Submitting Claims

You can obtain Claim Forms from:

  • Your human resources department,
  • The Forms section, or
  • Manitoba Blue Cross:

Phone: (204) 775-0151
Toll-free: 1-800-873-2583 (outside Winnipeg)
Fax: (204) 772-1231
Website: mb.bluecross.ca

Include your client and certificate number on any communication to Manitoba Blue Cross. Your client and certificate number can be found on your Manitoba Blue Cross ID card.

Manitoba Blue Cross accepts either copies or original receipts for medical expenses; however, original receipts will not be returned. If you are claiming medical expense deductions on your Income Tax Return, you do not need to provide original receipts. The Canada Revenue Agency will accept the Explanation of Benefits that Manitoba Blue Cross issues to you with your benefit cheque. Please retain the Explanation of Benefits for your records.

Note: Healthcare and Dental Plan claims must be submitted within two years of the date services were provided. Expenses that are more than two years old will not be accepted.

Please refer to Healthcare Spending Account Claims (below) for further details regarding the deadlines for submitting claims under the Healthcare Spending Account (HSA).

Ambulance/Hospital Benefits

You can present your Manitoba Blue Cross ID card to the ambulance provider or the hospital to receive coverage.

For out-of-pocket expenses, submit the itemized receipt for reimbursement to Manitoba Blue Cross.

Prescription Drugs - BlueNet Claims

Use your direct-pay Manitoba Blue Cross ID card to receive on-the-spot coverage for your prescription drug purchases. You pay only the portion that is not covered under your plan. This system eliminates the need to file paper claims.

If your pharmacy does not participate in the BlueNet system, submit paper claims to receive reimbursement for your prescription drug purchases.

Vision Care Claims

Submit claims for eligible vision care expenses by completing a Health Benefits Claim Form along with itemized receipts and a copy of a valid prescription from the dispensing optometrist or optician to Manitoba Blue Cross.

Employee Travel Health Claims

For expenses incurred within Canada, present your original receipts or statements to your provincial health plan. Upon receipt of payment, submit the following documents to Manitoba Blue Cross:

  • Completed Travel Health Plan Claim Form.
  • Copies of your receipts.
  • Your provincial health plan statement of payment.
  • Proof of departure and return dates. Examples of acceptable proof include airline tickets, passport stamps, travel itineraries and dated receipts.

For expenses incurred outside of Canada, Manitoba Blue Cross will coordinate payment with Manitoba Health. Submit the following documents to Manitoba Blue Cross:

  • Completed Travel Health Plan Claim Form.
  • Copies of your receipts.

Other Healthcare Benefits Claims 

For other eligible healthcare expenses, please submit the following to Manitoba Blue Cross:

  • Completed Health Benefits Claim Form.
  • Copies of itemized receipts.
  • Any required documentation (e.g.. doctor's prescription, referral, provincial plan statement).
Pre-authorization is available for health benefits on high cost items such as wheelchairs, braces, etc. These require a separate form. Contact Manitoba Blue Cross for details.

Dental Claims

  1. If required, obtain a Dental Claim Form from your employer. A separate Claim Form is required for each member of your family who obtains dental services. Present the Claim Form to your dentist at the first appointment.
  2. Following your examination, the dentist may discuss a proposed course of treatment and possibly book follow-up appointments. If the cost of treatment exceeds $500 or if treatment consists of major dental services (e.g., crowns, bridges, orthodontics), the dentist will have to submit a completed Dental Claim Form to Manitoba Blue Cross for approval before treatment can begin.
  3. Your dentist has the option of billing Manitoba Blue Cross directly or continuing to bill you. Please inquire at the beginning of treatment how billing will be made. Should your dentist choose to seek payment from Manitoba Blue Cross directly, it will not be necessary for you to submit the claim. You will be asked to assign the benefits over to the dentist, where indicated on the Dental Claim Form.

Healthcare Spending Account (HSA) Claims

The HSA benefit year runs from January 1 to December 31.

Claim Limitation Period (CLP)

The HSA plan has a grace period following the benefit year which is referred to as the claim limitation period (CLP). Claims must be received and requested within the CLP to be eligible for reimbursement with current year credits.

If you have unused credits at the end of the policy year, there is a 90-day CLP which allows for any prior year’s eligible expenses to be claimed. Any prior year’s credits remaining after this time period will be forfeited. If your eligible expenses in any year are greater than the benefit dollars credited to you, the excess will be carried forward into the next benefit year.

Note: Expenses cannot be carried forward more than one benefit year.

Carrying Forward Claims

1. Prior Year Claims - Claims incurred in the prior year must be submitted by March 31 of the following year in order to be paid from the prior year’s HSA benefit amount. If not submitted by March 31, these claims may be carried forward and paid from the following year’s HSA benefit amount. If carried forward, claims must be submitted by December 31 of the following year, or will no longer be eligible for reimbursement. For example, any eligible expenses incurred in 2019 must be claimed in either the 2019 benefit year, or the 2020 benefit year, but not further. The maximum allowable carry forward for a claim is one benefit year.

Example: In 2019 you incurred a vision care claim for $400 and were reimbursed $150 from the Healthcare Plan. You did not submit an HSA Claim Form to request the remaining $250 to be paid from your 2019 HSA benefit amount by March 31, 2020. Although you can no longer request the reimbursement of this claim from your 2019 HSA benefit amount, you can carry this claim forward to be paid from your 2020 HSA benefit amount.

In order to have the claim paid from your 2020 HSA benefit amount, you must submit the HSA Claim Form by December 31, 2020. If you do not submit the HSA claim form to request payment by December 31, 2020, the claim is forfeited and no longer eligible for reimbursement.

2. Excess Claims - If you incurred a claim in excess of your prior year’s HSA benefit amount, you may carry the excess claim forward to the next HSA benefit year. The excess claim cannot be carried forward more than one HSA benefit year.

Example: In 2019 you submitted a vision care claim for $1,000 to the Healthcare Plan. An amount of $150 was reimbursed under the Healthcare Plan, and $250 was reimbursed from your 2019 HSA benefit amount. The remaining amount of $600 is carried forward to the 2020 HSA benefit year. You may request payment for the remaining amount, limited to your maximum HSA benefit amount for 2020. Any excess amount still remaining for the claim after December 31, 2020 is not eligible for reimbursement.

Submitting an HSA Claim

The easiest way to access your HSA credits is to check “Yes” where the online or paper claim asks if you’d like to “Pay remainder from Health Spending Account.” This way you will be reimbursed directly for any eligible unpaid balances you have on this claim.

To request HSA reimbursement after a claim has been submitted:

  1. Use the HSA Online Request feature within mybluecross®, or
  2. Obtain an HSA Claim Form from mybluecross® or the HEB Manitoba website.
  3. Complete the HSA Claim Form in full and include:
    • the printed itemized medical receipts and
    • if applicable, an Explanation of Benefits (EOB) from another carrier. If you have coverage under another Plan, you must first submit your claim to the other insurer for processing in order to be eligible for your HSA reimbursement. Note: If this receipt was previously submitted to Manitoba Blue Cross through the Healthcare or Dental Plans, it does not need to be resubmitted. An HSA Claim Form is still required.
  4. Submit all documents to Manitoba Blue Cross for payment. Late claims will not be processed (no exceptions will be allowed).

Claims will be paid out if your eligible HSA expenses are $50 or more. If your claims have been submitted and do not exceed $50 in eligible expenses, they will be paid out after the 90-day CLP from the end of the benefit year.

For coordination of benefits between two or more benefit plans, see the Coordination of Benefits section.

For more information about your benefits or claims procedures, contact Manitoba Blue Cross directly at:

Manitoba Blue Cross
Phone: (204) 775-0151
Toll-free: 1-800-873-2583 (outside Winnipeg)
Fax: (204) 772-1231
Website: mb.bluecross.ca 

© 2020 HEB Manitoba

 

Disclaimer - This website provides a basic overview of the Healthcare Employees' Pension Plan (HEPP) and the Healthcare Employees' Benefits Plan (HEBP) (collectively the HEB Manitoba Pension and Benefit Plans). Not all employers participate in all Plans. Please check your eligibility for benefits with your employer.

HEB Manitoba is a name notation registered by the Healthcare Employees’ Pension Plan – Manitoba and the Healthcare Employees’ Benefits Plan – Manitoba and under which each of their respective undertakings is carried out.

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