How to file a claim
The claim procedures vary according to the type of expense, as follows:
Concordia provides a practical and convenient drug card handled by Desjardins Financial Security.
Drugs
The card offers lots of advantages.
- There are no forms to complete.
- You know right away your portion of the drug’s cost and the plan’s portion of costs, too.
- The back of the drug card includes the telephone numbers of Sigma Assistel, which provides assistance 24 hours a day, seven days a week, in the event of medical emergencies while travelling outside your province of residence.
Want to know more?
The drug card applies for a wide range of prescription drugs, including those appearing on the formulary of the Régie de l’assurance maladie du Québec (RAMQ).
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If you are under age 65 |
If you are age 65 or over |
| 1 |
Give your card with your prescription to any participating pharmacist in Canada. |
Give your card with your prescription to any participating pharmacist in Canada. |
| 2 |
If your pharmacist asks you, your card is labelled a “deferred-payment” drug card. |
If your pharmacist asks you, your card is labelled a “direct-payment” drug card. |
| 3 |
Within seconds, this data is electronically processed. |
Within seconds, this data is electronically processed. |
| 4 |
You pay the total cost of the claim to the pharmacist. He or she will give you a receipt showing your portion of the cost and the plan’s portion. Do not submit your receipt to Desjardins Financial Security for reimbursement. Your claim is submitted automatically. |
You pay the total cost of your share of the claim to the pharmacist. He or she will give you a receipt showing your portion of the cost you have to pay, i.e., the deductible and coinsurance. |
| 5 |
You have no claim form to complete. You will receive a reimbursement cheque from Desjardins Financial Security upon the earlier of:
- 30 days; and
- when your accumulated unpaid reimbursement amounts reach $50.
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Desjardins Financial Security will automatically pay the other portion of your claim. You have no claim form to complete |
Get directly involved in managing the cost of the plan. By asking your doctor about less expensive therapeutic options or your pharmacist about generic options that cost less than brand-name drugs, you-and the plan - save money. This, in turn, helps keep your premium rates lower.
All participants (except part-time faculty who enrolled in the RAMQ Drug Equivalent Plan) can use the card.
Their eligible dependents can also use the drug card, provided you complete the Registration of Eligible Dependents form and return it to Benefits Services. All health insurance claims are handled based on the information provided on this form. Claims for dependents who are not properly registered will not be paid.
You must advise Benefits Services promptly of any changes to your covered dependents. No claims will be paid for any dependent that has not been properly registered under the plan.
The drug card will not work if:
Please note that if you reach age 65, your deferred-payment drug card will no longer work. However, you will be entitled to a direct-payment drug card.
In these instances, except if your spouse and dependent children are covered elsewhere, you must follow the same claims procedure as for non-RAMQ drugs.
If your spouse and dependent children are covered elsewhere, you may be able to claim a portion of their medical expenses under that plan.
Call Desjardins Financial Security at:
All expenses other than drugs
- Ask the hospital to send the bill for all expenses not covered by your provincial health plan to Desjardins Financial Security, or you can submit the claim yourself.
- Desjardins Financial Security will reimburse the hospital for all eligible expenses, according to the applicable percentage of reimbursement.
- You must pay the hospital directly for all expenses not eligible for reimbursement.
- For all eligible expenses not submitted electronically, keep all receipts for the medical expenses of each covered individual.
- Once the accumulated expenses exceed the deductible, complete a Desjardins Financial Security claim form.
- Complete the form, attach the original receipts, and send everything to Desjardins Financial Security, at the following address:
Desjardins Financial Security
Dental and Health Claims
P.O. Box 3950
Lévis, QC G6V 8C6
Eligible expenses for you and your dependents will be reimbursed directly to you.
When to file a claim
Claims must be submitted within four months following the benefit year in which the eligible expenses were incurred.
If your insurance ends for any reason, all claims must be submitted within 90 days of the date your coverage ends.
In the event of an accident, you must send written notice to Desjardins Financial Security within 30 days after the accident.
No action or proceedings may be initiated against Desjardins Financial Security for the recovery of any claim within 60 days or after three years following the expiration of the time in which proof of claim is required.
Submitting a claim
Since the insurer receives your eligibility information after the enrolment period has ended for each benefit year, it can only reimburse claims once it has processed this information. You may still submit claims during the first two months, but they will only be handled afterward. The drug card will not work during this period.
To make sure the insurer has the right information on file and can continue covering you and your dependents, please keep Benefits Services informed of any changes in personal data on you and your family.
When an eligible life event occurs, you can modify your benefit choices within 60 days following the event.
Eligible life events include a new spouse, having a baby, divorce or legal separation, and the loss of your spouse’s coverage where he or she works. Please be aware that changes presented within 60 days of the event will become effective on the exact date of the event. Evidence of insurability may be requested when changes are presented more than 60 days after the event.
If you wish to cover any dependent children who are full-time students age 21 or over and who depend on you for support, you must complete the section on Dependent Information on the enrolment form.
This confirmation of full-time school attendance is required once a year and is valid for a full school year from September until August 31 of the following year.
If proof of full-time school attendance is provided for any session other than the fall session starting in September, that proof will be valid only until the end of the benefit year; new proof of full-time school attendance will be required again in the following year.
