Understand Your Out-of-country Emergency Medical Coverage

Enough has been said about making sure you have adequate out-of-country emergency medical coverage before you step foot outside Canada. Equally important is understanding the coverage you have, so that if you are faced with a medical emergency while outside the country, you know what to do and what to expect.

Employer Health Benefit Plans

Out-of-country emergency medical insurance is sometimes included in an employer’s Extended Health Care benefits. If you or your spouse recently joined the employer, be aware of the waiting period before coverage comes into effect. To be eligible for benefits under a group plan, you must first be covered by provincial health care. If you’ve just moved into the province, check to see how long the waiting period is before provincial coverage takes effect.

Most employer health benefit plans have limitations and exclusions on out-of-country emergency medical coverage. For example:

  • Maximum trip duration — typically 30 to 60 days per trip
  • Overall coverage maximum — usually between $1 million and $5 million
  • Exclusion of pre-existing conditions that are not stable or conditions that could reasonably have been expected — this includes known side effects of ongoing treatment, or illness related to a preexisting condition, for instance, susceptibility to disease because of a compromised immune system

Individual Plans

If you do not have extended health care benefits through your employer, you can purchase out-of-country emergency medical coverage through individual medically underwritten policies. You can choose coverage for a specific trip, in which case the premium is based on the number of days you will be away; or you can choose coverage for multiple trips over an extended period of time up to one year.

Regardless of the type of individual coverage you choose, disclose all medical conditions on the application so that a claim cannot be declined due to non-disclosure.

If a Medical Emergency Occurs

When you are out of the country, always carry the contact numbers for your emergency medical coverage. Before you leave, read the instructions on how to access medical services and make a claim. If an emergency occurs, you need to know the correct procedure so that you have quick access to the necessary health care providers and payment isn’t an issue.

Your insurance company will have negotiated rates with a network of preferred emergency medical service providers. You or someone you trust must phone the appropriate emergency number when you require out-of-country medical service. You will be directed to the appropriate medical personnel and facilities.

If the sick or injured person is able to travel, the insurance provider’s preference will be to arrange safe transport home as soon as possible for treatment.

For Information

For information regarding out-of-country emergency medical insurance or for assistance in understanding your coverage, please contact your Nakamun Advisor, who will direct you to the appropriate resource.

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em. blair@onyxfinancial.ca

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