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Going out of country? Take your benefits card with you


Coronavirus (COVID-19): Information for plan members

For information about the coronavirus and your travel coverage, check out our article “Novel Coronavirus: Information for plan members.”

OHIP winds down the Out-of-Country Travellers Program

As of January 1, 2020, Ontario residents are no longer eligible for up to $400 per day for out-of-country hospital care through the Ontario Health Insurance Plan (OHIP).

Ontario residents are still covered by OHIP for physician and hospital services when visiting or moving to another Canadian province or territory.

Learn more about OHIP coverage while outside Canada.

Your Out-of-Province/Out-of-Canada coverage under the ELHT benefits plan

If you have the Extended Health Care benefit under your Employee Life and Health Trust (ELHT) benefits plan, you are covered for medical emergencies while travelling out-of-province/out-of-country. You can check your benefits booklet for details on what is covered in the Out-of-Province/Out-of-Canada section.

The emergency travel insurance provider, Allianz Global Assistance, offers immediate assistance to you, 24 hours a day and seven days a week. The goal of this coverage is to stabilize the medical condition and, when applicable, return the patient to their home province (e.g. if further medical treatment is required).

 

When travelling out-of-province/out-of-country, medical emergency is defined as:

  • 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.

NOTE: If you incur expenses for a previously diagnosed injury or medical condition that was not medically stable prior to departure, they will not be eligible under the Out-of-Province/Out-of-Canada coverage.


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 be covered under the Extended Health Care benefit.

The coverage may include expenses for eligible physician and ambulance services, hospital accommodation, trip interruption/delay and other types of hospital-related fees.

There is a lifetime maximum per person for emergency medical treatment. You can check your benefits booklet for details.

The ELHT Out-of-Province/Out-of-Canada coverage does not:

  • Replace the government health insurance plan (i.e. it does not cover routine medical care like a doctor’s visit or routine lab work)
  • Allow for elective, alternative or experimental treatment
  • Cover trip cancellation

In cases where additional treatment may be required, once the attending physician feels that based on the medical evidence, a patient is stable enough to return to his/her home province or territory to get additional treatment, AND the patient chooses to continue their travels, any related expenses to this travel medical emergency will not be covered by the plan.

Travel claims are paid directly by Allianz where possible, however, if you are required to pay up front, be sure to ask for an itemized bill from the service provider.

Travelling within Canada

If you and/or the patient is travelling between provinces and requires in-patient emergency medical treatment (i.e. ward hospital accomodation, in-hospital care), there will be no charge to the patient.

For any other out-patient services (e.g. physician's fees), you can contact Allianz for assistance and/or payments.

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.
  • 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 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.  

Are you in:

Dial:

Canada/U.S.:

1-800-265-9977

Mexico

00-1-800-514-3702

Dominican Republic

1-888-751-4403

Cuba and all other countries

Operator to call collect: 519-741-8450

International toll-free for participating countries only

Country prefix + 800-9221-9221


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

If you paid any medical expenses up front, you may be eligible for reimbursement. You can complete and submit the Out-of-Province/Out-of-Country Claim Form.

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 patient records

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).
 
Source: http://groupbenefits.manulife.com/Canada/GB_v2.nsf/LookupFiles/EBNQ204Benefitstogo-English/$File/Bentogo.htm
 
 Related links:
 

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?

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