session, clearing all caches in the browser and trying again.  

If the same message appears, please take a screen shot for future reference and call the PSHCP Member Contact Centre at 1-855-415-4414, Monday to Friday from 8 am to 5 pm, your local time, Saturday to Sunday between 9 am to 5 pm ET until December 17, 2023.  

If a prescription drug, product or medical service that was covered for you previously is declined, first check the Plan Directive to confirm if there have been plan coverage changes. 

If your claim is for an urgent, life-sustaining item, beginning November 6, 2023, we are introducing an urgent escalation process to have your previously filed claim assessed on a prioritized basis. 

The appeals process is available to all PSHCP members who do not agree with a decision regarding their claim, benefit entitlement or coverage (for example, level of coverage, waiting period, refund of contributions) and wish to have their file reviewed. However, prior to submitting an appeal, you should first attempt to resolve the issue with us if your appeal is claim-related, or with your departmental compensation office or Pension Centre if your appeal is coverage-related.

If you’re still not satisfied with the decision from Canada Life after it has been reviewed, you can submit an appeal to the Federal PSHCP Administration Authority.

Members wishing to submit an appeal to the Federal PSHCP Administration Authority may send a written submission to:


Federal PSHCP Administration Authority
PO Box 2245 Station “D”
Ottawa ON
K1P 5W4

For more information on the appeals process, visit:  https://pshcp.ca/appeals/how-to-submit-an-appeal/

We recognize that some claims require immediate attention. That’s why as of November 6, 2023, we’re expanding our processes to ensure urgent claims are quickly identified and prioritized by our teams.

Please use this process if your claim is for urgent, life-sustaining prescription drugs, services or treatments including, but not limited to:

  • Mechanical ventilation
  • Renal dialysis or Insulin 
  • Cancer drugs
  • Artificial nutrition and hydration supplies like feeding tubes

This process is only for claims already submitted. 

If your claim does not fall into these urgent categories, it will not be expedited. This is to ensure we can triage the most urgent claims on a priority basis.  

The Day Supply Limit for prescription drugs under the Public Service Health Care Plan (PSHCP) is 100 days for both acute and maintenance drugs. 

If you are travelling for an extended period, you can request an increase to your Day Supply Limit for up to 200 days from your pharmacist. You do not need to call Canada Life for approval. 

Two weeks before you travel, ask your pharmacist to submit your request for additional day supply. Your pharmacist will need your PSHCP benefit card to submit your request and the applicable dates. 

If your pharmacy is unable to process the request, please call the PSHCP Member Contact Centre at 1-855-415-4414, Monday to Friday from 8 am to 5 pm, your local time, Saturday to Sunday between 9 am to 5 pm ET until December 17, 2023.  

The Government of Canada, along with the PSHCP Partners Committee, comprised of bargaining agents, the employer and pensioner representatives have successfully negotiated benefit improvements and changes to the PSHCP that came into effect July 1, 2023. Information about the improvements and changes can be found at canada.ca/pension-benefitsOpens a new website in a new window

The improvements and changes to the PSHCP are unrelated to the change in plan administrator. Canada Life will administer your coverage based on the PSHCP Directive, which is available on the National Joint Council website at njc-cnm.gc.caOpens a new website in a new window.

If you’ve completed positive enrolment for the Public Service Health Care Plan (PSHCP), you’re set up in our system to have your claims reimbursed. 

Your pharmacist needs your certificate and plan number (the information on your PSHCP benefit card) to accurately submit claims to Canada Life. 

Your certificate number is the same as it was with Sun Life and can be found on an old explanation of benefits or on your old benefit card. However, your plan number changed based on your month of birth:

  • (52111) January, February, March
  • (52112) April, May, June
  • (52113) July, August, September
  • (52114) October, November, December
  • (52115) the plan number for eligible surviving dependants (spouse or eligible children) 

Please note that these numbers are the same for you and your eligible dependants. 

Additionally, please ask them to confirm if they’ve correctly entered the following information:

  • Carrier number 12
  • Your plan number (based on your birth month)
  • Certificate number (the same as it was with Sun Life)
  • Card issue number 01

Effective July 1, 2023, prescription drugs under the Public Service Health Care Plan (PSHCP) are subject to mandatory generic substitution. This means that the PSHCP provides coverage for eligible prescription drugs at 80% of the lowest-cost generic drug when a generic is available. Generic drugs are approved by Health Canada and are pharmaceutically equivalent to the brand name drug as they contain the identical medicinal ingredients. 

If you were taking a brand name drug prior to July 1, 2023, the PSHCP will provide a legacy period ending December 31, 2023. During the legacy period, prescribed brand name drugs will still be reimbursed at 80% of their cost for those with existing prescriptions. Before this period ends, discuss the 3 options below with your health care provider. 

If you have a prescription for a brand name drug and a generic version is available, there are 3 options: 

  1. Purchase the generic drug. The PSHCP will reimburse 80% of the eligible cost.
  2. Purchase the brand name drug. The PSHCP will reimburse 80% of the cost of the generic drug and you’ll have a higher out-of-pocket cost (this is known as the co-payment amount).For example, a brand name drug costs $100 and the generic costs $80. If you purchase the generic, the PSHCP will cover 80% of the $80 charge, which is $64. Your out-of-pocket amount is $16. If you choose to purchase the brand name, the PSHCP will still cover $64, but your out-of-pocket amount will be $36. 
  3. If there’s a medical reason why you cannot take the generic drug, have your doctor complete a PSHCP – "Request for brand name drug coverage" form, available on the Forms page on the PSHCP Member Services website. Any fees your physician may charge for providing this information will not be reimbursed. Submit the completed form to Canada Life at the mailing address, email address or fax number on the form .Please allow 7 to 10 business days to complete a review of the medical information provided. Canada Life will send a letter outlining the decision.

The pharmacy’s computer system believes that you or your dependant under the Public Service Health Care Plan (PSHCP) has “Other insurance” (OI). 

OI can be other private insurance or provincial/territorial health insurance. 

There are different intervention codes for private insurance and provincial/territorial health insurance. If your pharmacy has entered the wrong intervention code, a “DIN Covered by Other” message might appear. 

This message will also appear if your pharmacy has entered an intervention code when OI does not exist. 

Confirm with your pharmacy that they have entered the correct intervention code. If you or your dependants do not have any OI, you can easily update this information on your PSHCP Member Services accountOpens a new website in a new window. Simply go to the 'Your Profile' section and select 'Dependants and other Coverage'. Then click on 'Your other Coverage' and make the necessary updates. 

Any updates made to your PSHCP Member Services account may take 1 to 2 days to take effect.

This error will show up in 2 cases:

  • The pharmacy has entered a date of birth that does not match what’s in your positive enrolment information in our system.
  • The date of birth provided by the pharmacy is correct, but they mistakenly entered the wrong relationship code. For example, the medication is meant for your dependant, but the pharmacist entered the relationship code 01, which is intended for you, the plan member.

Please inform the pharmacy about the patient's relationship with you as the plan member.

To check the list of dependants covered under your Public Service Health Care Plan (PSHCP), navigate to 'Your Profile' and select 'Dependants and other Coverage'. 

If you cannot add a dependant or the option is not available for you, please ensure that you have changed your coverage level from ‘Single’ to ‘Family’. If you need to change your coverage from Single to Family, or vice versa:

  • Active employees can amend their coverage type through the secure online Compensation Web Application (CWA). If you cannot access the CWA, you may complete a paper application form and submit it to your departmental compensation office or Pay CentreOpens a new website in a new window.
  • Retired members can submit a paper application form to their pension office. 

A waiting period may be applied by your employer, and Canada Life will not receive notice of this change until it is finalized. Your file will be updated to allow you to add a dependant in your PSHCP Member Services account once your employer or pension office informs us that your change request has been authorized.

To update your address for the Public Service Health Care Plan (PSHCP), sign in to your PSHCP Member Services account. 

Navigate to the 'Your Profile' tab and select 'Personal Information.'

Our Benefit Payment Office service turnaround time is measured from the date the claim is received to the date the claim is resolved. 

Our average service level is as follows:

  • Electronic claims – 5 calendar days
  • Paper claims (except out-of-province) – 9 calendar days
  • Out-of-province claims – 10 calendar days
  • Comprehensive Coverage claims – 10 calendar days 

We might occasionally exceed the above service levels due to:

  • Experiencing higher claim volumes
  • Claims that are complex and require additional review

Please allow 1 to 2 days from the submission date to show up on your Claim History.

Sun Life will continue to process claims that were pending before July 1, 2023. Please check your Sun Life Member Services account. 

If you cannot find the information on your Sun Life Member Services account, you can resubmit the claim to Canada Life. 

Please note that if claims get paid by both Sun Life and Canada Life, the resulting overpayment will be collected.

If you’ve processed Public Service Health Care Plan (PSHCP) claims through Sun Life, you may access the report by signing into your Sun Life Member Services account. 

Similarly, for claims processed by Canada Life, you may download them from your Canada Life PSHCP Member Services account.  You may also call the PSHCP Member Contact Centre at 1-855-415-4414Opens in a new window, Monday to Friday from 8 am to 5 pm, your local time, to request a paper report be sent to you in the mail.

Plastic benefit cards will not be issued for the Public Service Health Care Plan (PSHCP). This is a green initiative supported by the Government of Canada and Canada Life. You may access your PSHCP benefit card for yourself and your covered dependants through the PSHCP Member Services website and save it to your mobile device and/or print it. You may also call the PSHCP Member Contact Centre at 1-855-415-4414Opens in a new window, Monday to Friday from 8 am to 5 pm, your local time, to request a paper PSHCP benefit card be sent to you in the mail. 

If you have difficulty downloading your card once you’ve located it, log out, check to see that your browser is permitting pop-ups and then try again.

If you’ve completed positive enrolment for the Public Service Health Care Plan (PSHCP), but your claim is still not going through at the pharmacy, ask the pharmacist to confirm the following:

  • Did the pharmacist enter your new plan number and your existing certificate number? These numbers can be found on your new Canada Life PSHCP benefit card.
  • Your certificate number is the same as it was with Sun Life and can be found on an old explanation of benefits or on your old benefit card. However, your plan number changed based on your month of birth:
    • (52111) January, February, March
    • (52112) April, May, June
    • (52113) July, August, September
    • (52114) October, November, December
    • (52115) the plan number for eligible surviving dependants (spouse or eligible children)
  • Did the pharmacist select “Carrier 12” which is the unique number associated with the PSHCP? The carrier number is the same as it was with Sun Life.
  • Did the pharmacist enter the TELUS provider number associated with PSHCP Carrier 12, and not the provider number used with Canada Life’s other clients?  

When your pharmacist submits claims for your eligible dependants (spouse, common-law partner or eligible children) your pharmacist will need to enter their name exactly as you did when you completed positive enrolment. If you want to verify the spelling used during positive enrolment, sign in to your PSHCP Member Services account through the PSHCP Member Services website or the positive enrolment confirmation package you received in the mail, to see your dependants.

Positive enrolment (PE) is a mandatory process by which you provide information about yourself and, if applicable, your eligible spouse or common-law partner and each eligible dependant child eligible for coverage under the PSHCP. Members must also provide consent for Canada Life’s use of this personal information to process their PSHCP benefits. 

This information is vital for all members covered under the PSHCP. If you do not complete positive enrolment, your health care claims will not be processed or reimbursed. 

If there is information that cannot be updated or corrected through the positive enrolment process, please contact your pension or compensation office.

New plan members to the PSHCP or members who haven’t received a positive enrolment email or package in the mail, can visit the top of this page and click on the link to complete positive enrolmentOpens a new website in a new window.

Your certificate number will remain the same, however, your plan number will change. Your new plan number is based on your month of birth:  

  • (52111) January, February, March 
  • (52112) April, May, June 
  • (52113) July, August, September 
  • (52114) October, November, December 
  • The plan number will be 52115 for eligible and surviving dependants (spouse or eligible children) 

Following the positive enrolment process, you’ll receive your PSHCP benefit card, either on your account through the PSHCP Member Services website or mailed to your home if you requested paper delivery. You can find both these numbers on your benefit card.

If you complete your positive enrolment with Canada Life online, you’ll have access to a new digital PSHCP benefit card right away. If you complete your positive enrolment by paper, you’ll be mailed a confirmation of enrolment that includes a new paper PSHCP benefit card, approximately 4 weeks after Canada Life receives your positive enrolment form.

You may notice that only the first 3 letters of your first name appear during Positive Enrolment. Rest assured we have your correct information from your Employer or pension office. Work is underway to display your full name in our system. Please note this will not affect your benefit coverage. If you notice a discrepancy with your last name or date of birth, please contact your departmental compensation office, Pay Centre, Pension Centre to update this information. Canada Life cannot update this information for you.

Canada Life is developing a customized PSHCP application for you.

In the meantime, you can use your mobile accessible PSHCP account online through the Canada Life PSHCP Member Services website, linked at the top of this page.

Positive enrolment must be completed and consent must be provided to have your claims processed by Canada Life after July 1, 2023. You will not be able to both complete positive enrolment and send in a claim on the same day. Allow at least 48 hours for your positive enrolment to process.

Complete your positive enrolment today to avoid being out of pocket for your health claim expenses.

Plastic benefit cards will not be issued for the Public Service Health Care Plan. This is a green initiative that is supported by the Government of Canada and Canada Life. 

You can access your PSHCP benefit card through the Canada Life PSHCP Member Services website, linked at the top of this page, to save it to your mobile device or to print a copy. Alternatively, call our Member Contact Centre at 1-855-415-4414Opens in a new window, Monday to Friday from 8 am to 5 pm your local time, to request a paper PSHCP benefit card be sent to you in the mail.

While Canada Life was able to securely transfer some of your personal information from Sun Life, it’s still important that we receive your most up-to-date information and your consent. Your consent is required for Canada Life to use your personal information to administer the Plan, and to adjudicate and pay your claims.