Health Care Spending Account -- good news

Hey all 

Good news for those of you who have gone/are going to Mexico for surgery if you have a Health Care Spending Account with Blue Cross. (This might also apply to those of you who have had to pay out-of-pocket for things when you've  gone out of the province, but I don't know how that works.)  My husband and I were both notified of direct deposits by Blue Cross today.  They paid out the full amount of mine and my husband's Health Care Spending Accounts.  

The person processing the claim to my husband's plan wanted a receipt showing how much Manitoba Health paid towards the surgery (obviously nothing).  I had to send my receipt to Manitoba Health to get a letter of denial.  I sent that three or four weeks ago and just received the denial letter today.  

The person processing the claim to my plan requested a "prescription" from my doctor. (I only received that notice a little over a week ago.)  My doctor wrote me a one-line note that stated I needed VSG surgery for morbid obesity.   I mailed a copy of that letter to Blue Cross last week and it obviously satisfied both plans.

So, if you are in that situation, maybe you could ask for a note from your doctor ahead of time and send that off with your receipt and save some time in receiving your money.   

Thanks for the info Dianne..I am in that boat so I will definitely get the papers together ahead of time. Don't want to wait any longer than I have to for that money.

Dianne, I have a health care spending account. I want to use it towards plastics. I was told that they would borrow against my health care spending account but didn't understand how it work.

Hi Michelle 

I don't know if all HCSAs are the same, but for ours, we have to submit receipts for services we have already paid for.  From my understanding, our HCSAs cover anything that is an eligible health care deduction on your income tax.  I'm not sure if plastic surgery would be eligible unless it was medically necessary.  CRA removed cosmetic surgery as a qualifying medical expense a few years ago.  It's certainly worth checking into with Blue Cross and Revenue Canada, though. 

Thanks :)

 Just a question, how much does Blue Cross cover? And how does a spending account work exactly? Do you just sign up for a plan and it is included or is it something that is built up over the life of your plan? I have coverage through my and my husband's work but if Blue Cross is going to cover the costs of the surgery, or at least parts of it, then it is worth the switch.

Thanks in advance!

Hi 

The Health Care Spending Accounts are part of our Blue Cross plans through work.  We're allotted a certain amount per year that can be used to cover expenses our regular Blue Cross coverage doesn't cover (ie, extra prescription costs, extra dental costs, eye glasses, etc.).  If the HCSA isn't already included in your Blue Cross plans through work, I don't think there's any other way to get it.  

I've used up most of mine this year, but I might look into how much is left and is it worth it.

Revenue Canada will cover plastic surgery if it corrects a deformity . I would think that removing skin and repairing muscle in the tummy would count... This is from their site....

• cosmetic surgery - expenses for purely cosmetic procedures including any related services and other expenses such as travel, incurred after March 4, 2010, cannot be claimed as medical expenses. Both surgical and non-surgical procedures purely aimed at enhancing one's appearance are not eligible. These non-eligible expenses include the following:
  • liposuction;
  • hair replacement procedures;
  • botulinum injections;
  • teeth whitening
  An expense, including those identified above, may qualify as a medical expense if it is necessary for medical or reconstructive purposes, such as surgery to address a deformity related to a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease.

In connection to health care spending, let me share that the Institute of Medicine, part of the National Academy of the Sciences, has compiled a report detailing developments in health care spending. Among other findings, the IOM found that an enormous quantity of cash is down to healthcare waste, or on anything but helping patients. Healthcare waste, including unneeded treatments and administrative overhead, makes up about $750 billion each year. I guess, some of you already heard about this.