Is healthcare received outside Canada covered?
Are you spending the Holidays at the beach with your family? Are you visiting your loved ones abroad for the New Year celebrations? When you travel outside the country, you may receive healthcare covered by the Québec Health Insurance Plan. However, these expenses will not be reimbursed in full. Here are 2 common situations that could increase the cost of your stay abroad.
Emergency or sudden illness
The 2 examples below refer to an emergency or a sudden illness. These persons must be treated without delay. That’s why the Québec Health Insurance Plan reimburses CA$50 per day for an outpatient hospital stay and a maximum of CA$100 per day of hospitalization. If you are receiving planned or preventive care, you will not receive these amounts for hospital expenses. Only doctors’ fees may be reimbursed, based on the rates in force in Québec.
1
Ear infection under the sun
A few days after your arrival under the palm trees, your child develops symptoms that resemble those of an ear infection. You have no choice! You need to see a doctor.
If you go to hospital, you will receive 2 invoices:
- One for the fees of the doctor who will examine your child
- One from the hospital for an emergency consultation
The doctor’s fees will be reimbursed by the Québec Health Insurance Plan up to the Québec rates in effect, regardless of the amount claimed. In the United States, fees can be up to 250% higher than in Québec.
As for the hospital bill, the plan reimburses a fixed amount of CA$50 for a hospital consultation when the person is not hospitalized. However, in the United States, this bill could exceed US$1,000.
Before seeing a doctor, your child may also be seen by a member of the nursing staff. Please note that these fees are not reimbursed by the public plan. Only doctors’ fees are reimbursed.
2
A heart attack away from home
Your holiday is overshadowed by a heart attack. It’s a state of emergency for you and your family. You take the ambulance to the nearest hospital.
First of all, you should know that ambulance transport is not an insured service. It will therefore not be reimbursed by the Québec Health Insurance Plan.
Let’s assume that your health condition requires a 3-day stay in hospital. The public plan provides for a maximum of CA$100 per day of hospitalization.
For example, a 3-day hospital stay in Florida following a heart attack could cost you up to US$200,000, excluding doctors’ fees. The amount reimbursed by the Québec Health Insurance Plan would be CA$300 (CA$100 per day). You would then have to pay the amount remaining. Now that’s a convincing argument for taking out travel insurance!
Similar to the ear infection example, doctors’ fees may be reimbursed up to the Québec rate in effect.
Travel insurance is a must!
The Québec Health Insurance Plan reimburses certain healthcare received outside Canada, but without travel insurance, you could end up paying a significant sum. Leave with peace of mind and take out travel insurance that covers you in all circumstances.
Do you have a chronic illness? Have you recently been diagnosed with a new illness? Are you pregnant? Before you leave, contact your travel insurance provider. Check whether your new condition could compromise reimbursement for healthcare not covered by RAMQ.
Finally, you should always keep the documents you received during your consultations abroad (invoices, receipts, proof of payment, operation report, etc.). These documents will be needed to process your request for reimbursement.
Travel safe!