Health Spending Account Frequently Asked Questions

1. What is a Health Spending Account?

   A Health Spending Account is a group benefit that provides reimbursement for a wide range of health-related expenses, over and above regular benefit plans. HSA's are administered in accordance with Canada Revenue Agency guidelines.

2. Who is eligible to enroll under the HSA?

   The employee and dependents as defined in the Income Tax Act of Canada. The definition of dependent may be broader than for your Dental or Extended Health Care plans. Check your Member Profile for more information.

3. What medical expenses are eligible under the HSA?

   You can claim any item or service allowed under the Income Tax Act of Canada as a medical expense. Your HSA is available for unpaid balances or expenses not covered under your other benefit plans (including government plans, your group benefits plan and, if applicable, your spouse's group benefits plans). The list includes vision care expenses (glasses, contact lenses, and laser eye surgery), prescription drug expenses commonly excluded on Extended Health Care plans (fertility drugs, erectile dysfunction drugs), paramedical practitioners (psychologists, optometrists, acupuncturists), adult orthodontics (dental braces). Balances not reimbursed on your Dental or Extended Health Care plans, such as deductible amounts and coinsurance, are also eligible.

4. What is considered an acceptable medical expense receipt when submitting a claim under my HSA?

   According to the Income Tax Interpretation Bulletin No. IT-519R2, proper receipts must support all amounts claimed as qualifying medical expenses. A receipt should indicate the purpose of the payment, the date of the payment, the patient for whom the payment was made and, if applicable, the medical practitioner, dentist, pharmacist, nurse, or optometrist who prescribed the purchase or gave the service. A cancelled cheque is not acceptable as a substitute for a proper receipt.

5. What are some examples of eligible medical expenses that can be claimed under my HSA per the Income Tax Act?

   The following are examples of eligible medical expenses according to the Income Tax act:

   • Payments to qualified medical practitioners, hospitals etc.
   • Premiums to private health services plans
   • Guide and hearing-ear dogs and other animals

   For more information on claimable expenses, go to the Canada Revenue Agency (CRA) website

6. What are some examples of ineligible expenses that can't be claimed under my HSA per the Income Tax Act?

   The following are examples of ineligible expenses according to the Income Tax Act:

   • Services of non-qualified medical practitioners
   • Premiums to public health service plans
   • Supplements
   • Ear Plugs -Allervac vacuum cleaner for allergies
   • Exercise balls
   • Hot tubs
   • Counsellors
7. How do I make a claim?

   Expenses to your Health Spending Account can be submitted online with Member Profile or the Pacific Blue Cross Mobile App. Refer to this document for more information on how to submit a claim to your Health Spending Account and to help you determine the required claims details for your submission.

   You can also use the Health Spending Account claim form provided by Pacific Blue Cross. Remember to attach original detailed receipts and any benefits statements if the expense has been submitted to any other coverage you may have. You may submit expenses to be covered by your EHC and Health Spending Account together on the same form.

8. What is the deadline for submitting claims?

   Deadlines will vary depending on the time period chosen of 30, 60 or 90 days after the end of the HSA plan year. For more information, please refer to either your plan booklet, or your Member Profile.

9. How do I appeal a claim decision?

   If you wish to appeal a decision about a recent claim, contact our Call Centre. Often an issue can be resolved by simply providing you with more information about your claim or what is covered by your plan.
   
   If one of our customer service representatives is unable to resolve the matter with you, they can escalate your request to a Benefit Review Committee for further review. They will explain how to file your appeal and help you to provide all relevant information regarding your claim.

10. How do I notify PBC of my change of address?

    At this time, address change requests are handled via e-mail or telephone. Please provide us with your old address and new address. We will be happy to assist you in updating your address.

11. If I incur an expense in any month prior to my claiming deadline, but still within the claiming year, can I submit the claim?

    Yes. All claims with a date of service of that plan year can and must be received in Pacific Blue Cross' office by the claiming deadline.

12. What is my HSA amount?

    HSA amounts are credited to your HSA periodically as directed by your plan. Some plans credit amounts monthly and others credit them once per year. Check your booklet or your Member Profile or speak to your plan administrator.

13. What are the Carried Forward and Forfeit amounts?

    For balance carry forward plans, if your annual claims do not exceed your Annual Election for the current plan year, the credit balance is carried forward into the next plan year. The credit balance is the Carried Forward amount. If the credit amount carried forward is not used by the end of the next plan year, this amount is forfeited.

14. What happens to my HSA if I leave my employment mid year? What is the deadline for submitting claims?

    Claims for that plan year with a date of service prior to your cancellation date would be eligible expenses under the HSA. The claiming deadline would still be the deadline for the group (i.e. 30 days, 60 days, etc) after the plan year.

15. How can I get information about my HSA?
    • To speak to a Pacific Blue Cross Service Representative, call:
      604 419-2000 or toll free 1 877 722-2583
    • Log onto your Member Profile for up-to-date information, 24 hours a day.
16. What type of information is available on your Member Profile?

    Your Member Profile provides the following HSA information for the last two plan years:

    • your credits deposited
    • your claims paid amount
    • your current HSA balance
    • forfeited amount