Benefit Coverage Through Your Spouse's Plans

You have a real advantage if your spouse has health insurance coverage through their employer.

  • Any payroll deductions for medical and dental coverage that your spouse pays may be claimed through your health spending account. Submit a copy of the pay stub showing deductions or an annual letter from their employer with your claim form.
  • Any claims paid by your spouse’s insurance plan can be toped-up through your health spending account. Submit a copy of the explanation of benefits (EOB) with your claim form.

The key to making this work in your favour is to make sure that your spouse’s plan administrator understands that you have a health spending account and not an insurance plan.

  • If your spouse is asked if you have health insurance coverage through your employer, the correct answer is NO.
  • If your spouse is asked if you have health benefit coverage through your employer, a much longer answer is required. The answer is that you have a health spending account and that according to page 4 of the Canadian Life and Health Insurance Association Inc. Guideline G4 - Coordination of Benefits , claims should be submitted to a health spending account only after claims have been made through all other group insurance plans.
  • Submit all claims to your spouse’s plan first and then then send whatever hasn’t been paid to this plan.