Frequently Asked Questions: Personal Health Plans

Using your member portal or mobile app is the most convenient way to submit claims. Learn more here.

For Travel Claims, please refer to the Travel Assistance & Claims section here.

As a not-for-profit organization, we take great care in ensuring that our Personal Health Plans continue to be among the most affordable and sustainable in Saskatchewan. The rates you pay go towards claims, service and administration costs – not profit margins.

Annually, Personal Health Plans undergo a rate review to adjust for factors including general inflation, the cost of health care and paramedical services for all Saskatchewan members on our Personal Plans, and enhancements to the benefits and service options offered to you.

Personal Health Plan pricing is also aligned to 10-year age increments, providing greater stability in your plan pricing over time. Rate adjustments occur when you enter a new age group, and can be a contributing factor in your renewal rate.

Our rates are determined by the following age brackets:

Blue Choice®, Conversion, and Guaranteed Acceptance

Under 35 | 35-44 | 45-54 | 55-64 | 65-74 | 75-84 | 85+

Retiree

50-64 | 65-74 | 75-84 | 85+

For Personal members: You can apply to add your child and/or partner to your policy by completing the Personal Health Plans Application here. 

For Group plan members: Please contact your plan administrator to inquire about adding your partner and dependents. 

Learn more about managing your plan here. 

The Blue Choice®, Conversion, Guaranteed Acceptance and Retiree plans provide coverage for health benefits above the provincial plan, such as hospital accommodations, emergency ambulance services, health practitioners like massage therapy, and many more! Please contact our office at 1-800-667-6853 and a member of our team would be happy to discuss further details. 

For Blue Choice® and Guaranteed Acceptance plans: Your coverage begins on the first day of the month following the approval of your application and the receipt of your payment. 

For Conversion and Retiree plans: Apply and secure coverage that starts within 90 days of leaving an employer benefits plan and experience no interruption in coverage. 

You’ve reached the retirement milestone, congratulations! Our Retiree Plan is designed to support you through this important and exciting transition. Coverage must begin within 90 days of your group benefits ending and the Retiree Plan offers no interruption in coverage, no waiting periods, and no medical review. 

Designed with flexibility in mind, the Retiree Plan allows you to tailor your coverage to match your lifestyle, health goals, and budget—making your transition into retirement simple and stress-free.

Are you ready to design a Personal Health Plan that fits your needs and lifestyle? Apply today! 

You may choose pre-authorized monthly debit from a bank account or pay annually using your credit card.

When you are covered under more than one health plan, you can enjoy the benefits of both. Submit your claim under one plan, and then submit the remainder of that claim (for example, the remaining 20% of a claim that is covered up to 80%) to the other plan. Learn more here.

Yes! Sign up for direct deposit using your member portal or SK Blue Cross Member App.

If you have signed up for direct deposit, eligible reimbursement will be direct deposited into your bank account and the funds should appear in your bank account within 1-3 business days from time of processing.

If you haven’t signed up for direct deposit, you’ll receive a cheque in the mail. To get your money back faster, sign up for direct deposit.

Claims adjudication (i.e. whether a benefit is paid, declined, or limits applied) is based on the provisions in your Personal Health Plan Policy. These can include co-insurance amounts, dollar maximums, frequency limits, fee schedules, exclusions, and/or usual, reasonable, and customary limitations.

Pharmacies and Dentists can direct bill Saskatchewan Blue Cross in real-time using an electronic submission method.

For all other claims, your wait time will depend on the type of claim, how it was submitted, and our current claims volume. Our standard turnaround time is 3-5 business days from time of receipt. For the simplest process and quickest turnaround time, we encourage you to register for the member portal or mobile app.

The Blue Choice, Conversion, Guaranteed Acceptance and Retiree health plans provide coverage for health benefits above the provincial plan, such as hospital accommodations, emergency ambulance services, health practitioners like massage therapy, and many more! Please contact our office at 1-800-667-6853 and a member of our team would be happy to discuss further details.

You can view your balances through your member portal or the SK Blue Cross Member App or by calling our Member Experience Centre at 1-800-667-6853.

For Personal members: Our Personal Health Plans include coverage for diagnosis or treatment by the following health practitioners:

• chiropractor
• chiropodist/podiatrist
• physiotherapist/athletic therapist
• registered massage therapist
• psychologist/counsellor/social worker
• naturopath
• acupuncturist
• speech-language pathologist

When a profession is regulated in a specific province/territory, we will confirm that the health practitioner is listed in good standing with the regulatory body that governs that profession. However, not all healthcare professions are regulated in every province/territory in Canada. As a result, some healthcare professions have developed associations which have varying membership requirements. Such associations are evaluated against established criteria to determine if their members will be approved providers with Saskatchewan Blue Cross.

We recommend you contact our Member Experience team to ensure expenses for services or supplies from a specific health practitioner are eligible for coverage before the expenses are incurred.

For Group plan members: Please refer to your member portal, mobile app or employee benefits booklet for details on what your plan covers.

Your member portal and mobile app give you a centralized platform to view your coverage benefits. Follow the steps in the video below:

You can also find information in your Personal Health Plan policy booklet or Employee Benefits booklet.

If you’re unable to find the information you’re looking for, contact our Member Experience team at 1-800-667-6853.

You can use your member portal or app to get 24/7 access to view your benefit plan details, along with many other self-serve features.

You can submit an estimate into our office in the same manner you would submit your claims (through your member portal or app, online directly through our website, in person or by mail).

The Special Support Program (SSP) is designed to help those whose drug costs are high in relation to their income. This program is available to residents of Saskatchewan that hold valid Saskatchewan Health. Based on family income and the drugs that are used in a year, Saskatchewan Health determines the level of coverage they will provide. This program is family-based and everyone is eligible to apply for this coverage.

Personal Health Plans are annual plans; as such, payment must be made either annually by cheque or credit card, or monthly by automatic withdrawal.

Yes, however you will need to complete a new application for coverage at that time. Coverage for Blue Choice® Health Plans is evaluated and offered based on your medical history, which means we cannot guarantee that you would receive the same offer when you re-apply.

Saskatchewan Blue Cross Personal Health Plans are a great fit for entrepreneurs with fewer than 3 employees. By offering a health plan for yourself and your employees, you can ensure that your employees' healthcare needs are taken care of without impacting your operations.

As a sole proprietor, a Personal Health Plan serves as a tax deductible expense on your personal tax return. Deductibility is limited to $1,500 for each self-employed person.

If you’d like to offer Personal Health Plan coverage for yourself and your employees, each person should apply for their own Personal Health Plan. You as the business owner can decide how much coverage you’d like to offer, or how much of the plan premium you’ll reimburse for your employees. For more information, please contact us.

The Guaranteed Acceptance Personal Health Plan is available to any resident of Saskatchewan with a valid Saskatchewan Health Care Card. There is no age restriction or timeframe requirement (after leaving another benefits plan) applicable. There is no review of medical history required.

If you'd like to apply for the Guaranteed Acceptance plan, you can apply online here, contact our Member Experience team at 1-800-667-5853, or reach out to your insurance advisor for assistance. and a Saskatchewan Blue Cross representative can assist them with their application and provide an offer for coverage.

The Guaranteed Acceptance Personal Health Plan is a comprehensive package, bundling our most popular benefits:

• Core health (20+ benefits)
• Prescription drugs up to $1500
• Dental
  • 80% for Basic services & 50% for Major services
  • Combined maximum of $1500 per policy year
• VIP Travel

Click here to compare the benefits included in the Guaranteed Acceptance plan to other plan options.

The Guaranteed Acceptance Personal Health Plan is designed to cover anyone who needs health insurance, regardless of their medical history or what stage of life they're in.

The plan bundles our most popular benefits, providing comprehensive, affordable coverage.  These benefits include core health, prescription drug, dental and VIP Travel coverage. No changes can be made to the coverage offerings, including reductions of coverage amounts or excluding benefits.

Click here for a complete review of the benefits included in the Guaranteed Acceptance personal health plan.

Premiums for the Guaranteed Acceptance plan are calculated using the age of the eldest member on the policy and the number of family members that will be covered.  Premiums are designed to focus on our members' needs, providing coverage for a range of benefits that will aid their pre-existing conditions while still being competitive in the market.

Get a quote for coverage here.

The Retiree Plan is available to residents of Saskatchewan aged 50 and older who are nearing retirement, or have recently retired, and are leaving a group benefits plan. Coverage under the Retiree Plan must begin within 90 days of the date on which you lost coverage through your employer benefits plan.   

Retiree Application Requirements

• Applicants must be at least 50 years of age and have retired within the last 90 days, losing group benefits coverage.
• Applicants must also be residents of Saskatchewan.

There are no upper age limits, and all benefits remain available regardless of age.

Not at this time. The Retiree Plan is only available to members who have retired and lost coverage through a group benefits plan in the past 90 days.

The Retiree Plan provides essential coverage tailored for retirees. Each plan includes health benefits, travel insurance, prescription drug coverage, and optional dental care. Each benefit module has three levels of coverage to choose from, offering 36 possible plan combinations to fit different budgets, health and wellness goals, and lifestyles. 

Core Health Benefits: 

✔ Hospital accommodations
✔ Vision care (eye exams, glasses, and more)
✔ Ambulance services 

✔ Mental wellness benefits (access to counselling, online resources, and more)
✔ Virtual Care
✔ Mobility aids and walkers
✔ Accidental dental 

Travel Benefits: 

Travel coverage is as a core offering within the health benefits, with coverage for a minimum of 30 days per trip and up to $5 million for emergency medical services. The level of travel coverage matches the coverage level selected for core health. 

Prescription Drug Benefits: 

Prescription drug coverage is included in all plans, with flexibility in choice based on individual needs. There are three coverage levels to choose from, with varying benefit maximums and the option to select coverage for medications that extends beyond drugs listed on the Saskatchewan Drug Plan Formulary. 

Dental Benefits (optional): 

The dental portion of the plan is an optional benefit that supports affordability and flexibility.

Full Plan Details

You’ve reached the retirement milestone, congratulations! Our Retiree Plan is designed to support you through this important and exciting transition. Coverage must begin within 90 days of your group benefits ending and the Retiree Plan offers no interruption in coverage, no waiting periods, and no medical review. 

Designed with flexibility in mind, the Retiree Plan allows you to tailor your coverage to match your lifestyle, health goals, and budget—making your transition into retirement simple and stress-free.

Are you ready to design a Personal Health Plan that fits your needs and lifestyle? Apply today! 

If you'd like to apply for the Retiree Plan, you can apply online or contact our Member Experience team at 1-800-667-5853. 

Yes, the Retiree Plan is a guaranteed acceptance plan that provides coverage for essential health needs that retirees may not secure elsewhere. Upon application, there is no medical questionnaire, with guaranteed coverage.  

A 90-day stability clause applies to emergency medical travel coverage. This means that there is no travel coverage for medical conditions that are not stable for the 90 days before your trip’s start date.