Coronavirus disease (COVID-19) – Temporary measures: Public Service Health Care Plan (PSHCP)

To: The Public Service Pay Centre, Compensation Managers, Heads of Human Resources, Participating Separate Employers and Deputy Ministers

In response to the coronavirus disease (COVID-19) outbreak, the Government of Canada has implemented temporary changes to the Public Service Health Care Plan (PSHCP). These measures are designed to help PSHCP members and eligible dependants access health care benefits while at the same time minimizing social interaction with health care professionals. The following temporary measures will be in effect from March 24, 2020, until April 24, 2020, with the possibility of being extended.

All other PSHCP provisions and coverage for members and eligible dependants remain the same during the coronavirus disease (COVID-19) outbreak. For additional information on the PSHCP, please consult Canada.ca/pension-benefits.

Emergency Benefit While Travelling
For PSHCP members and eligible dependants who experience a medical emergency while travelling on vacation or business, the PSHCP covers up to $500,000 (Canadian) for eligible emergency medical expenses (such as hospitalization and hospital services) in excess of the amount payable by a province or territory to treat an injury or disease that occurs within 40 days from the date of departure.

Temporary extension of travel emergency benefits
The limit of 40 days from the date of departure from the province or territory of residence has been extended to 60 days for those who left their province or territory of residence to travel outside of Canada before March 17, 2020, in advance of the Government of Canada’s Travel Health Notice, and are still outside of Canada after March 17, 2020.

This means that if a member or eligible dependant left their province or territory of residence before March 17, 2020, they will have their Emergency Benefit While Travelling coverage extended from 40 to 60 days.

The extension does not apply to those who had already exceeded the 60‑day threshold on March 17, 2020.

In other words, if a member or eligible dependant left their province or territory of residence on or before January 17, 2020, they will not be covered under the new temporary 60-day extension.

The following are not reimbursed under the PSHCP:

  1. travel expenses as a result of trip cancellations or changes
  2. expenses incurred as a result of a quarantine if the member or eligible dependant does not contract COVID-19
  3. transportation expenses arranged by Canada back to a quarantine location

For assistance with travel‑related medical emergencies, PSHCP members travelling in Canada or the United States can call Allianz toll‑free at 1-800-667-2883. Plan members in all other countries should call Allianz collect at 519-742-1342.

Drug benefit
Under the PSHCP, the dispensing limit for eligible prescription drugs is 100 days for both acute and maintenance drugs. A pharmacist cannot dispense another 100‑day supply of medication before a member has consumed two‑thirds of their current supply.

Temporary relaxing of the dispensing limit for maintenance medications that allow the pharmacist to exercise professional discretion whether to dispense the medication sooner
Until April 24, 2020, the PSHCP will allow pharmacists to exercise their professional discretion to dispense maintenance prescription drugs beyond the 100‑day limit. This measure will reduce trips to pharmacies. However, please note that prescription medications which are in limited supply may not be dispensed in large quantities to ensure those individuals with urgent needs have access to essential drugs.

Maintenance prescription drugs are medications that are commonly used for the treatment of chronic (long-term) conditions. Maintenance drugs are used to help control or manage disease rather than cure it (examples include blood pressure, diabetes and cholesterol lowering medications).

The temporary removal of the dispensing limit does not apply to acute medications. Acute prescription drugs refer to medications that will only be used for a short period of time (examples include antibiotics, pain medications, and medications used in an emergency like a heart attack).

Medical Practitioners Benefit
Under the Medical Practitioners Benefit, the PSHCP covers services rendered by practitioners such as psychologists. These practitioners must be registered, licensed or certified to practice in the province or territory where they work.

To be eligible for coverage for some services, members require a prescription from a physician.

Temporary changes to accepted mental health practitioners
Until April 24, 2020, social workers will be included as mental health professionals along with psychologists for all PSHCP members and eligible dependants, regardless of where they are located.

To be covered for services by a social worker all claims must be sent by mail using a completed PSHCP Claim Form (PDF, 614 KB) for Supplementary Coverage or a PSHCP Claim Form for Out-of-Country Claims for Comprehensive Coverage. Attach supporting documentation (original receipts, bills, invoices, physician or practitioner statements, and/or questionnaires, etc.). Mail the form to the address indicated on the form along with the supporting documentation.

Temporary changes to prescription requirements
Until April 24, 2020, a prescription from a physician is not required for mental health or physiotherapy services.

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