Going out of country? Take your benefits card with you
Vacation is meant to be a time of family fun and adventure. Unfortunately, unexpected sicknesses and accidental injuries can happen at any time.
Your Employee Life and Health Trust (ELHT) benefits plan includes Out-of-Province/Out-of-Canada coverage*. The goal of this coverage is to stabilize the medical condition and return the patient to their home province.
The emergency medical insurance provider, Allianz Global Assistance, offers immediate assistance to you, 24 hours a day and 7 days a week.
*If you participate in the Extended Health Care benefit, it includes the Out-of-Province/Out-of-Country coverage.
Travel medical emergency:
A sudden, unexpected injury or a new medical condition which occurs while you or your eligible dependant (e.g. spouse/child) is travelling outside of his/her province of residence, or
A specific medical problem or chronic condition that was diagnosed but medically stable prior to departure.
A medical emergency ends when the attending physician feels that, based on the medical evidence, a patient is stable enough to return to his/her home province or territory.
What your ELHT benefits plan covers
Your ELHT benefits plan provides coverage for treatment required due to a medical emergency that occurs during the first 60 days while the patient is temporarily outside the province of residence. The patient receiving the treatment must also be covered by a government health insurance plan (e.g. OHIP in Ontario, RAMQ in Quebec, Manitoba Health in Manitoba).
Up to a maximum of $5 million per lifetime, the coverage may include expenses for eligible physician and ambulance services, hospital accommodation, trip interruption/delay and other types of hospital-related fees. You can check your benefits booklet for details on what is covered in the Out-of-Province/Out-of-Canada section.
The ELHT Out-of-Province/Out-of-Canada coverage does not:
- Replace government health insurance plan (i.e. it does not cover routine medical care like a doctor’s visit)
- Allow for ongoing treatment, regardless of member’s travel plans
- Allow for elective, alternative or experimental treatment
- Cover trip cancellation
Travelling within Canada
When you show your valid health card in another Canadian province or territory, you will be covered for some of the same services you’re covered for in your province of residence. Any service or treatment you receive in another Canadian province or territory must be medically necessary for it to be covered by your government health insurance plan.
Before you go
- Review your Out-of-Province/Out-of-Canada coverage provided in your ELHT benefits plan.
- Determine if you need extra travel insurance.
- Contact OTIP Benefits Services for any questions on medically stable requirements. <Link medically stable to NEW ARTICLE “Are you medically stable enough to travel?”>
- Discuss your pre-diagnosed medical condition(s) with your doctor before travelling (if applicable) to determine if there is any risk of complications. (NOTE: There is no guarantee of coverage for a pre-diagnosed condition or any condition. Claims are assessed at the time of claim and based on the information provided at that time.)
- Just in case you need to call for emergency medical assistance, find out the country code of the place you are travelling to.
- Share your itinerary and emergency travel assistance information with a family member or your emergency contact person who is not travelling with you.
- Pack your benefits card and have it handy. On the back of your benefits card, you will find your plan number and the phone numbers below to call for help.
In an emergency, call for help
In the event of an emergency, you, your family member or travelling companion must call Allianz as soon as possible, either during or immediately following the emergency. It is important to make the call using a landline phone if possible as your mobile phone may not work.
The 24/7 emergency medical assistance contact centre provides immediate assistance to travellers in their language of choice with:
- Referral to local medical care and/or legal assistance
- Monitoring of medical care
- Paying medical bills where possible
- Arranging medical transportation for the patient
- Return home of dependent children
- Communicating with family members
- Assisting with replacing lost or stolen travel documents or tickets
- Arranging for the return of a vehicle
- Returning the remains of the deceased traveller
Be sure to check your benefits booklet for complete details on what is included in the Medical Emergency Assistance section.
When you return home
Travel claims less than $200 CAD must FIRST be submitted to your government health insurance plan for reimbursement. For OHIP, you can complete the Out of Province – Country Claim Submission form. Once you have a decision or response from OHIP and still need to submit your claim to your ELHT benefits plan, you can complete and submit the Out-of-Province/Out-of-Country Claim form (found at www.otip.com/forms) and include OHIP’s claim statement.
Travel claims over $200 CAD are paid directly by Allianz where possible and the appropriate provincial plan. However, if you are required to pay “up front”, be sure to ask for an itemized bill from the service provider.
To minimize delays in claim processing, the following supporting documents (if applicable to your emergency medical situation) may be required for review:
- Itemized bill/invoice from the service provider
- Release of medical records
- Treating physician records from destination
- Primary care physician records
- Government health insurance plan records or claim statement
If you have any questions regarding the travel claims process, understanding a claim decision, or need a status update on a claim, you can contact Allianz directly at 1-800-363-1835.
No matter where someone travels, or for how long, it’s a safe bet that nobody looks forward to dealing with a medical emergency while vacationing. Preparation is key for a safe, worry-free trip. By reviewing your travel insurance (government, individual and your ELHT benefits plan), ensuring a stable medical condition and having your benefits card handy, you can have peace of mind and make all the plans necessary to have a “bon voyage.”
Looking for information and advice for travelers? Visit the Government of Canada and the Canadian Automobile Association (CAA).
Travel coverage: What you need to know
Are you medically stable to travel?
Ask the expert: When do I need to consider extra travel insurance?
What travel coverage do I have under my benefits plan?
Do I have trip cancellation coverage in my employee benefits plan?