The Out-of-Province Benefit is available only to members with Supplementary Coverage.
The benefit consists of the following components:
- Emergency Benefit while Travelling
- Emergency Travel Assistance Services
- Referral Benefit
Emergency Benefit while Travelling
Each participant is covered for eligible medical expenses incurred as a result of an emergency while travelling on vacation or on business. The maximum eligible expense per participant is $500,000 (in Canadian dollars) per period of travel (not exceeding 40 consecutive days).
Eligible expenses mean the reasonable and customary charges in excess of the amount payable by a government health insurance plan, if they are required for emergency treatment of an injury or disease that occurs within 40 days of the date of departure from the province/territory of residence.
Services of a physician.
|Evacuation (including ambulance services)||
Medical evacuation, which may include ambulance services, when suitable care, as determined by Sun Life, is not available in the area where the emergency occurred.
|Family assistance||Family assistance benefits up to a combined maximum of $2,500 for any one travel emergency, as follows:
|Hospitalization and hospital services||
Public ward accommodation and auxiliary hospital services in a general hospital.
Return of the deceased in the event of death of a family member. The necessary authorisations will be obtained and arrangements made for the return of the deceased to the province/territory of residence. The maximum payable for the preparation and return of the deceased is $3,000.
|Return to province/territory of residence||
One-way economy airfare for the patient's return to their province/territory of residence. Airfare for a professional attendant accompanying the patient is also included where medically required.
Emergency travel assistance services
The PSHCP provides a toll-free number which gives you 24-hour access to a world-wide assistance network of professionals who offer help with medical, legal, or other travel-related emergencies.
Please note, however, that assistance services are not available in countries of political unrest. The list of countries, as maintained by Sun Life, will change according to world conditions.
Neither Sun Life nor the company providing the assistance network is responsible for the availability, quality, or result of the medical treatment received by the participant or for the failure to obtain medical treatment.
|Advances||Advance payment on behalf of the participant or a covered dependant for the payment of hospital and medical expenses.
To arrange for advance payment of hospital and medical expenses, the participant must sign an authorisation form allowing the Administrator to recover payment from the provincial/territorial health insurance plan. The participant must reimburse the Administrator for any payment made on their behalf which is in excess of the amount eligible for reimbursement under the provincial/territorial health insurance plan and the PSHCP.
|Arranging of care||
Transportation arrangements to the nearest hospital that provides the appropriate care or back to Canada.
Medical referrals, consultation and monitoring.
A message service for family and business associates; messages will be held for up to 15 days.
A telephone interpretation service.
Official travel status
Employees required to travel on "official travel status" for government business are covered under the Emergency Benefit while Travelling and are eligible to use the Emergency Travel Assistance Services during the entire period of "official travel status". Although there is no time limit to be on "official travel status", the $500,000 (in Canadian dollars) benefit coverage limit still applies.
Referral services must be:
- performed when the participant physically leaves the province/territory of residence,
- following a written referral by the attending physician in the person's province/territory of residence,
- for a service that is not offered in the person's province/territory of residence.
Eligible expenses under this benefit will be limited to the reasonable and customary charges in excess of the amount payable by a provincial/territorial health insurance plan and to a maximum eligible expense of $25,000 per illness or injury.
Services of a physician or surgeon
|Hospitalization and hospital services||
Public ward accommodation and auxiliary hospital services in a general hospital
Laboratory services including those services which when ordered by and performed under the direction of a physician provide information used in the diagnosis or treatment of disease or injury. Services include, but are not limited to, blood or other body fluid analysis, clinical pathology, radiological procedures, ultrasounds, etc.