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Travel and Your Provincial Health Plan

May 27, 2011
Canadians are lucky to live in a nation where health care is available to all residents; however, when you travel outside your home province you can't always take that coverage with you.   Depending on your province of residence, there are important facts you should know about how and when you are covered when you are travelling, whether for business or pleasure.   Purchasing a travel insurance policy is a simple way to eliminate the worry about your potential medical costs while abroad. 

The Canadian provinces have a reciprocal agreement that allows them to bill each other for care provided to travelling Canadians outside of their home province.   This agreement lets you show your province's health care card in any Canadian province in order to receive coverage.     The most notable exception is Quebec, which does not have a reciprocal agreement with any other province; you are required to pay for services up front and apply for a reimbursement.     The same is true of travel outside of Canada, where no agreements are available and travelers are responsible for all medical bills incurred.   The basics of provincial travel coverage differ slightly depending on your province of residence; here are a few of the things you can expect from your province.

The Western Provinces:
If you reside in British Columbia or in Alberta, your health plan will cover you in any province in Canada, except, of course, Quebec.   In Quebec or outside of Canada, you will need to pay for services yourself and apply for a reimbursement.   Bear in mind that the coverage is extended only to care by physicians, other practitioners such as chiropractors are not included; prescription drug coverage is not included either, so prescriptions should be obtained prior to travel.   Services for ambulances, transport of injured people back to their home province, and numerous other exclusions apply.   Albertans are covered for medically required oral care such as oral surgery when travelling, but not for routine care.

The Prairie Provinces:
If you live in Saskatchewan or Manitoba you have the same reciprocal agreement as the other provinces, excluding Quebec.   Saskatchewan residents can obtain medical care as well as prescription drugs in other provinces and have the services covered by their plan, while Manitobans must obtain drugs in their home province.   Outside of Canada, Saskatchewan and Manitoba residents are required to pay out of pocket for all medical care and submit for reimbursement upon their return.   There are multiple exclusions to the coverage available while travelling, and ambulance and transport are not covered at all.

Ontario:
For Ontario residents, the reciprocal agreement applies to all provinces except Quebec.   Ontario's health plan will cover you for physician and hospital services received in other provinces, as long as the services are received at a publically funded hospital.   Prescription drugs purchased outside Ontario are not covered.   Travel outside Canada requires that you pay up front and apply for a reimbursement when you return; coverage is very limited and does not include ambulance or transport services.

The Maritime Provinces:
The Maritime provinces: New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland all have a reciprocal agreement with each other as well as with all other provinces except Quebec.   Newfoundland offers an Out of Province Coverage Certificate which ensures continued coverage for up to twelve months while travelling.   For all maritime province health plans, coverage outside of Canada is limited and up front payment must be made at the time of service and submitted for reimbursement.

Quebec:
Quebec is unique in Canada in that it does not have an agreement for direct billing for health care services with any other province.   Residents of Quebec should therefore expect to pay out of pocket for any medical services obtained while travelling outside the province, whether in Canada or out of the country.       Some services are reimbursable, while others are not.

The Territories:
In addition to the provinces, the territories of Canada also offer health coverage for their residents.   Both the Northwest Territories and Nunavut, as well as the Yukon, have reciprocal agreements with the provinces other than Quebec, but outside of Canada all costs must be paid up front.

When it comes to travel outside of your home province and especially outside of Canada, it is a wise idea to have alternate health insurance coverage.   While your province may reimburse you for some of the costs of emergency care in another country, they will only pay the standard rate for care in your province.   This is usually vastly different from what hospitals in other countries charge, and you will be responsible for the difference.   In most cases you are also responsible for ambulance and other transport costs; including the cost of being transported home for further care if necessary.   It can quickly add up to thousands of dollars.

Provincial health care coverage does not provide any reimbursement for services that aren't considered medically necessary; coverage is generally only extended for emergencies.   You will have to pay all bills that don't meet this requirement, and that can mean significant amounts of money.

Travel health insurance is the best way to prevent a health emergency from becoming a financial emergency as well.   Depending solely on your province's health plan to provide total coverage could be a very costly mistake.   Even if you are in good health, an accident or sudden illness can happen anywhere, and to anyone.   Your provincial health plan provides only limited coverage when you travel - severely limited for travel outside of Canada.   Leaving home without travel health insurance can leave you in a very difficult financial situation, so make sure you are covered.   Cheap travel insurance can easily be found, investigated and even purchased online, so there's no reason to take your chances abroad.   Protect yourself and your family so you can fully enjoy your travel!

  • Susan Payne

    It is great to get health travel insurance but what if you can’t get it. My husband has ITP since childhood. We have travelled in the US with work travel insurance but we may not have been insured. Now we are in our 60′s retired and would love to travel but because my husbands condition is considered unstable we don’t seem to be able to get insurance. So the decision is to stay home or travel without insurance. Do you have any suggestions thanks Sue

  • Nick – InsuranceHotline.com

    Hello Susan,

    You may find some help through the Canadian Association of Retired Persons. Here I their website: http://www.carp.ca/

    Thank you

  • Conrad

    My wife and I are planning an extensive 90 day cross Canada trip by RV. Am I correct to say we are covered in all provinces except Quebec with our B.C. health care.

  • http://www.insurancehotline.com/ InsuranceHotline.com

    Hello Conrad,

    Please speak to your BC http://www.servicebc.gov.bc.ca/

    to inquire about what you are covered for when you cross the country.

    Thank you.

  • Kathy

    My brother is moving back from saskatoon to ontario but he is on dialysis and has diabetes. Will his treatments be covered from saskatoon in ontario until he gets his ohip back on line. He owns a home in ontario and is originally from ontario.

  • http://www.insurancehotline.com/ InsuranceHotline.com

    Hello Kathy,

    I don’t know if Saskatchewan will continue his coverage as some provinces do and some do not.

    Please speak to the Saskatchewan Ministry of Health

    http://www.health.gov.sk.ca/Contact

  • http://www.insurancehotline.com/ InsuranceHotline.com

    Hello

    You are best to check with the BC government on that.
    thank you

  • http://www.insurancehotline.com/ InsuranceHotline.com

    Hello

    You are best to check with an insurance professional for that information.

    Thank you

  • http://www.insurancehotline.com/ InsuranceHotline.com

    Hello

    It would be a good idea for her to contact them just to be sure.

    Thankyou

  • http://www.insurancehotline.com/ InsuranceHotline.com

    hello

    Each state and province is different. You are best to check with your provincial provider.

    Thanks

  • http://www.insurancehotline.com/ InsuranceHotline.com

    hello

    I believe that she must pay into OHIP in order to receive provincial benefits.

  • http://www.insurancehotline.com/ InsuranceHotline.com
  • grace

    Its my 1st month here in ontario and I’m expecting to give birth on the first of february, but i dont have ohip yet and they said we need to pay the hospital and doctor.. can i refund my payment if ever i have ohip after giving birth?

  • Nakita

    Can I fill a perscription in Ontario if I’m from Quebec?

  • http://www.insurancehotline.com/ InsuranceHotline.com

    hello

    You are best to check with the Ministry of Health.
    here is their website http://www.health.gov.on.ca/en/public/programs/ohip/

  • desperate

    my daughter was diagnosed with cancer and is very sick. she was living in Montreal but lost her job and apartment because she could not work. so we have flown her to Alberta where we live. now we are having trouble getting her any medical attention because they don’t bill to Montreal health care. even the cancer center wont take her. what can we do. it is too expensive to pay for all her tests she needs and medications ???????????????

  • Ree

    I live in Nova Scotia, I haven’t renewed my health card in about 6 years..do I still have the health insurance?!

  • Dylan

    Is it possible for you to provide a list of links/resources used to obtain all of this information so that I could do some further reading?

  • Colleen Haire

    I have traveled from BC to Ontario. Will my BC CARE card cover me while I’m here?

  • Mike

    Hi there, I’m currently a BC resident, but am in Manitoba for a while receiving counseling for addictions. I pay $40 per session right now. Does BC med cover this right away, or do I have to keep all of my receipts for submission later on? I’m not working either so I won’t be able to pay for these sessions much longer. Thanks.

  • Terri Watts

    I am from Alberta and will going stay Ontario for temporary staying like 6 to 8 months and need to cover my health card? I do not want throw away my health card from Alberta and to get new Ontario Health card. I will find a temporary job reason to help my income to fix my house then sell.. When house is sold then return back my home at Alberta. How can I solution? Important for my health cost for medical expenses.

  • Sharon

    I live in a rural area in BC close to the Alberta border,, I had a knee replacement done at the Trail hospital and it was done improper and having many issues including infection around the bone area, have been living with it for the last 2 years, now having many issues because of the infection. Can I see a Dr. In Alberta at the knee clinic in Edmonton, and have future surgery covered by BC med.?

  • Michaela

    I am just wondering how I would be able to reimburse a bill.
    I work in Alberta and made 2 trips to the Medicentre in which I had to pay for my trips as I am still covered under Nova Scotia’s Health Plan.
    I was just wondering if there is a website to get more information on how to send these bills home & get them reimbursed.

  • Xandria Culver

    I just moved to BC and have Alberta Healthcare. Iam also 10 weeks pregnant and a very important ultrasound needs to be done really soon. Will I have to pay for the ultrasound till I can get BC health care?