Emergency Out-Of-Province/Country Medical

Emergency Out-Of-Province/
Country Coverage

Medical emergencies can happen anywhere, any time. With that in mind, the DGC Benefits Plan offers important insurance to help protect you and your family when you travel outside your home province.

Coverage Levels

Your out-of-province/country emergency medical insurance is based on your coverage level.

What's Covered

EMERGENCY MEDICAL CARE

DETAILS

The plan covers the cost of medical care if you experience a sudden, unexpected injury or acute illness while traveling outside of your province of residence for vacation, business or education. If you are covered under your provincial health plan, the plan will cover reasonable and customary expenses for:

A bed in a standard or semi-private ward or intensive care unit;
The services of a doctor;
Diagnostic services;
Hospital services and supplies;
Drugs; and
Out-patient services.

If you are in Level II or III and under age 80, the plan will cover expenses incurred within 90 days of your departure from Canada, unless you are still hospitalized at the end of the 90 days, in which case coverage will be extended until your release from hospital. The maximum benefit is $5 million per lifetime (up to $1 million if age 70 – 79).

Life Members who are under age 80 are covered for trips up to 90 days. The same dollar limits as above apply.

If your medical condition permits a return to Canada, your coverage will be the lesser of:

The cost of continued treatment outside of Canada, and
The cost of comparable treatment in Canada, plus return transportation.

Lodging benefits are limited to moderate quality accommodation and $1,500 per confinement. Coverage for travel within Canada is limited to emergencies arising more than 500 kilometres from home.

Limitations

Exclusions listed under your health coverage also apply for emergency medical care.

In addition, emergency medical care services or supplies received out-of-province but in Canada, are not covered unless:

The person is covered by the government health plan in their home province or the government coverage replacement plan sponsored by the plan holder; and
This plan would have paid benefits for the same services or supplies if they had been received in the person’s home province.

EMERGENCY TRAVEL ASSISTANCE

DETAILS

While you and your eligible dependants are traveling for vacation, business or education, you will have access to Global Medical Assistance (GMA), a world-wide communications network serviced by Global Excel. If you have a medical emergency, GMA can help you locate medical services and obtain approval from Canada Life for covered services — at any time of the day or night.

Subject to prior approval from Canada Life, covered services include:

Medical evacuation to the nearest suitable hospital.
Onsite hospital payment when required for admission up to a maximum of $1,000.
Medical evacuation if suitable local care is not available. If traveling within Canada, you will be moved to the nearest suitable hospital. If traveling outside of Canada, you will be moved to: the nearest hospital equipped to provide treatment, or to a hospital in Canada.
Lodging, expenses, and return transportation, as well as custodial services, for children left unattended due to the death or hospitalization of the covered person with whom they are traveling.
Round-trip economy transportation and lodging for one family member joining a covered person who was traveling alone and who has been hospitalized for more than seven days.
Lodging and expenses for a family member who remains with a covered person who is hospitalized and whose return trip has been delayed.
The cost of comparable return transportation for a covered person and one traveling companion if a prearranged, prepaid return trip is missed because the covered person is hospitalized. A rental vehicle is not considered pre-arranged, prepaid return transportation.
Up to $1,000 towards getting your vehicle home or to the nearest rental agency if a covered person dies or is hospitalized. This benefit is not payable if the cost of comparable return transportation is paid.
Preparation and return transportation for the body of a deceased person who is covered under the plan.

Lodging benefits are limited to moderate quality accommodation and $1,500 per confinement. Coverage for travel within Canada is limited to emergencies arising more than 500 kilometres from home.

Limitations

Out-of-province/country coverage does not include trip cancellation insurance, trip interruption insurance, or coverage for lost or stolen baggage.

When Coverage Ends

Out-of-country emergency medical insurance coverage ends when you turn 80 or no longer qualify as a member in Active Good Standing… whichever comes first.

Your spouse’s coverage ends when your coverage ends or your spouse turns 80… whichever comes first.

Coverage for a dependent child ends when your coverage ends or the child no longer qualifies as a dependant… whichever comes first.

Survivor Benefits

If you die while a member in Active Good Standing, your surviving dependents cannot buy up to a higher level of coverage. However, the Trustees may offer to continue coverage to your dependents (spouse and dependent children) for a period of time based on your years of membership in the DGC (see table below).

The minimum coverage is Level II, which includes family coverage. If you have Level I or II coverage at the time of your death, your survivors will receive Level II coverage. If you have Level III coverage at the time of your death, then your survivors will receive Level III.

YEARS OF DGC MEMBERSHIP	PERIOD OF CONTINUING COVERAGE
Less than 15 years	3 years
15 – 19 years	4 years
20+ years	5 years

Emergency Out-Of-Province/Country Coverage