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Provided you have coverage under the Supplementary Medical Plan and you (or your insured dependent) are temporarily out of the province or out of the country on vacation or business, you are covered for emergency health care.
For travel within Canada there is a reciprocal agreement among provincial health care plans in all provinces except Quebec. In Quebec charges are higher than those in the other provinces, and Great-West Life will pay the amount not paid by OHIP, therefore should you require emergency medical treatment in Quebec, you need to access the MEDEX toll free line to ensure appropriate processing of claims.
When travelling outside of Canada, charges for emergency treatment will be paid at 100% if you are under age 65 and 80% if you are age 65 or over. Therefore, if your coverage level is 80% you may wish to purchase additional out-of-country insurance. The following services are included:
Note: MEDEX Assistance Corporation must be notified within 48 hours, or when reasonably possible, following an emergency. Claims may be denied or reduced if contact is not made with MEDEX Assistance Corporation within 48 hours of admission to hospital.
If in the opinion of a physician or MEDEX Assistance Corporation the patient can be returned home or to another medical facility for immediate or continuing treatment and the patient chooses not to for whatever reason, the claim will be denied for payment by MEDEX.
"Emergency" means any sudden critical, unforeseen or unexpected occurrence requiring immediate medical attention and which takes place outside your province of residence while the coverage is in force. The following out of country expenses are generally not covered by Great-West group plans:
Expenses related to pregnancy or delivery after the 34th week of pregnancy or at any time prior to the 34th week if the patient’s Canadian physician considers the pregnancy a high risk.
"Hospital" means an institution having diagnostic facilities that provides active, chronic care or emergency treatment with physicians and registered nurses in attendance 24 hours a day and is so licensed by the appropriate governmental authority. It does not include an institution providing convalescent care, a nursing home, home for the aged, a rest home or any other facility providing similar care.