Health Care Plan
The Public Service Health Care Plan
The PSHCP is a voluntary health care plan for federal public service employees (and their eligible dependents) designed to supplement provincial or territorial health insurance plans. It reimburses all or part of an employee’s eligible medical costs after these plans have provided the coverage that the employee is entitled to receive. SunLife administers the Plan.
Benefits covered under the PSHCP are divided into two broad categories:
Extended Health Care Benefits – Plan members are reimbursed for reasonable and specific medical services and products such as prescription drugs, private nursing services, eyeglasses and contact lenses, some physiotherapist and massage therapist services, orthotics, and ambulance services. Please note that many categories carry a maximum allowable annual reimbursement and some expenses, such as unlisted medications or durable products, athletic therapy, and convalescence, are not covered.
Hospital Benefits – Plan members and their dependents are covered for hospital costs in excess of standard charges up to specified limits, based on the three levels of coverage available. Members are automatically placed in the lowest coverage category and may elect to pay for superior coverage by submitting a request. The levels of coverage as of June 2019 are as follows:
- Level I – maximum payment of $60 per day;
- Level II - maximum payment of $140 per day; and
- Level III - maximum payment of $220 per day.
IMPORTANT: Actual coverage levels can change over time.
Note that a deductible amount is applied each year to Extended Health Care Benefits. There is no such annual deductible applied to Hospital Benefits.
The Public Service Health Care Plan Benefit Card
Since November 1, 2010, the PSHCP benefit card has been accepted at pharmacies across Canada. With the card, pharmacies may be able to bill the PSHCP directly for the medication, with members paying only their portion of the expense. The card allows pharmacists to process expenses electronically.
In addition, benefit recipients can obtain a 90-day supply when refilling their prescription for any PSHCP-eligible drug. If you are travelling abroad for an extended period and need a bigger supply of medication, you can contact SunLife, who will work with your pharmacist to make it available to you for purchase.
While the Card covers generic drugs "by default", you can still obtain brand name drugs if "no substitutions allowed" has been specified on your prescription.