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Overview

If you suddenly and unexpectedly become ill or injured while outside your province of residence and you require immediate medical treatment, the plan will cover all eligible expenses, up to specified limits. You must be eligible for benefits under a government health plan in Canada to qualify for emergency out-of-province/country coverage or travel assistance coverage.

For a summary of your travel coverage, refer to the Benefits At-a-Glance section. There you will find information on reimbursement levels and applicable maximums.

Eligible expenses must be reasonable and customary, medically necessary and incurred while the individual was covered under the plan.

Payment will be based on reasonable and customary charges in the area in which the treatment is given as determined by the insurer adjudicating benefits. Limits may apply to specific services and supplies.

For a list of travel plan exclusions, see the Exclusions section.

Out-of-country emergency coverage

100% reimbursement, to a maximum of $1 million per emergency above what your provincial health plan pays

Note: Certain expenses, such as prescription drugs, are covered to the same extent as they would be in Canada.

Out-of-province referrals

100% reimbursement for the difference between:

  • the actual cost, and
  • the amount available under the provincial plan, provided the provincial plan is first payer.

What’s Covered

Eligible Expenses Special Notes

Hospitalization

Hospital room at the ward rate

Hospital services and supplies also covered

Living expenses for a companion travelling with the patient, to stay with the patient beyond the original return date

Reimbursed up to $150 a day, for a total reimbursement of $1,500

Includes cost of accommodation, meals, telephone and taxi or rental cars

The travel assistance provider must approve the charges beforehand.

Medical evacuation home or transportation to another medical facility

Economy airfare for transportation home

Physician services

 

Referrals to physicians or medical facilities, if necessary

The travel assistance provider is not responsible for the actions or advice of any persons that you are referred to.

Return home airfare (economy class) for a travel companion

For a companion who is travelling with the patient and who has forfeited their ticket because of a delay caused by the insured person’s illness, injury, or death.

The travel assistance provider must approve the charges beforehand.

Return home airfare (economy class) for each child

For each child left alone because of the insured person’s illness, injury, or death.

The travel assistance provider will also arrange for a qualified attendant to accompany the children, if necessary.

The travel assistance provider must approve the charges beforehand.

Return of deceased

Reimbursed up to $3,500

Return of vehicle (to insured person’s home or the nearest rental agency)

Reimbursed up to $1,000

The travel assistance provider must approve the charges beforehand.

Round-trip economy airfare for a visiting family member

Provided the insured person is travelling alone and must be hospitalized for more than 10 days.

The travel assistance provider must approve the charges beforehand.

Wheelchairs, prescription drugs, crutches, and other eligible expenses under the plan’s health coverage

Covered to the same extent as they would be in Canada.

Non-medical services

  • Multilingual assistance by telephone, 24 hours a day, 365 days a year, to obtain aid, assistance, and exchange information relating to the covered services
  • Arrangements for direct payment, wherever possible, for physicians’ services, hospitalization and other insured services
  • Communication with the physician who is treating the insured person to get an understanding of the situation and monitor the condition
  • Telephone interpretation services in most major languages
  • The sending and receiving of urgent messages
  • Help to locate Embassy or Consulate services
  • Help to locate lost documents or luggage

Out-of-province referrals

The plan covers the usual cost of treatment, in relation to referrals for treatment in Canada and the United States only.

If treatment is available in your home province, the plan will not cover the referral expenses. A physician in your home province must give a written referral for treatment that is not performed in that province.

Canada Life must approve the referral beforehand.

What the Plan Does Not Cover

Your travel coverage does not pay for any expenses incurred directly or indirectly as a result of:

  • your pregnancy, if expenses are incurred outside Canada within nine weeks of your expected delivery date,
  • the birth of a child born outside of Canada within nine weeks of the expected delivery date, or after the expected delivery date,
  • an accident that occurred while you were operating a vehicle, vessel, or aircraft, if you:
    • were impaired by drugs or alcohol, or
    • had a blood-alcohol level higher than 80 milligrams of alcohol per 100 millilitres of blood,
  • abuse of illegal substances.

The plan also does not provide coverage as described in this section:

  • for emergency treatment while travelling for health reasons,
  • once emergency treatment for a condition is completed, for any ongoing treatment related to that condition, and
  • for medical emergencies in your home province.

General exclusions also apply. See the Exclusions section for more information.

Travel Advice

Things to Keep in Mind Before You Travel

Out-of-country emergency coverage provides protection for certain medical expenses incurred by you and your eligible dependents as a result of a medical emergency that occurs while traveling outside Canada, typically when travelling for business, vacation or education purposes.

A medical emergency is:

  • a sudden and unexpected injury,
  • the onset of a condition not previously known or identified prior to departure from Canada, or
  • an unexpected episode of a condition known or identified prior to departure from Canada.

An unexpected episode means it would not have been reasonable to expect the episode to occur while travelling outside Canada. If a person was suffering from symptoms before departure from Canada, Canada Life may request medical documentation to determine whether, in the circumstances, it could have reasonably been anticipated that the person may require medical treatment while outside Canada.

For pregnant travellers, this means that any pregnancy-related expenses incurred outside Canada may not be covered if, for example, they are incurred:

  • on or after day one of the person’s 35th week of pregnancy, or
  • at any time prior to the 35th week of pregnancy and the person’s Canadian physician considers the pregnancy to be high risk.

Planning a Vacation?

If you’re planning a get-a-way, be sure to check if the country you’re visiting requires proof of travel health insurance. If proof is required, contact Johnson Inc. at 1 800 371-9516 to have confirmation of your emergency travel insurance sent to you by mail, email or fax. In some countries, such as Cuba, proof of coverage can be shown in the form of a proof of coverage letter and/or your provincial health card.

If you do not have the appropriate proof of coverage when you enter a country, you may be required to purchase additional coverage on the spot.

When travelling it is recommended to have the following information with you:

  • wallet ID card,
  • provincial health card,
  • a valid passport, and
  • coverage confirmation letter (provided by Johnson Inc.).

What to Do in the Event of an Emergency

In the event of an emergency where you become ill or are injured outside your home province or Canada, call the travel assistance provider as soon as possible. You can find the contact number on your travel assistance card, which you should always keep on you while you are traveling.

If you or your representative does not call the travel assistance provider right away, your benefits may be reduced by 40% of covered expenses, with a maximum reimbursement of $25,000.

Calling immediately will enable the travel assistance provider to co-ordinate payment directly with the hospital and/or medical provider involved, only if the travel assistance provider obtains your approval to co-ordinate payment with the provincial health plan.

Following Doctors’ Orders

If your physician or the Travel Assistance Centre recommends that you return to your home province and you choose not to go, your emergency coverage and travel assistance coverage will end.

If your physician or the Travel Assistance Centre recommends that you be moved to another facility and you choose not to go, your benefits will be reduced by 40% of covered expenses, with a maximum reimbursement of $25,000.

Exclusions

The same list of exclusions as describe under the health plan, also apply to the travel benefit. See the health Exclusions section for details.