Submitting a Claim

Our plan provides a drug card, so you will not need to submit a claim. Simply present your drug card to the pharmacist when filling a prescription and the pharmacist will submit your claim electronically on your behalf. If you do not use your drug card when picking up a prescription, you will need to pay for your prescription and then submit a claim for reimbursement in the same way you submit other types of paper  health claims (see below).  Alternatively you can go to nexgenrx.com then go to the member login page.   Upon initial eligibility, you will receive a username with your benefit card and a temporary password is mailed separately.  Once you are registered, you will be able to view your claim history and file many claims yourself.  Be sure to keep copies of all receipts as you may be audited by NexgenRX  and you will be responsible for any payments for which no receipt is provided.

You can find a Health Claim Form here.

Ensure that all sections of your claim form are complete, signed by the plan member and that you attach your receipts and submit to the address on the claim form. Alternatively you can go to nexgenrx.com then to the member login page.   Upon initial eligibility, you will receive a username with your benefit card and a temporary password is mailed separately.   Once you are registered, you will be able to view your claim history and file many claims yourself.  Be sure to keep copies of all receipts as you may be audited by NexgenRX  and you will be responsible for any payments for which no receipt is provided.

If you’re claiming expenses for a spouse or child, be sure to show their name and relationship to you, and show the name of your spouse’s plan sponsor or employer or your child’s post secondary institution if your child is an over-age dependent.

Staple receipts to your claim form before mailing, including the pharmacy receipt, not just the cash register receipt.

For paramedical services, such as chiropractors, physiotherapist, massage therapists, etc (see full list in booklet)  be sure that their registration or licence number is on their invoice.  These providers may also file electronically on your behalf(fastest for repayment)  and you may be able to assign reimbursement payment directly to them, or you may be required to pay initially and be reimbursed yourselves.  Click here for required form.    Note: Massage Therapy also require a referral from your physician.   Staple receipts to the paper claim form and submit with a claim form to the address provided on the form.

You can obtain a Dental Claim Form from here.

It is common for dental offices to submit your claim electronically on your behalf. Some dental offices choose not to send claims electronically, but may provide a claim form from their computer system with their portion already complete. You then simply complete your portion, sign the form and submit it for payment. If your dentist does not provide this service, click the dental form link above. Take it along with you when you visit your dentist, then make sure that all portions are fully completed to avoid delays in paying your claim.