IN AN EMERGENCY
If you require emergency medical services while travelling outside your province of residence, contact Allianz Global Assistance (Manulife's emergency travel assistance service provider) as soon as possible. To do this:
- Contact Allianz Global at one of the numbers listed on your benefit card. If you do not have a card, you can print one directly from Manulife's Plan Member Secure site.
- Quote the Plan ID number (9505), as well as your Manulife Plan Contract Number (85210).
As a member of the McGill Supplemental Health Plan, while you are travelling outside your province of residence, the Emergency Travel Assistance benefit provides you and your eligible dependents coverage for medical services required due to a sudden and unforeseen medical emergency, provided your provincial health care coverage is in force. Coverage is limited to trips of 90 days duration; and is subject to a lifetime maximum of $5,000,000 per person. Note that eligible dependent children studying outside their province of residence are covered for periods of 90 days maximum duration.
It is important that you understand, prior to your departure, the coverage details and limitations of your health insurance plans while you are away. This pertains to both the McGill Supplemental Health Plan Emergency Travel Assistance benefit and the Quebec Health Insurance Plan (RAMQ).
Make sure you are covered! Check Important - RAMQ Travel Restrictions before you travel.
(Note: This plan does not include cancellation insurance or coverage for lost luggage.)
What is a medical emergency?
A Medical Emergency occurs when an insured person requires immediate medical attention due to or related to:
- A sudden, unforeseen and unexpected injury, or a new medical condition which begins while an insured person is travelling outside their province of residence.
- A previously identified medical condition that was medically stable at the time of departure from the insured person's province of residence.
- A medical emergency no longer exits when, in the opinion of the attending physician and supporting medical evidence, the insured person is able to return to their province of residence.
What does 'medically stable' mean?
As defined by Manulife Financial, for a medical condition to be considered medically stable under the McGill Health Plan, during the 90-days leading up to your departure, retirees and/or their eligible dependants must not have:
- Been treated or tested for any new symptoms or conditions;
- Had an increase or worsening of any existing symptoms;
- Changed treatments or medications (other than normal adjustments for ongoing care);
- Been admitted to the hospital for treatment of the condition.
- In addition, coverage for travel medical emergencies is not available if, prior to departure, you or your dependants have scheduled non-routine appointments, tests or treatments for an existing medical condition or another undiagnosed condition to be done after your return.
In addition, coverage for travel medical emergencies is not available if, prior to departure, you or your dependants have scheduled non-routine appointments, tests or treatments for an existing medical condition or another undiagnosed condition to be done after your return.
Make sure to obtain a fully itemized bill for any in-hospital expenses or treatment, and keep all receipts.
To claim expenses when you get home you will need to:
- Submit a claim for reimbursement to the Régie de l'assurance-maladie de Québec. For more information, go to Reimbursement of cost of services received during the stay.
- Once you receive reimbursement from the Régie, submit a claim to Manulife for the unpaid balance. Include copies of all receipts and the statement from the Régie.
- Coverage is for emergency medical services only. Expenses incurred for ongoing treatment/tests/doctor visits and follow-up for an existing medical condition are not covered.
- Routine medical tests or doctor visits are not covered.
- Coverage is limited to trips of a maximum 90 days duration. You must return to your province of residence for a minimum of 24 hours in order for a trip to be considered a new trip - for the 90 days to start anew.
- Coverage maximum is $5,000,000 per lifetime (lifetime maximum includes emergency travel both as an active employee and as a retiree).
- If your coverage under the Quebec provincial health insurance plan does not continue while you are away, your coverage under the McGill Supplemental Health plan for emergency out-of-province medical services will not continue for the entire duration of your absence.
The plan covers 100% of the following services provided they are ordered by a doctor (or dentist where applicable) and provided part of the charge is payable under the provincial health plan in the province of residence:
Medical Services and Hospitalization
- emergency hospital expenses incurred during the first 90 days of a trip outside of Canada, but not lasting beyond 14 days, unless the attending doctor (M.D.) certifies that the covered person should not be moved back to his/her home province.
- charges in accordance with the average rate for semi-private hospital accommodations in the locality where the facilities and services are provided. This includes any admittance, coinsurance or utilization charges where permitted by law.
- hospital services and supplies.
- diagnosis and treatment of a licensed physician (reasonable and customary charge according to locality).
- hospital out-patient services.
- X-rays and laboratory tests.
Transportation and Related Services
- emergency transportation to the nearest appropriate medical care facility, and if necessary, from the medical care facility to a hospital in Canada (province of residence).
- charges incurred for the return of a deceased Member or dependent.
- charges incurred for the return of dependent children under 16 to their residence in Canada in the event the Member or Member's spouse is hospitalized and the children are left unattended.
- charges incurred if the return trip is delayed due to hospitalization.
- charges incurred for transportation of an immediate family member to visit a hospitalized individual.
- charges incurred in connection with the return of a vehicle (does not include commercial vehicles or rented cars) in the event the Member is unable to return it due to illness, injury or death.
Services not covered
- charges which are not incurred as a result of an emergency while travelling.
- expenses incurred for ongoing treatment/tests/doctor visits and follow-up for an existing medical condition, or routine medical tests/doctor visits.
- Pregnancy: Routine doctor visits and tests; and any medical emergency related to a pregnancy for insured persons who are pregnant and travelling (or on sabbatical leave) after the beginning of the 32nd week of pregnancy.
- Childbirth: charges in connection with childbirth, and medical complications resulting from childbirth when delivery takes place after the beginning of the 32nd week of pregnancy.
- Services incurred while the insured does not have provincial health care insurance.