If you have an accident or become ill outside of your province of residence, your provincial health care plan may not cover all your medical bills, even when travel is within Canada. The Travel Emergency Medical benefit has been designed to cover many of the types of expenses that can occur when a medical emergency occurs while away from home.
When a Travel Emergency Medical benefit is provided there are some provisions which are very important and which could jeopardize claim payment. Because of their importance some of these items are noted here. The Travel Emergency Medical benefit:
Please refer to the Exclusions and Limitations sections below for complete details. These are also contained in the Travel Emergency Medical Coverage Summary issued by the provider, iA Financial Group, and which you are encouraged to read carefully before you travel and perhaps include with your passport and important papers while travelling.
Back to topIf you are insured for benefits with the Arts & Entertainment Plan®, reside in Canada and will be under age 84 for the duration of your Benefit Year you are eligible to participate in the Travel Emergency Medical benefit. If you insure your dependant(s) they are also eligible to participate provided an insured spouse/partner is under age 84 for the duration of your Benefit Year.
Having a copy of the Travel Emergency Medical Coverage Summary does not guarantee that you or your family are insured for these benefits. Please refer to your Certificate of Insurance to verify eligibility for the current Benefit Year .
Back to topCoverage commences automatically upon leaving your province of residence for scheduled trips of 90 days or less in duration to the participant under age 80 and 30 days or less in duration to the participant age 80 but under age 84. There are no limits to the number of trips taken during the course of the year.
Please note that any person outside of the province of residence for a scheduled duration in excess of 90 days with respect to the participant under age 80, and 30 days with respect to the participant age 80 but under age 84; is not covered under this insurance.
You will need to purchase separate travel emergency medical coverage as a top-up or extension of this policy if your trip is in excess of the allotted days.
Back to topThere is a maximum of two million dollars ($2,000,000) payable for each insured person for emergency hospital and medical expenses in excess of the amounts paid by your provincial health plan or other insurance plans per injury or sickness while this policy remains in place.
Back to top| Reimbursement Maximum/incident | |
|---|---|
| Excess Hospital Benefit Reasonable and necessary emergency hospital expenses incurred up to and including standard semi-private accommodation during confinement as an inpatient. When confinement exceeds the maximum trip duration, insurance will continue for a period of no more than 90 days from the date that the first insured expenses were incurred. In the event that discharge is on or after the maximum trip duration, coverage will be extended for 72 hours immediately following discharge. | |
| Excess Medical Benefits The reasonable and necessary expenses for the following treatment or services on an emergency basis for:
| |
| Prescription Drug Reimbursement Reimbursement of prescription drugs or medicines on an emergency basis as prescribed by the attending physician. (Oral contraceptives, patent medicines when a generic equivalent is available, vitamins, repeat prescriptions, maintenance and chronic care drugs are excluded.) | |
| Accidental Dental Expense If an injury is sustained to a whole or sound tooth (capped or crowned teeth will be considered whole and sound) due to a force or blow that is external to the mouth. | $3,000 |
| Dental Treatment Benefit If emergency treatment for pain relief is required, other than as a result of force or a blow to the mouth. All treatment must be initiated within 48 hours from the time the emergency began and completed no later than 90 days after the treatment has begun. | $500 |
| Evacuation Transportation, medical services and supplies necessary for emergency evacuation. All arrangements must be recommended by the attending physician, certifying that the severity of the injury or sickness warrants the emergency evacuation. Payment of one-way economy return airfare for dependant children who must be accompanied by a parent or guardian, and a one-way economy return airfare for such parent or guardian, to the province of residence will be paid in conjunction with the insured’s evacuation. Pre-approval by iA is required prior to evacuation. | $200,000$5,000 |
| Special Transportation Stretcher accommodation on a regularly scheduled airline in order to return to the province of residence during an emergency evacuation. | $7,500 |
| Attendant Transportation If recommended by the attending physician, or if required by the air carrier’s regulations, the presence of a medical attendant during the emergency evacuation will be reimbursed the reasonable and necessary expenses for round trip airfare plus one day accommodation and board. | $5,000 |
| Ambulance Expense Ground or air ambulance to the nearest medical facility qualified to provide the necessary emergency services | Ground - $500 Air - $5,000 |
| Repatriation When a covered medical emergency results in death, the reasonable and necessary expenses incurred for the transportation of the body to the province of residence, including the preparation of the body for transportation | $10,000 |
| Board, Lodging and Travel Expenses When hospitalized for at least five consecutive days prevents the return to the province of residence, and the attendance of an immediate family member or companion is certified as medically necessary by the physician, reimbursement will be for round-trip economy airfare, meals and accommodation up to $150 per day. If injury or sickness results in death, reimbursement will be made for a single round-trip airfare for an immediate family member or companion to identify the mortal remains, as well as meals and accommodation up to $150 per day for a maximum of five consecutive days. | $5,000 |
| Trip Interruption Reimbursement of non-refundable, pre-paid travel costs or the cost of travel to rejoin a tour or group when a trip is interrupted as a result of a medical emergency. | $1,000 |
| Hotel Convalescence If as a result of injury or sickness, the physician certifies that the insured, due to the medical condition, is prohibited from resuming any travel following discharge from hospital following at least a 7 day confinement, reimbursement will be made for board and accommodation (in the vicinity of the hospital). | $1,000 |
| Meals and Accommodation If an injury or sickness results in hospitalization as an inpatient, reimbursement will be made for additional reasonable living costs, child care costs for accompanying dependant children and essential calls and taxi fares incurred by the insured. | $3,000 |
In the case of confinement in a hospital or emergency surgery, iA must be notified no later than 48 hours from the date of hospitalization or emergency surgery. Failure to notify iA may limit coverage to a maximum of $10,000 for all expenses incurred .
Back to topTravel Emergency Medical benefits will not be paid for loss, fatal or not fatal, caused by or resulting from any of the following:
Your access to the Travel Emergency Medical Benefit will cease:
Coverage for your insured dependant(s) will terminate on the earliest of:
The information in this section applies only when a medical emergency occurs.
The numbers below cannot be used to obtain additional information about the Travel Emergency Medical Benefit.
If possible, before obtaining any medical service or advice, or within 48 hours thereafter, contact:
iA’s Emergency Assistance Line (open 24 hours a day, 7 days a week) 1.800.255.2008 or Outside North America * dial 0, wait for the operator, and ask to call collect (305) 865.8895
At the time of the call, you will need the following information:
Insurance Company:Industrial Alliance Insurance and Financial Services Inc. (iA)
Policyholder: Actra Fraternal Benefit Society
Policy Number: 100009655
The information above is included on the Travel Emergency Medical Coverage Summary issued by iA and is shown on the Certificate of Insurance wallet card of eligible Members. Be sure to check your Certificate of Insurance to determine if you have Travel Emergency Medical Benefits for the current Benefit Year.
The operator will also want to know:
*Depending on where you are travelling, collect calls may not be possible from cell phones; access to international operators may be limited; and there may be complications dealing with long distance and country codes. It can be stressful when an emergency occurs, so ensuring you know how overseas calls can be made from your destination ahead of time is helpful.
**Please be aware that if you use a stage name, this information must be provided.
Back to topIt is also important that you advise iA in writing of any claim within 30 days of the occurrence of the emergency. When you return to your province of residence, you will be required to submit a claim directly to iA. Claim forms may be obtained online at www.ia.ca/specialmarkets-forms www.ia.ca/specialmarkets-forms or by contacting:
Industrial Alliance Insurance and Financial Services Inc., Claims Department 400 - 988 West Broadway, PO Box 5900, Vancouver BC V6B 5H6 Phone: 1.800.266.5667 or outside North America collect to 1.604.737.3802 Email: SpecialMarkets-claims@ia.ca
Please make sure that, when you pay any expenses yourself, you obtain original receipts. Submit all expenses first to the provincial health care plan of your province of residence. Then send a copy of the statement you receive from your provincial health care plan, together with the original receipts of any bills not paid by them, and the completed claim form to iA.
Documentary evidence of the duration of your scheduled trip, such as a transportation ticket or an official stamp at a customs office will be required.
Back to topIf, after reviewing the Travel Emergency Medical Coverage Summary, you have questions about how your circumstances might be impacted by a specific aspect contact
iA Special Markets Phone: 1.800.266.5667 (Monday to Friday, 10am to 7pm ET) Email: SpecialMarkets-claims@ia.ca
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