The Benefit Booklets provided below are the official documents which outline benefit coverage. There are other tools available, such as the Drug Lookup Tool provided on the Sun Life website (www.mysunlife.ca), that may help you with understanding whether specific items are covered. While the Drug Lookup Tool is a convenient feature, it currently provides information about pay-direct drugs only. Other drugs, such as vaccines which are not available through the pay-direct card and have to be submitted with a paper claim, are not included in the Drug Lookup Tool.
Sun Life regularly looks at the claiming and administrative practices of medical and dental healthcare service providers and pharmacies. Sometimes, the review will lead to delisting. If you receive healthcare services or supplies from a delisted provider, Sun Life will not reimburse you for your expenses. You can still choose to obtain services or supplies from a delisted provider; however, your claim will be denied. You can see a list of providers by province by logging into your My Sun Life account. You are encouraged to check this list before you make an appointment, so you don’t unknowingly use a delisted provider. Additional information can be found here.
To understand your benefit plan coverage, refer to the appropriate booklet below. If you have questions about your benefit plan provisions and would like to enquire about available coverage for specific items, you can also contact Sun Life at 1-800-361-6212. In the event of any discrepancy or inconsistency of information, the Benefit Booklets will govern.