Scope
Introduction
At locations outside Canada, doctors, dentists and hospitals may not be prepared to wait for payment from medical, dental or hospitalization insurance plans. Accordingly, where the employee can demonstrate eligibility for future reimbursement for health care or dental expenses, either from the Public Service Health Care Plan or the Public Service Dental Care Plan or pursuant to the Foreign Service Directives, the employer will make an advance to the employee for the purpose of paying medical or dental expenses.
The intent of this directive is to provide financial support for larger expenses, rather than for routine medical and dental expenditures.
Please refer to the Instructions and Guidelines at the end of this Directive for additional information or greater clarification of certain sections.
Directive
42.1 Application
(Note: Refer to Instructions and Guidelines)
42.1.1 Where an employee incurs expenses for health and/or dental care and is eligible for reimbursement either from the Public Service Health Care Plan or the Public Service Dental Care Plan or pursuant to the Foreign Service Directives, the deputy head may authorize an advance to the extent of such expenses. Such advances shall be authorized only:
(a) where the advance is not less than $200; and
(b) where, subject to subsections 42.1.3, 42.1.4 and 42.1.5, the employee agrees to repay the advance within 6 months; and
(c) where the employee submits an estimate of costs from the doctor, dentist or hospital representing 90% of the advance requested, when the amount of the advance exceeds $500; and
(d) on condition that the employee undertakes in writing on the Medical and/or Dental Expense Advance form to endorse and remit to the Receiver General for Canada any cheque issued by the underwriters or by the employer under the provisions of another foreign service directive in reimbursement for the medical or dental expenses for which the advance was authorized; and
(e) in the case of an advance for dental expenses for dependants not covered by the Public Service Dental Care Plan (PSDCP), employees may be asked to provide proof of coverage.
42.1.2 Except as provided in subsection 42.1.5, where, for any reason, any cheque issued by the Plan Administrator or by the employer under the provisions of another foreign service directive in reimbursement for the medical or dental expenses for which the advance was authorized is not endorsed and remitted to the Receiver General for Canada by the employee, such advance shall be repaid upon receipt of such settlement.
42.1.3 Except as provided in subsection 42.1.5, where an employee who has received settlement from the Plan Administrator or from the employer, fails to repay any outstanding portion of the advance within 60 days of the date(s) on which the settlement cheque(s) were issued, such outstanding portion of the advance shall be subject to recovery pursuant to the relevant provisions of the Financial Administration Act.
42.1.4 Except where provided in subsection 42.1.5, where an advance has been authorized under this directive, the employee shall ensure that a claim under the Public Service Health Care Plan or the Public Service Dental Care Plan is submitted as soon as possible, notwithstanding the time requirements that the plans have in place for accepting claims. In the event that a claim is rejected under the plan because of lateness, the employee may not claim under FSD 39 of these directives and shall be responsible for full repayment of the advance, which shall be subject to recovery pursuant to the relevant provisions of the Financial Administration Act. (Note: Refer to Guidelines)
42.1.5 An extension of the repayment period may be granted where the deputy head is satisfied that exceptional circumstances beyond the reasonable control of the employee prevent an employee from repaying the advance granted pursuant to subsection 42.1.1 within the required period.
Instructions
Instructions for 42.1 - Application
1. Provisions related to the financing of advances made under subsection 42.1.1 are contained in Appendix B to FSD 10 - Posting Loan.
2. In order to protect employees from exchange rate fluctuations, advances may be calculated and reimbursed in Canadian dollars or in some other currency, where this is the currency used in all of the following:
(a) the estimate of costs from the health care provider submitted by the employee in support of the medical/dental expense advance;
(b) the payment for services for which the advance was approved; and
(c) the reimbursement of the employee's claim of insurance.
3. The deputy head has delegated authority to the Head of mission to approve and monitor all medical/dental advances for employees at their mission(s) of responsibility. It is the HOM's responsibility to ensure the legality and suitability of the currency in which the advance is requested, where this is not Canadian dollars. In the case of an advance to the HOM, authority must be sought from the FSD Policy and Administration Division, DFAIT.
Guidelines
Guidelines for 42.1 - Application
1. An employee shall not be eligible for an advance for medical expenses incurred following relocation to Canada when the hospital, doctor or other health care facility is prepared to await settlement from the employee's provincial or other medical insurance plan.
2. The period during which an employee is eligible to receive an advance for medical expenses incurred following relocation to Canada shall terminate on the date on which the employee's provincial medical insurance plan number is reinstated.
3. A medical advance should not be necessary where an employee returns to Canada during an assignment for health/medical care, since health care facilities may bill the Plan Administrator directly. To arrange this, the employee should call 1-800-667-2883. If it can be demonstrated that the health care providers will not accept direct billing to the Plan Administrator, a suitable advance shall be issued.
4. Ontario and some other provinces permit immediate reinstatement to the provincial plan for foreign service personnel returning to Canada.
Guidelines for 42.1.4 - Application
1. Currently, under the PSHCP, employees must file claims with the Plan Administrator no later than six months following the end of the calendar year in which the expense was incurred.
2. In the case of the PSDCP, claims must be submitted to the PSDCP Administrator (currently Great West Life) within 15 months of the date of service.
Forms
TB 330-18 - Medical and/or Dental Expense Advance
TB 330-19 - Medical and/or Dental Expense Advance Request for Extension