The OMA Priority Insurance Program's Health Spending Account (HSA) is a flexible program that pays for eligible health and medical expenses. An HSA holds credits that can be used to reimburse a wide variety of eligible health-care services or supplies that are not already covered by OHIP or any other insurance plan.
HSA is only available to those members who opt out of Health coverage because they have health insurance coverage elsewhere or because they are over age 65.
OMA members, under age 65, who participate in OPIP and may have Health coverage through their employer's plan or their spouse's plan can opt out of the Health plan and participate in the Health Spending Account (HSA) with a $350 maximum per benefit year. Members over age 65 who participate in OPIP may also have an HSA of $500 as an alternative to health benefits.
If you are under age 65 and have opted out of Health coverage your coverage includes $350 HSA and $50,000 Critical Illness coverage.
Members who are age 65 or over and who have opted out of Health coverage are allotted $500 for their HSA.
You can claim a wide range of expenses as long as they qualify as a medical, dental or hospital expense under the Income Tax Act (Canada). HSA-eligible expenses include items such as:
Your HSA can cover expenses for yourself and your dependents, even if they are not covered under your benefits plan1.
If you do not use all of your credits in the calendar year, the OPIP HSA allows you to roll over the balance of unused credits to one subsequent year. The credits for any year can only be rolled over once. Roll-over credits will always be used first to pay claims before any new credits are used.
For example, credits granted in Year One – if not fully used in Year One – can roll forward to Year Two. If still unused at the end of Year Two, they will expire. If Year One credits are carried forward into Year Two, then eligible claims submitted in Year Two will be paid for by Year One credits first, until all remaining Year One credits are fully used.
The rules for HSA eligibility are established through the Income Tax Act (Canada) as determined by the Canada Revenue Agency. Items that do not qualify include fitness club fees, non-prescribed drugs, home gym equipment, health and wellness books, Critical Illness insurance premiums, etc.
Complete information, regarding details on eligible expense rules, can be obtained through the Canada Revenue Agency website at www.cra-arc.gc.ca.
Once you are enroled in OPIP, you can register at sunlife.ca/member to submit HSA claims electronically or print claim forms.
To learn more about the my Sun Life mobile app visit
If you don’t have the my Sun Life Mobile app you can still file a claim by completing an Extended Health Care and Health Spending Account Claim Form.
1 A dependent for the purposes of the HSA is your spouse, your children or any other person whom you may claim as a dependent under the Income Tax Act (Canada). For example, this could include members of your extended family, such as your parents, grandparents or grandchildren.