Health Claim Decisions (Benefit Tips ® - © 2009)

You can maximize the value of your benefit plan by making careful purchase decisions and shifting claims to preserve your benefit coverage.

Ensure You Receive Value

Medication

• Dispensing fee: The professional fee charged by pharmacies varies and should reflect the level of service provided.
• Ingredient cost: The lowest available ingredient cost should be used in the pricing calculation.
• Markup: The markup on ingredient cost varies by pharmacy

Dental

• Frequency: How often you see your dentist should depend on your biology and oral hygiene practices. Some people need to go every 3 months while annually is fine for others.
• Markup: The rates charged by dentists differ.
• Specialists: The quality provided by a specialist often exceeds the incremental price difference.

Coordinate with Other Plans

Submit claims to other plan before using your health spending account. Page 4 of the Canadian Life and Health Insurance Association Inc. Guideline G4 - Coordination of Benefits specifies that claims should be submitted to a health spending account only after claims have been made through all other group insurance plans.

Become aware of coverage through your provincial health plans such as the Ontario's Trillium Drug Plan and Ontario's Assistive Devices Program.