Blue Cross offers several convenient options to quickly and efficiently submit your benefit claims.
The claimant's insurance must be in force when treatment is rendered for benefits to be payable.
Dentist Direct Submit
Many dentists will bill Medavie Blue Cross directly and bill you for any remaining balance. However, in those instances where you do need to submit a claim, your dental professional should complete the Standard Dental Claim Form.
For Approved Providers who have registered to submit claims to Blue Cross through electronic claims submission service, e-claim service allows approved professionals to instantly submit claims at the time of service. This eliminates the need for you to submit your claim to Blue Cross and means you only pay the amount not covered under your group benefits plan (if any).
You can quickly and easily submit your health, drug and dental claims (as applicable) through MBC secure plan member website. Simply take or scan a digital image of your paid-in-full receipts and submit it through the applicable link on the plan member website.
Filing a claim has never been quicker or easier! Submit your claims through the Medavie Mobile app and have your reimbursement deposited directly to your bank account.
Medavie Benefits (kiosk)
Located in Scotia Square at 1894 Barrington Street
Check with Medavie Blue Cross for service hours.
- Chat with a Medavie Benefits Speciality
- Benefit/coverage inquiries
- Onsite assistance/support self service tools (mobile app, submit a claims)
In determining if an expense is covered, Medavie Blue Cross may require the following information:
- X-rays and a complete dental chart showing any extractions, fillings, or other work performed prior to the date of the incurred expenses for which claim is being made;
- Itemized bills from the dentist or other sources of services or treatments; and
- Laboratory or hospital reports, casts, molds or study models, or other similar evidence of the condition or treatment of the teeth or mouth.
Pre-determination of benefits: To ensure a smooth claim process, we believe there is value in knowing the cost of planned treatment; therefore we do encourage you and your dentist to consider requesting a pre-determination of benefits.
When a proposed course of treatment is expected to cost more than $500, a treatment plan should be filed with Medavie Blue Cross before treatment begins. Medavie Blue Cross will advise you of the amount covered and you will share this with your dental professional. Dental charges over and above insurance benefits remain the responsibility of the claimant.
What if my spouse also has coverage?
Canadian insurance companies follow a process called Coordination of Benefits (CoB) when a plan member is covered under more than one health and/or dental plan. CoB ensures you receive the maximum benefit available from your policies. In fact, two policies can be combined to give you up to 100% reimbursement of eligible claims.
When you are covered under your plan and under a spouse’s plan, here's how Coordination of Benefits works:
- Submit your expenses first to your benefits plan. You can then submit any unpaid portion of your claim to your spouse’s plan.
- Submit your spouse’s expenses first to your spouse’s benefits plan. You can then submit any unpaid portion of your spouse’s claim to your plan.
- If your dependent children are covered under your and your spouse’s benefit plans, you must submit all their claims first to the benefit plan of the parent whose birth date falls earliest in the calendar year (the month, then day). Any remaining balance can then be reimbursed from the other plan. When parents are separated or divorced, the custodial parent claims under his or her plan first, then their spouse’s plan (where applicable), then the plan of the parent without custody, and then their spouse’s plan.
- When you submit a claim for an unpaid balance from another insurance company, you plan will need a copy of the receipt and a copy of the statement (Explanation of Benefits (E0B)) showing the portion of the claim paid by the other company. Although you have 18 months to claim under the HANS plan any remaining balances, your receipts should be submitted as soon as possible.
If you need help determining the order claims should be submitted, call the Medavie Blue Cross Customer Information Contact Centre toll-free at 1-800-667-4511. Alternatively, you can email your questions to firstname.lastname@example.org
If you are covered by more than one plan, please call Health Association Nova Scotia toll-free at 1-866-886-7246 regarding any changes or updates to your Coordination of Benefits information.
CONTINUATION OF COVERAGE
What happens during a leave of absence?
If you take an approved paid leave of absence, you must continue coverage for up to 12 months.
If you take an approved unpaid leave of absence, you may continue for up to 12 months. If you take an approved maternity or parental leave, you may continue for the duration of the leave. If you choose not to continue the benefit during your leave, coverage is reinstated on your return to work.
If you are approved for your employer sponsored Long Term Disability benefits, you may continue coverage. For cost sharing arrangements, please check your collective agreement or contact your employer for more details.
What happens If I lose coverage under another plan?
If you had opted-out of the dental plan because you were covered under another plan, you MUST join the Health Association plan if you lose the other coverage. If you apply late, after 60 days, your coverage will be restricted to $125 for the first 12 months.
What happens to coverage if I die before retirement?
In the event of your death before retirement, your spouse and dependent children may continue their coverage for up to 24 months after your death. No premiums are required for this coverage.
What happens to my coverage when I retire?
There is no dental plan for Retirees. Dental Coverage ceases when you retire.
Can I convert my coverage?
You may choose to convert your coverage to an individual policy within 31 days of your coverage ending. To convert to a dental insurance plan, members can call Medavie Blue Cross toll-free at 1-800-873-2583. You can also visit their corporate website at https://www.medaviebc.ca/en/plans/moving-off-an-employers-plan
Health Association Nova Scotia reserves the right to review the employee benefits program and to modify, amend, discontinue, and/or make exceptions to the program. All information is subject to change. This document provides a information around the key benefits available to you under the Health Association Nova Scotia Single Group Benefits Plan. In the case of a discrepancy, the contracts will prevail.