Overview
When submitting a claim, selecting the right expense category is a key step in getting the claim processed smoothly.
As part of the process, you’ll choose from a dropdown list of categories, each designed to classify different types of expenses.
This isn’t just a formality—our Claims team relies on this selection to verify eligibility and ensure accurate processing.
But here’s the catch 🎣 : Sometimes, you’re not sure which category to pick, and that’s where this article comes in!
Let’s break it down and make choosing the right category a breeze.
The details
Paramedical & Therapeutic Services
These Healthcare providers offer treatments to support overall wellness, pain relief, rehabilitation, and mental health. Services focus on improving mobility, managing chronic conditions, and promoting holistic well-being.
- Acupuncturist – Expenses related to using fine needles to stimulate specific points in the body for pain relief and overall health provided by an acupuncturist.
- Audiologist – Expenses related to diagnosing and treating hearing and balance disorders.
- Chiropodist – Expenses related to foot care, including treatment of foot pain, nail conditions, and orthotics provided by a Chiropodist.
- Chiropractor services – Expenses related to spinal adjustments and musculoskeletal health to relieve pain and improve mobility.
- Dietician services – Expenses related to personalized nutrition plans to support health conditions and overall wellness.
- Kinesiologist – Expenses related to using movement-based therapy to improve strength, endurance, and physical function.
- Massage therapist – Expenses related to using manual techniques to relieve muscle tension, improve circulation, and reduce stress.
- Naturopathic services – Expenses related to treatment by a naturopath using natural therapies and holistic approaches to support health and healing.
- Occupational services – Expenses related to developing or regaining skills needed for daily living and work-related activities.
- Osteopathic practitioners (DO, DOM P/M, OMSc) – Expenses related to using techniques to treat structural imbalances and improve overall body function provided by an osteopath.
- Physical therapy – Expenses related to injury recovery and pain management through targeted exercises and treatments.
- Physiotherapist – Expenses related to movement therapy to restore function, manage pain, and prevent further injury where the service provider is a physiotherapist.
- Podiatrist services – Expenses related to the diagnosis and treatment of foot and lower limb conditions, including injuries and biomechanical issues.
- Psychologist – Expenses related to mental health therapy and assessments for emotional well-being where the service provider is a psychologist, psychotherapist or counsellor.
- Reflexology – Expenses related to reflexology treatment which uses pressure techniques on the feet, hands, or ears to promote relaxation and overall health.
- Social worker – Expenses related to counseling and support for mental health, family issues, and social challenges where the service provider is a social worker.
- Speech language pathologist – Expenses related to assistance with speech, language, voice, and swallowing disorders.
- Wellness – Includes services that promote overall health, stress reduction, and lifestyle balance. This category is for Members who have a Wellness feature on their Plan. You can always find a listing of your Plan features on your Member Centre dashboard.
Vision Care
Services and products related to eye health, vision correction, and preventative eye care.
- Contact lens prescription – Contact lens expenses.
- Eye exams – Evaluations of eye health and vision needs.
- Eye glasses prescription – Prescription glasses, prescription sunglasses.
- Laser eye surgery – Procedures like LASIK to correct vision and reduce dependence on glasses or contacts.
- Optometrist services – Eye health assessments, vision correction, treatment of minor eye conditions and vision therapy.
Dental Care
- Dental services – Routine cleanings, fillings, and other general dental care.
- Dentures – Custom-made replacements for missing teeth.
- Orthodontic services – Braces, aligners, retainers and other treatments to correct teeth and jaw alignment. Claims for Invisalign would go under this heading.
Medical Services & Diagnostics
Healthcare services and tests used to diagnose, monitor, or treat medical conditions.
- Hospital services – Inpatient and outpatient medical care provided in a hospital setting.
- IVF Treatment – Fertility treatments, including in vitro fertilization.
- Laboratory/radiological/other diagnostic – Blood tests, MRIs, X-rays, and other diagnostic procedures.
- Medical clinic services – Walk-in or family doctor visits for general medical care.
- Medical Services – General medical treatments and procedures. This is where claims for yearly subscriptions like MedCan would go, along with Doctor’s notes.
- Midwife – Expenses related to Pregnancy, childbirth, and postpartum care provided by a Midwife.
Medical Equipment & Supplies
Devices and equipment needed for medical conditions, treatment, and daily health management.
- Diabetes devices – Blood glucose monitors, insulin pumps, and other devices for diabetes management.
- Diabetes supplies – Test strips, insulin, and other consumable diabetes-related products.
- Hearing device – Hearing aids and assistive listening devices.
- Medical devices and equipment – Includes mobility aids, CPAP machines, braces for limbs, and other health-related equipment.
Prescription & Alternative Medicine
Medication and treatments used for medical conditions, including prescription drugs and alternative therapies.
- Medical marijuana/cannabis – Prescribed cannabis products for pain management and other medical conditions.
- Prescription drugs – Medications prescribed by a licensed healthcare provider for treatment of various conditions.
Insurance
Provides financial protection for healthcare-related expenses, ensuring coverage for medical services and emergencies.
- Health insurance premiums – Payments for private or employer-sponsored health insurance plans.
- Travel insurance premiums – Coverage for medical expenses incurred while traveling. Members can only claim for the Medical portion of this insurance.
Other
A category for expenses that don’t fit into the above classifications.
- Other – Miscellaneous health-related expenses that may be covered but don’t have a specific category. We like Members to be as specific as possible when submitting claims, so this one should only be used as a last resort! Homeopathic expenses will go into this category.
Anything else?
You can familiarize yourself with more claims-related information in the following Help Centre articles: