Frequently asked questions

Your certificate number is located on the front of your ID card. If you have an older card, this may show as contract number.

We accept photocopies of receipts for all claims, except travel claims.

There is no maximum to the number of emergency ambulance trips you can take. If you have emergency ambulance coverage, it is covered at the coverage per cent indicated by your plan and subject to the usual & customary rates in place for the region of service.

* This does not include Out of Province ambulance and Medical Transfer benefits. These benefits are separate and subject to their own exclusions and limitations.

Usual, customary, and reasonable charges refer to the range of charges by individuals of similar training and experience providing the same services or supplies within a specified location/province. These may also include charges considered justifiable under special circumstances by the provider's professional association.

If your provider charges more than the reasonable and customary limit (including more than one visit in a day), you will be responsible for paying the difference. Shopping around for health care products and services helps members reduce out-of-pocket expenses and helps employers reduce benefit plan costs.

You are covered anywhere outside of Manitoba, unless the Government of Canada has placed an "avoid all travel" advisory on your destination. View travel advisories on the Government of Canada website.

A Health Spending Account (HSA) is a benefit offered with some group plans that provides reimbursement for a variety of health-related expenses that may or may not be covered by your core group plan. This ensures you can manage necessary health care expenses and minimize out-of-pocket costs.

In general, expenses are considered eligible if they qualify as a medical expense tax credit under the Income Tax Act of Canada and have not been 100 per cent reimbursed by another benefit plan. An HSA is administered in accordance with Canada Revenue Agency guidelines and is always last payer (after government, employer, individual, student and spousal plans).

There are a number of ways to maximize your drug coverage:

• Check with several pharmacies to find out who has the lowest dispensing fees and mark-up. Pharmacies have their own practices and costs, resulting in various prices for the same prescription. Dispensing fees can range from $4 to $20 or more per prescription across different pharmacies. You have the option to shop around.
• Reduce your dispensing costs by purchasing the maximum supply of a prescription drug at one time (100-day supply).
• Choose generic wherever possible. Generic drugs are strictly regulated in Canada and must contain the same active ingredients, provide the same strength per dosage, and be administered the same way as their brand-name counterparts. If prescribed a brand-name medication, ask your doctor about a generic alternative. You can also ask your pharmacist to substitute a generic version when filling your prescription.

Vision coverage frequency varies by plan. Visit Coverage in mybluecross® and view your vision eligibility to find out when you are eligible for your next eyeglass or lens purchase, or contact us.

The Employee Assistance Program (EAP) is a comprehensive, voluntary program that provides confidential counselling to assist in identifying and resolving concerns affecting you and your family's health and well-being.

To submit a claim that has been partially paid by another carrier or the government program:

• Respond "Yes" to the question: "Has a portion of this expense been paid by another policy or a government program?". This field is required even if the amount paid was zero.
• Enter the amount paid by the other plan(s) under "Other Plan(s) Paid", "Government Paid", or both, depending on who paid a portion of your claim. The amount entered should reflect what is shown on the Explanation of Benefits (EOB) provided by the other plan.

Click the Back button to go back to make any corrections. Ensure all information is correct before submitting your claim.

If the Paid Amount is $0.00, please review the claim details.

If the claim status is Processed and a Paid Amount is indicated, a payment will be direct deposited with 1-3 business days from the Processed Date. Cheque payments are issued weekly.

Only specialty claim forms are required.

Queued means your claim is being held for processing. This has happened because you have a claim in Audit status. When a claim is selected for audit, the system places a temporary hold on all subsequent claims. Once Manitoba Blue Cross receives the requested receipt(s) for your Audited claim, all Queued claims will be released for processing.

Manitoba Blue Cross is committed to protecting your benefits from fraud and abuse. One of the ways we do this is by auditing claims to confirm the accuracy of information provided.

Visit Insurance Fraud and Abuse to learn more.

Claims are processed in the order in which they are received.

Some Canadian provinces, including Manitoba, have Pharmacare programs, which provide drug cost assistance to eligible individuals. The provincial program for Manitoba is income based, which means an annual deductible is determined based on your total adjusted family income. (This is the amount you must pay out of pocket or through a benefits plan before the provincial program will cover eligible expenses.)

In Manitoba, once your annual deductible has been met through the purchase of eligible prescription drugs, the Manitoba Pharmacare program will pay 100 per cent of eligible prescription costs for the remainder of the benefit year. (The Manitoba Pharmacare benefit year is April 1 to March 31.)

For eligible Manitoba residents, you must submit an enrollment application to Manitoba Pharmacare. (Click here to confirm eligibility requirements for Manitoba’s Pharmacare program.)

Once registered, you will not need to submit a completed application form every year. (Once enrolled in Manitoba’s Pharmacare program, you are registered unless you choose to remove yourself from the program or do not file your income taxes.)

Manitoba Blue Cross may require proof of your deductible in the future for internal purposes. If this is required, you will receive notification from Manitoba Blue Cross to send us a copy of your deductible letter from your provincial Pharmacare program.

Virtual care is a convenient way to access medical support without having to go into a doctor’s office or clinic. It provides convenient healthcare and treatment over the phone or online so you can use it at home or on the go. It is particularly beneficial if you’re feeling unwell, have limited mobility or supports, or live in remote or underserved areas.

With virtual care through our partner Gotodoctor, you can speak to a licensed Canadian physician about medical questions, prescription renewals, laboratory diagnostic requests and referrals. The Gotodoctor team can address a wide range of health and wellness concerns that you would typically make an in-person medical appointment for, including:

Virtual care can be very beneficial to ensure you don’t need to leave your home when sick, while also providing medical support to those who may have disabilities, limited supports or reside in more remote or under serviced areas.

To confirm you have virtual care coverage as part of your Manitoba Blue Cross benefits plan, click View coverage. If virtual care coverage is included in your benefits plan, it will be listed here.

We are located at 599 Empress Street, Winnipeg MB. Our office hours are Monday through Friday 9 a.m. - 4 p.m. For additional contact information please visit our Contact us page.

Claims are processed in the order in which they are received.

For faster processing, register for direct deposit under Manage Account and payment will be transmitted as soon as your claim is processed. As an added benefit, you'll also be able to submit claims online through mybluecross. An EFT payment will be deposited to your bank account within 1-3 business days from the processed date.

Manitoba Health will cover the full patient cost of inter-facility transports when:

• the patient is a resident of Manitoba with a valid Manitoba Health card
• the patient medically requires transportation by ambulance as determined by a physician
• the patient is being transferred between designated health-care facilities for diagnostic tests or treatments, or from a more specialized level of care to another facility closer to home for rehabilitation or recovery.

We allow direct billing from all qualified service providers. Direct billing is free to set up with Manitoba Blue Cross. However, the decision to offer this is at the discretion of the provider.

Each country has its own documentation requirements. Before travelling, we recommend you visit the Goverment of Canada website for information on the country you're visiting. Be sure to travel with your Manitoba Blue Cross certificate or policy, which includes contact information for International Travel Assistance.

Based on coordination of benefits' guidelines, you must submit prescription drug claims under your own plan first, even if your spouse has BlueNet.

*This coordination of benefits guideline also applies to dependents. When making claims for eligible dependents, you must first claim under the plan of the parent with the earlier birth month in the calendar year.

For faster processing, register for direct deposit and gain access to submit claims online. This convenient service allows you to bypass the manual processing wait times by processing prescription drug claims in real time. As an added benefit, payment will be transmitted to your bank account as soon your claim is processed.

At the start of the orthodontic treatment, your orthodontist will prepare a written outline of the proposed treatment. This is called a treatment plan. Prior to service, your orthodontist should submit this treatment plan to Manitoba Blue Cross. Manitoba Blue Cross will in turn generate a pre-authorization.

Orthodontic claims are paid monthly based on the treatment plan outlined by your provider. You must submit a claim for each month's visit. If you elect to pay the entire amount upfront, you may submit the full receipt and Manitoba Blue Cross will reimburse monthly according to the length of your treatment plan, until the treatment plan ends or you've reached your yearly or lifetime maximum (whichever comes first).

No. Only sunglasses that contain corrective lenses are eligible for coverage.

All family members (including spouse and dependents) are covered under the plan.

Ensure the claim has been submitted under their primary plan first. Then, when adding an expense:

• Respond "Yes" to the question: "Has a portion of this expense been paid by another policy or a government program?". This field is required even if the amount paid was zero.
• Enter the amount paid by the other plan(s) under "Other Plan(s) Paid", "Government Paid", or both, depending on who paid a portion of your claim. The amount entered should reflect what is shown on the Explanation of Benefits (EOB) provided by the other plan.

To submit a claim that has been partially paid by another plan or government program, please upload your Explanation of Benefits or government statement along with your claim.

If the Total Paid Amount is $0.00, select "View this claim" to review claim details.

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To resolve an Audited claim, use Claim Search to find your claim and submit your receipt(s).

Important: If you prefer to mail your receipt(s), you must include the Reference Number of your audit, which you will find under Claim Details.

Only processed claims will appear in results. Most claims are processed in real-time by our system. However, claims that include document uploads are manually reviewed and will be processed in the order in which they are received. Note: Travel and Employee Assistance claims are not available for viewing in your Claim History. Contact us for information on these claims.

What you can claim on your HSA is determined by the Canada Revenue Agency. The list of what is covered is extensive and includes:

• prescribed medication
• eye care, including eye exams, prescription contacts or glasses, or laser eye surgery
• paramedical services (e.g. massage therapy, chiropractics, physiotherapy)
• dental care
• home care or home modifications for medical conditions
• prescribed medical supplies (e.g. air filters, mobility aids)
• diagnostic and rehabilitation services
• medically-required travel expenses (e.g. ambulance fees)

Expenses that are not covered by HSAs include but are not limited to:

• gym membership fees
• cosmetic surgery
• non-prescription medications, vitamins and supplements

Visit the Canada Revenue Agency website to find out if an item is eligible and whether supporting documentation, such as a prescription, is required to claim it on your HSA. For exclusions or exceptions specific to your group plan, refer to your benefit booklet or contact us.

Manitoba Blue Cross wants to ensure that we contain health costs and that your health benefits plan does not pay for expenses that could be covered by Pharmacare. The Manitoba Pharmacare program will cover 100 per cent of eligible drug expenses after a deductible amount has been met. (This deductible amount is based on your family income.)

If/when your eligible drug purchases reach your Pharmacare deductible, future eligible drug expenses will be covered by Manitoba Health. This alleviates the health costs incurred by Manitoba Blue Cross, allowing us to keep premium costs and expenses down.

To ensure integration with provincial coverage, Manitoba Blue Cross requires registration with your provincial Pharmacare plan, where applicable.  In some instances, Manitoba Blue Cross may need to collect your Pharmacare deductible information after a certain period of time, in which case, a letter will be sent requesting the recent Pharmacare deductible be submitted.

If we do not have a copy of your Pharmacare deductible letter when your drug purchases reach a certain amount based on your benefits plan, we will send you a letter asking you to register with the Pharmacare program as a requirement of your benefits plan. Manitoba Blue Cross will hold any further drug claim payments until the deductible letter from Pharmacare is received. Once received, we will resume processing your eligible drug claims.

If you have any questions concerning Pharmacare and your Manitoba Blue Cross health benefits plan, please don’t hesitate to contact us.

To book an appointment for virtual care coverage visit gotodoctor.ca/mbbluecross. Click the Book now button and enter your Manitoba Blue Cross certificate number and submit your request for the desired service.

Save time by registering in advance so you can skip this step when booking future appointments. Visit gotodoctor.ca/mbbluecross and click Register now to fill out the form. You can also request an appointment immediately after registering.

Select View or request an ID card, under the user account menu. Here, you can print a card for temporary use, request a new permanent card or immediately display the electronic version to your service provider.

You can also show providers your card or access your account details in the Manitoba Blue Cross mobile app. (Download the mybluecross mobile app from the App Store or Google Play.)  

You can also request a new ID card be sent to you by calling us at 204.775.0151 or 1.888.596.1032 (toll free).

If your card was damaged or is no longer legible, you can laminate future ID cards to protect them.

Cheques are mailed weekly (this does not include the time needed by Canada Post to deliver your claim or Explanation of Benefits statement). Busier periods or complex claims may require additional processing time.

For faster reimbursement, register for direct deposit by selecting Manage Direct Deposit under the account dropdown. It's safe, secure and eliminates the risk of lost or stolen cheques. Plus with direct deposit, payments will be transferred directly into your bank account (and not subject to mail delays like cheque payments) so you'll gain access to your money sooner.

If any part of the trip is outside of Manitoba, the trip would be considered under the Out of Province Ambulance benefit and subject to any maximums that may apply.

Visit Coverage in mybluecross® to view the details of your coverage.

In the event that any portion of the travel outside of Manitoba falls after the 31st week of gestation, charges associated with the required confinement of the mother and newborn infant due to childbirth and delivery will be denied by Manitoba Blue Cross. However, in the event of unexpected, pre-mature delivery prior to 31 weeks gestation, the coverage terms of the Policy will extend medical, hospital and necessary transportation costs for the mother and pre-mature infant.

Drugs not eligible under Manitoba Pharmacare (e.g. over-the-counter drugs) are generally not included as benefits of a prescription drug plan. Visit Coverage to view the details of your coverage or contact us.

• Basic Services covers basic diagnostic and preventative services. This includes examinations, radiographs, basic restorations, periodontal cleaning, maintenance of dentures, and extractions.
• Major Services cover major restorative procedures such as crowns, onlays, veneers, bridgework and dentures.
• Orthodontic Services cover treatment used to straighten teeth and align the bite.

* This information is based on a standard plan. Manitoba Blue Cross has many non-standard plans. For specific information regarding your plan, refer to your benefit booklet or contact us.

Some plans allow reimbursement toward laser eye surgery in lieu of vision benefits (at the same benefit level and maximum). Visit Coverage in mybluecross® to view the details of your coverage or contact us.

Areas of personal counselling include marital and family counselling, addictions, emotional/behavioural concerns, occupational stress, adjustment, and financial counselling. For active mybluecross® members, visit Coverage to view your benefit details or contact the Employee Assistance Centre at 204.786.8880 (within Winnipeg), 1.800.590.5553 (toll-free), or 204.775.0586 (TTY) to find out how we can help.

If your provider is not listed:

• Verify the name of the service provider entered matches the service provider shown on your receipt
• Try limiting your search to only one or two fields
• Try entering a partial name, using only some letters of each word per field

If you still cannot find your service provider, select "Can't find my provider" and upload your claim instead.

If a person is a member of more than one plan, the adjudication priority is as follows:

• The employer plan where the member is an active full-time employee
• The employer plan where the member is an active part-time employee
• The employer plan where the member is a retiree
• The individual plan that a member has purchased on their own
• The plan where the person is covered as a dependent

Some plans require a medical prescription for services or products to be eligible for coverage. You may upload your medical prescription at any time.

Important: If you prefer to mail your medical prescription, you must include your certificate number.

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If your pharmacy is not listed:

• Verify the name of the pharmacy entered matches what is shown on your receipt (e.g.: Loblaws Pharmacy, Drugstore Pharmacy, etc.)
• Try limiting your search to only one or two fields
• Try entering a partial name, using only some letters of each word per field

If you still cannot find your pharmacy, select "Can't find your provider?" and upload your claim instead.

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To understand the reason for a partial payment, select "View this claim" to review claim details.

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If you do not submit receipts for an Audited claim, we will be unable to process that claim or any future online claims.

Some members under a group plan may have a secondary card from Manitoba Blue Cross that is specific to Employee Assistance Program (EAP) coverage.

If you believe you have EAP coverage, but do not see it on your card or listed in your mybluecross account, please contact us at 204.786.8880 or 1.800.590.5553 (toll free) to confirm coverage.

An HSA can have one of two payment types: automatic or on request. To see which type your plan has, click View coverage and select Health Spending Account.  Here you can confirm the payment type, as well as:

• available coverage, including credits accrued and used
• minimum payment amount
• benefit period
• claim limitation period (This is the grace period following the benefit year. Claims must be requested and received within this time frame to be eligible for payment from that benefit year’s credits.)

If you have not registered for Pharmacare, once your pharmacare eligible drug purchases for the Pharmacare year have reached a certain amount, we will send you a letter asking you to register with the Pharmacare program as a requirement of your benefits plan. (The Manitoba Pharmacare benefit year is April 1-March 31.)

If we do not receive a copy of Pharmacare's deductible letter, Manitoba Blue Cross will hold any further drug claim payments until the deductible letter from Pharmacare is received.  

You can share a copy of the letter with us by uploading it in your mybluecross account. Click Add document on the left-hand side and choose Pharmacare documents in the drop-down menu. You can also mail it to our office or fax us at 204.772.1231.

Once received, we will resume processing your eligible drug claims.

If virtual care is part of your Manitoba Blue Cross health benefits plan, you and all eligible members covered under your plan can access virtual/in-person physician care and treatment at no cost through our partner Gotodoctor. (To confirm coverage, click View coverage. If virtual care coverage is included in your benefits plan, it will be listed here.)

In addition, Gotodoctor’s network of virtual pharmacy clinics and in-person clinics provides an enhanced level of care. With over 250 locations currently available across Canada, including over 10 locations in Manitoba, you can access on-site diagnostic testing and comprehensive assessments that go beyond standard virtual care.

• If you have benefits through an employer or group, it is recommended that you contact your plan administrator to update your address.
• If you have purchased benefits through Manitoba Blue Cross or an agent, please contact us to update your address.

Coverage details vary by plan. Visit Coverage in mybluecross® to view the benefits you are covered for, benefit eligibility, dollar maximums and frequency limitations of your plan.

• An emergency ambulance is an ambulance that is dispatched from a 911 call to provide immediate care and transport to a person with an acute illness or injury.
• A non-emergency ambulance is an ambulance that provides non-emergency transport by stretcher to a person who is medically stable but requires transportation by ambulance as determined by a physician (a non-emergency ambulance provides a higher level of care than a medical transfer).
• A medical transfer is a private company (Medi-Van, etc.) that provides non-emergency transport by stretcher to a person who is medically stable.

* Manitoba Blue Cross will only pay non-emergency ambulance or medical transfer claims when a medical doctor specifies a patient is non-ambulatory and cannot be transported by any other means (e.g. regular vehicle).

Some plans require a medical referral for services or products to be eligible for coverage. Review the coverage summary under Coverage to determine whether your plan requires a medical referral for the products or services being claimed. You may upload your medical referral at any time.

• If you have purchased benefits through Manitoba Blue Cross or an agent, visit our travel plans for detailed information regarding travel and pre-existing conditions.
• If you have travel coverage through an employer or group, consult the coverage provisions within your benefit booklet or contact us.

Irrespective of pre-existing conditions, travel health benefits will never cover:

• any person travelling for the purpose of seeking medical or hospital services of any kind
• any person aware of requiring medical or hospital services
• any person travelling against medical advice.

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The Pharmacare drug benefits list is divided into three categories:

• An EDS I or Part 1 drug is a drug that is allowed by Manitoba Pharmacare under all prescribed circumstances.
• An EDS II or Part 2 drug is a drug that is allowed by Manitoba Pharmacare only when a doctor specifically indicates it is medically necessary and "Meets EDS."
• An EDS III or Part 3 drug is a drug that is not ordinarily prescribed or administered in Manitoba or a drug that is ordinarily administered only to hospital in-patients. In order to be covered for an EDS III drug, your doctor must receive approval from the Manitoba Drug Standards and Therapeutics Committee and a copy of the approval must be provided to Manitoba Blue Cross prior to prescription fill.

Contact Pharmacare for more information on these definitions. Or, confirm which category your drug belongs to by entering the Drug Identification Number (DIN) under the Manitoba Drug Formulary Lookup.

Ask your dental provider if they charge in accordance with the Dental Fee Schedule. Manitoba Blue Cross pays dental claims based on the Fee Guide set by the Manitoba Dental Association. Your employer group determines the fee guide year upon which your coverage is based. If your dentist charges more than the dental fee guide for a service, you will be required to cover the difference.

Coverage for safety glasses varies by plan. Visit Coverage in mybluecross® to view the details of your coverage or contact us.

To accommodate work schedules and concerns about confidentiality, we provide flexible scheduling. Appointments can be scheduled for days, evenings and weekends.

View account details under Manage account to confirm all eligible dependents were added during enrollment, or upon date of eligibility (e.g. marriage date, birth date).

*For over-age dependents to be considered eligible, we must receive confirmation of full-time enrollment.

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Manitoba Blue Cross is committed to protecting your benefits from fraud and abuse. One of the ways we do this is by auditing claims to confirm the accuracy of information provided. Visit Insurance Fraud and Abuse to learn more.

To resolve an audited claim, simply upload your receipt(s) and any related documents (e.g. prescription, claim statement from another carrier).

Important: If you prefer to mail your receipt(s), you must include the printed claim showing the Reference Number.

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To request payment from your Health Spending Account, select "Yes" where it says "Pay remainder from Health Spending Account."

• Visit Documents in mybluecross® to view your Explanation of Benefits statements online.
• Visit Claim history in mybluecross® to view the details of your claims.

Visit Payments history once your claim is processed to view the details of your claim payment.

To resolve an Audited claim, click the Audited claim to submit your receipt(s) and any related documents (e.g. prescription, claim statement from another carrier).

Your Manitoba Blue Cross ID card is issued in the name of the member (cardholder) only. When you first became a member, you received two ID cards in the mail and your spouse or dependents can use the extra card as needed. You can also view, print or request additional copies of your ID card in your mybluecross online account (select View or request an ID card under the user account menu). You and your spouse can also show providers your electronic card available on that page or in the Manitoba Blue Cross mobile app. (Download the mobile app from the App Store or Google Play.)

How to make a claim to your HSA depends on the payment type that you have with your plan. ‍

Automatic claim payment plan: ‍

If you have an automatic claim payment plan, you do not need to request reimbursement. Manitoba Blue Cross will automatically reimburse you for remaining unpaid balances from a previously submitted health or dental claim or when you reach your HSA’s minimum payment amount. (The exception is if you have coverage with another carrier as you will have to provide the Explanation of Benefits (EOB) before any remaining balances can be paid. You can do this through your mybluecross online account by clicking “HSA coordination” under Claims.)

On-request claim payment plan: ‍

When submitting a health or dental claim, you must request which claims you want paid through your HSA. If you do not do so during claim submission, you can still request reimbursement for outstanding balances through your HSA at a later date through one of the following options:

• Use the Request an HSA payment feature in your mybluecross online account.
• Download a Health Spending Account claim form and follow the instructions on it. and submit the form along with any necessary medical receipts and, if applicable, an explanation of benefits (EOB) to Manitoba Blue Cross:
• ~by mail
• ~through our on-site, 24-hour drop box
• ~in person at our Customer Service Centre
• ~by fax

You can obtain a Manitoba Pharmacare application here or from your pharmacist or, if outside of Manitoba, from your provincial health department.

Please complete and mail the application to Pharmacare Provincial Drug Programs, 300 Carlton Street, Winnipeg, MB, R3B 3M9, or fax it to 204.786.6634. (Dependents age 18 and over must apply to Pharmacare separately.)

Once your Pharmacare application is processed, you will receive a letter from Manitoba Health stating your deductible amount. Please share a copy of this letter with us by uploading it in your mybluecross account. Click Add document on the left-hand side and choose Pharmacare documents in the drop-down menu. You can also mail it to our office  or fax us at 204.772.1231.

For information about Manitoba’s Pharmacare program, visit the Government of Manitoba’s website.

Virtual care services are available seven days a week, including evenings and weekends. Exact hours for each day can vary based on the volume of requests.

You can book an appointment online at any time for a future date and time.

There are no charges for services covered under the public health care system.

Charges may apply for publicly non-insured services, which are guided by the College of Physicians & Surgeons of Manitoba or the applicable physicians’ association in your province. Examples of uninsured services include sick notes for work or school purposes, prescriptions for insurance claims and driver’s fitness exams. For full details on uninsured services, visit the Doctors Manitoba website* or your province’s applicable association.

*Details regarding fees and responsibilities on the Doctor’s Manitoba website are guidelines and do not necessarily denote the exact fees that may be charged for uninsured services by Gotodoctor or another provider.

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If you have benefits through an employer or group, it is recommended that you contact your plan administrator to update your information.

If you have purchased individual or family benefits through Manitoba Blue Cross or an agent, changes to account information must be requested in writing by the member. Please submit your written request and appropriate supporting documents to Manitoba Blue Cross.

Please note: ID cards are for identification purposes only and do not guarantee eligibility or payment of your claim.‍

You may submit any claim as long as the expense:

• was incurred in Canada
• is payable to you
• is for you, or
• is for your spouse or dependents (provided they have already claimed through their primary plan, if applicable).

If a portion of your trip was outside of the province, the claim is processed under the Out of Province ambulance benefit and subject to any maximums that may exist under your plan.

Visit Coverage in mybluecross® to view the claim submission requirements for an individual benefit or contact us.

In the event of a medical emergency, contact International Travel Assistance as soon as possible and have your policy number ready. Failure to contact International Travel Assistance prior to receiving treatment may invalidate coverage.

In accordance with Canada Revenue Agency guidelines, 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 will not be accepted as a substitute for a receipt.

An EDS II or Part 2 drug is a drug that is allowed by Manitoba Pharmacare only when a doctor specifically indicates it is medically necessary and "Meets EDS."

One unit of scaling or polishing (as part of a dental cleaning) is equivalent to 15 minutes of time. Make a note of how long it takes to get your teeth cleaned (excluding the time it takes for your examination, X-rays and fluoride). Discuss any discrepancies about the number of units billed with your dental office and contact Manitoba Blue Cross if you have any unresolved issues.

The Manitoba Seniors Eyeglass Program provides financial assistance towards the purchase of eyeglasses for eligible Manitoba residents aged 65 years and over. Benefits are based on a fixed fee schedule and one pair of eyeglasses may be claimed every three years (more often if a medical practitioner or optometrist diagnoses a change in vision). There is a $50 deductible on eyeglass reimbursements. If two family members aged 65 and over require glasses between April 1 and March 31, only one $50 deductible is applied. For more information about this program, contact Manitoba Health.

If you are age 65 or older, you will need to submit your claim to Manitoba Health first. Then, submit the Manitoba Health statement to Manitoba Blue Cross to claim the balance.

Employee Assistance coverage is 100 per cent — there is no deductible or co-insurance.

Changes to account information must be requested in writing from the member.

• If you have benefits through an employer or group, it is recommended that you contact your plan administrator to update your account.
• If you have purchased benefits through Manitoba Blue Cross or an agent, please submit your written request to Manitoba Blue Cross.

*Provided the change is submitted within 30 days, coverage will be effective as of date of eligibility (e.g. marriage date, birth date). If the change is submitted outside this time frame, coverage will become effective after three full months in accordance with the enrollment rules of your plan.

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If your claim submission is successful, the final screen will confirm payment details. You will receive an email notification when payment is processed. Your bank account should reflect payment within 2-3 business days.

Once registered for Manitoba’s Pharmacare program, you will not need to submit a completed application form every year. Each Pharmacare year, you will receive your updated Pharmacare deductible. You may submit this to Manitoba Blue Cross when it’s received. In some circumstances, Manitoba Blue Cross may require proof of your deductible in the future and if so, you will receive notification from Manitoba Blue Cross that we require a recent copy of your deductible.  

If you withdraw your consent for Pharmacare to automatically process your annual deductible, you should also notify our customer service centre at 204.775.0151 or toll free in Manitoba at 1.888.596.1032.

If you have any questions concerning Pharmacare and your Manitoba Blue Cross health benefits plan, please don’t hesitate to contact us.

Changes to account information must be requested in writing by the member.

• If you have benefits through an employer or group, contact your plan administrator to update your information.
• If you have purchased benefits through Manitoba Blue Cross or an agent, please submit your written request to Manitoba Blue Cross.

Provided the change is submitted within 30 days, coverage will be effective upon date of eligibility (e.g. marriage date, birth date). If the change is submitted outside this time frame, coverage will become effective after three full months in accordance with the enrollment rules of your plan.

The claim limitation period indicates the deadline to submit health or dental claims for the prior benefit year and can vary based on your plan. Refer to the Claim Submission Deadline in Coverage.

*The health spending benefit has a separate limitation period.

If you are required to pay for the services, upload your itemized receipt via mybluecross® along with a completed Ambulance/Medical Transfer claim form for reimbursement.

Note: Non-emergency ambulance and medical transfer claims must include the name of the referring physician.

Benefit eligibility, dollar maximums, and frequency limitations vary by plan. Visit Coverage to view the benefits covered by your plan.

International Travel Assistance provides Manitoba Blue Cross travellers with access to multilingual coordinators world-wide, 24 hours a day. In the event of a medical emergency, it is essential you contact International Travel Assistance as soon as possible. They will help you locate the nearest medical care, help coordinate coverage verification, and even arrange emergency evacuation (when deemed medically necessary).

An EDS III or Part 3 drug is a drug that is only allowed by Manitoba Pharmacare under special circumstances. In order to be eligible, your doctor must receive approval from the Manitoba Drug Standards and Therapeutics Committee and a copy of the approval must be provided to Manitoba Blue Cross prior to prescription fill. EDS III drugs usually fall into one of the following categories:

• The drug is ordinarily administered only to hospital in-patients but is being administered outside of a hospital because of unusual circumstances.
• The drug is not ordinarily prescribed or administered in Manitoba, but is being prescribed because it is required in the diagnosis or treatment of an illness, disability, or condition rarely found in Manitoba.
• Evidence, including therapeutic and economic evidence, is provided to the Health Minister in accordance with established criteria and supports a specific treatment regime which includes use of the drug.

No, a pre-authorization is not required for claim approval; however, to avoid unexpected costs associated with a product or service, ask your provider to send in a detailed description of the service or product with the estimated charges. Manitoba Blue Cross will then provide pre-authorization based on benefit eligibility, frequency limitations, and maximums of your plan.

• For online purchases, submit a Vision claim via mybluecross®, and include the order form and paid receipt. These are typically provided to you by email, or on the package the order came in.
• For purchases outside of Canada, provide the paid receipt and make sure that it indicates the currency of the receipt.

* All receipts require the name of the patient, the dollar amount paid, and the detailed item/service provided.

Our professional intake is available via phone 24 hours a day, 7 days a week. Contact the Employee Assistance Centre at 204.786.8880 (within Winnipeg), 1.800.590.5553 (toll-free), or 204.775.0586 (TTY). You can also reach us online.

* Calls after 7:00 p.m. will be picked up by an answering service. In the event of a crisis, you will be promptly connected with a qualified and experienced professional.

Ensure all certificates have been added to your online account. Visit Add certificates in mybluecross® to add a missing certificate to your account.

If you are covered under our National plan, your certificate is not eligible for claim submission through this application.

In accordance with Canada Revenue Agency guidelines, an HSA must be the last payer after government, employer, individual, student and spousal plans. If you have more than one health benefits plan, all claims must be submitted through all carriers first before an HSA claim can be made.

If your other benefits plan is also with Manitoba Blue Cross, we will automatically coordinate your family’s claims on an ongoing basis, provided you have notified us that you have more than one Manitoba Blue Cross plan.

If your other benefits plan is with another carrier, you must submit the claim to that carrier first, and then provide Manitoba Blue Cross with the Explanation of Benefits (EOB) statement issued by that carrier when submitting your HSA claim.

For more information about your HSA coverage, click View coverage and select Health Spending Account or contact us.

When you receive your initial deductible letter from Pharmacare upon enrollment or if we have requested an updated letter, you can share a copy of the letter with us by uploading it in your mybluecross account. Click Add document on the left-hand side and choose Pharmacare documents in the drop-down menu.

You can also mail it to our office or fax us at 204.772.1231.

There is no limit to the number of virtual care sessions available to you as part of your Manitoba Blue Cross health benefits plan. You can access care any time you need medical support.

Visit Update Direct Deposit in Manage Account to add or edit your bank account information.