To find out the status of your claim:
- Contact our individual health unit.
How to submit your claim form
Once your claim form is completed, send it by mail to the address on the form.
We need all the information that we ask for on the forms. To avoid delays, ensure all questions are answered in full.
Be sure to include your Sonata Health policy number on all claim forms. You can find your policy number on the policy specifications page in your Sonata Health information package, or on your personalized ID card.
Make sure you’ve attached all the receipts supporting your claim, and that all receipts are originals. We cannot accept photocopies. Your original receipts will not be returned. You will, however, receive an explanation of benefits for your records.
For help with completing a form, contact the.
Unless you’ve chosen to have payment sent directly to your service provider (dentist, chiropractor, etc.), Great-West will mail all cheques to your home address with a complete explanation of benefits paid.
You may also choose to have claims paid to you by direct deposit.
Travel insurance is designed to cover losses arising from sudden, unexpected and unforeseeable circumstances. It is important that you read and understand your policy before you travel as your coverage may be subject to certain limitations and exceptions. If you have any questions about your coverage, please call The Great-West Life Assurance Company individual health unit at 1-866-430-2863.
You should also review your provincial plan coverage before travelling to ensure you have sufficient insurance. Your provincial plan coverage may have time limits on submitting claims that would also apply to your policy.
A pre-existing exception will apply to medical conditions and/or symptoms that existed prior to your trip. Check to see how this applies in your policy and how it relates to your departure date, date of purchase or effective date.
In the event of an accident, injury or sickness, your prior medical history will be reviewed when a claim is reported.
Your policy provides travel assistance. You are required to notify the designated assistance company prior to treatment. Your policy limits benefits if you don’t contact the assistance company within a specified time period.
Contact your provincial health plan before leaving the country to determine the extent of its coverage. Many provincial health plans have time limits for submitting claims. These time limits will apply to your Sonata Health claim as well.
If your provincial health plan refuses payment, you may be asked to reimburse Great-West for any amount we have already paid on their behalf.
For emergency assistance and advance approval of major medical treatments.
Before entering a hospital or being treated for a medical emergency, immediately call, or have someone call on your behalf, one of the following numbers. These numbers appear on your Sonata Health Emergency Travel Assistance card, which you should carry with you when travelling.
Your benefit amount may be reduced if you do not call before beingtreated. In addition to helping you find appropriate medical care, theassistance centre will obtain Great-West’s prior approval for medicalservices and supplies and assistance services, where required, and will arrange to have hospital and doctor bills sent directly to us for payment.
To submit emergency travel medical claims
If you have paid a medical provider for emergency medical services while travelling, contact our individual health unit when you return home. We will send you the necessary forms and help you prepare and submit a claim.
For eligible claims, Great-West will pay your provincial health plan’s share of the claim for you, on the province’s behalf (except for residents of Manitoba, where the province pays its share of the claim directly). The provincial health plan requires that you sign a release permitting them to reimburse Great-West for their portion of the claim.
Complete the following forms:
- Out-of-country benefits claim form Opens in a new window
- A provincial third-party agreement form, required in most provinces. Use the information here to determine what is required for your province.
Along with your out-of-country benefits claim form Opens in a new window, you may also be required to submit a provincial third-party agreement form.
Great-West has entered into third-party agreements with most Canadian provinces. If your province of residence has a third-party agreement with Great-West, we may submit your out-of-country medical expenses to your provincial healthcare plan on your behalf. To do so, the provincial healthcare plans require specific provincial authorization and release forms to be completed, in full, by the person who incurred the medical expense.
You must submit the provincial authorization form with your completed out-of-country benefits claim form Opens in a new window.
If you have any questions or need help in completing these forms, contact our individual health unit.
For the appropriate authorization form, choose your province of residence here.
Important: Adobe Reader XI or higher is required in order to fill out and save a completed form. To download the most recent free version of Adobe Reader XI go to: Opens in a new windowwww.adobe.com/ca/products/reader.html Opens a new website in a new window
Certain prescription drug claims need to be approved before we can consider reimbursement. If your benefits plan covers the drug you're being prescribed and you want to be considered for coverage:
- Read the document under "General information for Prior authorization drugs".
- Print the individual health prior authorization form.
- Ask your attending physician to complete it.
- Send the completed form to us by mail, fax or email.