Should I submit an ADHD assessment estimate to Sun Life before I pay in BC?

Submitting an ADHD assessment estimate to Sun Life before you pay in British Columbia is often a practical way to learn what your specific booklet will consider, but it is not required by MSP, and a predetermination is not a guarantee of payment. Many group extended health plans let members send a predetermination or pre-authorization for a large psychology or paramedical expense so the insurer can apply the plan’s provider rules, annual maximum, and any exclusion for educational testing. Sun Life plan designs differ by employer, so the member site or the booklet, not a community post, is the source for whether your plan offers that step. Ask the clinic for a written estimate that lists the psychologist’s name and credentials, the type of assessment, and the fee. Send that to Sun Life with your certificate number and ask them to confirm in writing what, if anything, would be eligible if the service is performed as described. Rules, coverage and referral pathways vary by province and can change; confirm the current position with the relevant institution or provincial program. References: https://www2.gov.bc.ca/gov/content/health/accessing-health-care/bcs-primary-care-system/provincial-attachment-system

This is only my personal experience with Sun Life in B.C. I emailed the clinic estimate before I paid. They sent back a predetermination showing my remaining psychology maximum would cover only a slice of the ADHD assessment. I waited and budgeted the rest. I am not saying every Sun Life member must do this or that the written estimate always matches the final cheque.