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Many Canadians understand the importance of purchasing emergency medical insurance for international trips. However, they often overlook the need for travel insurance in Canada when travelling outside of their own home province/territory. In this post we will discuss the basics of how the Canadian provincial/territorial health care plans work when Canadians travel to different provinces/territories.
According to the Canada Health Act, provinces and territories will ‘extend coverage for medically necessary hospital and physician services to their eligible residents during temporary absences from the [home] province/territory’. Any ‘additional benefits,’ which include prescription medications or ground/air ambulance services, are generally not covered outside of a traveller’s home province/territory. As such, travel insurance is necessary to supplement provincial/territorial health care plans when travelling outside of your province/territory of residence.
Before you travel, it is important to understand the terms of coverage under your provincial/territorial health care plan.

How Does Our Canadian Health Insurance Program Work, in Canada, Between the Provinces?

The Canada Health Act has established reciprocal billing agreements between the provinces/territories. Eligible residents, therefore, are provided the necessary hospital and physician services required and the provinces/territories will bill each other for the services rendered directly.
Portability of health care coverage between provinces means, in most cases, you can show your health card in another province/territory, rather than paying for eligible services out of your own pocket.

The following is a list of the standard hospital services that are covered under the reciprocal billing agreements:

• preferred accommodation if medically required;
• nursing services;
• insured laboratory, radiological and other diagnostic procedures, together with the necessary interpretations;
• insured drugs, biological and related preparations when administered in the hospital;
• use of operating room, case room and anaesthetic facilities, including necessary equipment and supplies;
• medical and surgical equipment and supplies;
• use of radiotherapy facilities;
• use of physiotherapy facilities; and, services provided by persons who receive remuneration from the hospital

Medical expenses not covered under reciprocal billing agreements:

Medical expenses, referred to as ‘additional benefits,’ that include prescription drugs as well as ground/air ambulance services, that your province/territory may cover under its health insurance plan are generally not available to residents outside of their home province/territory.

How Do I Access Medical Services Outside of My Province/Territory of Residence while Travelling within Canada?

To obtain out-of-province/territory medical services, while still in Canada, you must show your valid health card prior to receiving medical treatment. If you do not provide your provincial/territorial health card at the time that treatment is required, the hospital or physician may require you to pay for the out-of-province services up front and submit for reimbursement from your home province or territory’s health insurance plan.
Note: when travelling in Quebec you may have to pay for medical services yourself, at the time you seek medical treatment, even if you bring your health care card to the treatment facility.
Tip: keep all your original receipts as they may be required for auditing and verification processes.

Claiming for Reimbursement

If you are covered under a provincial/territorial Canadian health insurance program and receive medical bills while travelling within Canada, you may be eligible to submit those bills for reimbursement to your provincial/territorial Ministry of Health.
If you are eligible for reimbursement, you will be paid according to the standard treatment rates that are applicable in your province/territory of residence.
For example, if you are an Ontario resident and receive a medical procedure in Quebec that costs $5,000 and the same procedure only costs $3,000 in Ontario, then you may have to pay $2,000 out-of-pocket.

Can You Afford the Risk of Travelling Without Travel Insurance Within Canada?

Medical emergencies can happen anytime, and in extreme cases, they may even lead to a tremendous financial burden. The cost for prescription medication, ground air ambulance services, and any other incidentals when you find yourself confronted with sudden and unforeseen illness can add up quickly since most provincial/territorial health care plans will not cover these services while you’re travelling out-of-province/territory.
The good news is that many emergency medical travel insurance plans provide coverage for ambulance services, prescription drugs and other additional medical services required. Purchasing the right emergency medical travel insurance plan for you, before you leave your home province/territory, will provide you with necessary coverage and better peace of mind.
To learn more about the terms and conditions of coverage under your provincial/territorial health care plan, visit your provincial/territorial website for details.
If you are traveling within Canada, protect yourself from unexpected medical expenses by purchasing travel insurance from a reputable travel insurance provider, such as Travelance.
Learn more about our affordable and flexible travel insurance products. As always, we want to hear from you. Contact us via our website or call 1-855-566-8555 for more information or to speak to a licensed broker about the right travel insurance in Canada for your needs!
*The above is a summary for illustrative purposes only. For further information and details visit your respective province’s/territory’s health care ministry for details.