Canadian citizen in US, medical facilities?

Question

I have an aunt who is visiting from Canada, and she has a medical condition, i was just curious, if she does visit the doctors here in the US how if at all does she go about claiming the same in Canada, as she is fully covered there.

Does she just send the bills there? or she does not get reimbursed? Anyone with answers to this or who can direct me in the right direction.

Thanks

Answer 1

Each province administers the health coverage for its citizens differently so it depends on which province she is from.  If she requires care she may or may not be re-imbused completely depending on the reason for hospitalization and, again, which province she is from.  Some form of supplemental health coverage (ie. Blue Cross) may be necessary.  The URL below is a FAQ sheet from the Federal Gov't.

Answer 2

I believe (sorry if I am wrong) that she would have to pay for any services in the US in full. The Canadian healthcare is strictly for Canada and has no hold in the USA. You can always call the office or facility that she will be seen at and ask to be positive.

Answer 3

I really hope she got extra travel insurance before she left home.  :(  If she did, she should call them and see what their policy is.  Depending on the travel insurance, they may ask the hospital to send them the bill directly or ask you to try and get your provincial health plan to cover it...then after you get the denial letter from the province, submit it to insurance to cover the difference.  (Insurance will know what the province covers, but they need that denial letter)

The home province will ONLY pay what they would normally pay in Canada, and that is usually a lot less than what hospitals in the USA charge.  eg an emergency room visit in Canada may cost $1000, in the USA it may cost $5000...the home province will only cover $1000...and the travel insurance will pay the difference.  For the part that is covered by the home province, you have to fill out an "Out of Province/Country" form and submit it along with the hospital bills to the provincial health plan.  Not everything is covered in the USA though, ambulance is not covered, and a lot of "non life threatening" medical treatments are also not covered and other things.  (prescriptions she may have covered in her home province if she is over 65 will not be covered in the USA either)

Bottom line...I really hope your aunt got travel medical insurance before she left Canada.  If not, she could be owing a LOT of money to medical services in the USA.

Answer 4

NO .SHe wouold have to take out travel insurance !!

Answer 5

She should call her insurance company, they'll let her know for sure, sometimes you pay upfront and are reimbursed, other times the insurance company can be billed directly.  Make sure her insurance company actually covers her if she travels outside of Canada though, because they might not.

Answer 6

each Provence has its own laws,in Ontario they will pay some of the cost of emergency treatment while visiting the US

if she has been away from Canada or more than 6 months her ohip is cancelled

Answer 7

The government does not cover all health-care cost outside your home province let alone another country.  She should get travel health insurance before she leaves or else everything will be coming out of her pocket.