OPIP - Health Spending Account
OPIP - Health Spending Account
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.
A Health Spending Account is only available to those members who opt out of Health coverage because they have health insurance coverage elsewhere.
What is the advantage of a HSA?
An HSA can be used to pay for a wide range of expenses as long as they qualify as a medical, dental or hospital expense under the Income Tax Act (Canada); up to the dollar limit of the HSA.
The annual cost for members with a Health Spending Account is $230— this amount is due on January 1st. Members with Critical Illness and a Health Spending Account will have their annual Critical Illness premium withdrawn from their bank account in 12 monthly payments.
How much is in my HSA?
OMA members 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).
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.
What is covered?
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:
- Health and dental deductibles/co-insurance payments or expenses above maximum coverage limits.
- Premiums for other health insurance plans (e.g., Extended Health Care, Dental Insurance).
- Dental care services, including exams, fillings, extractions and orthodontic services.
- Eyeglasses, contact lenses, laser eye surgery.
- Services of health-care providers, including physiotherapists, registered massage therapists, chiropodists, chiropractors, speech therapists, psychologists, etc.
Who is covered by my HSA?
Your HSA can cover expenses for yourself and your dependents, even if they are not covered under your benefits plan1.
Carrying unused credits forward
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.
Download the my Sun Life Mobile app
With the app you can:
- Submit claims
- Check your coverage details
- View your balances
- Access your coverage cards
- Take a screenshot of your coverage cards and keep them handy for whenever you're off the grid; or
- Save your coverage cards to the Apple Wallet* of your iPhone* for quick and easy access;
- Search for health-care providers, view ratings of and request appointments using provider search;
- Use your smartphone camera to scan the Drug Identification Number (DIN) to get information of a drug and its alternatives;
- Call Sun Life from the app – your plan details are linked to the call through the app;
- Find exclusive savings with marketplace. Browse through money-saving offers that include vision, fitness, wellness, food and nutrition.
To learn more about the my Sun Life mobile app visit sunlife.ca/mobile.
For details on converting between Health and Health Plus, see your benefits booklet or contact one of our OMA Insurance Service Representatives who will be happy to help you.
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.
* Apple Wallet, iPhone and App Store are trademarks of Apple Inc., registered in the U.S. and other countries. Google Play is a trademark of Google Inc.