1 Understanding Your UBC Travel Benefits Updated July 2015
2 Agenda for Today 1. Should I purchase additional insurance? What is my coverage? Factors to consider Situational examples 2. What documentation should I bring with me? 3. What should I do in the event of a medical emergency? 4. How do I make a claim? Questions and Answers
3 Should I purchase additional medical insurance?
4 It Depends Individual decision - important factors to consider: 1. Understand your UBC coverage 2. What is your Extended Health balance (as well as dependents)? 3. Do you have other coverage? 4. Pre-existing conditions / pregnant? 5. Exclusions / Limitations Then Decide
5 Factor #1: Understand your UBC coverage Expense In BC Outside BC/Canada Expenses that the BC Medical Services Plan normally covers Hospital room, hospital services & physician services Expenses that Sun Life normally covers Prescription drugs, ambulance, semiprivate or private hospital room, vision care, medical equipment & supplies, paramedical services Covered if medically necessary Covered if medically necessary, as specified in booklet Coverage Covered if medically necessary in the event of an emergency only Same as in BC, except paramedical services not eligible outside Canada and United States Reimbursement 100%, up to overall lifetime max of $1,000,000 per person reimbursement specified in booklet (BC rates), up to overall lifetime max of $1,000,000 per person 100% ambulance
6 Definition of emergency An acute illness or accidental injury that requires immediate, medically necessary treatment prescribed by a doctor. An emergency ends when you are medically stable to return to the province where you live. A sudden, unexpected illness or injury An acute episode of a medical condition that was not identified or being treated prior to departure from Canada. An unexpected and unforeseen acute episode of a previously identified medical condition that was stable and controlled at the time of departure from Canada.
7 Factor #2: Determine your Extended Health balance Out-of-province/country travel maximum falls under the $1,000,000 Extended Health lifetime maximum (per person) $1,000,000 is reduced by all Extended Health claims Sun Life has reimbursed you for Call Sun Life to find out your balance (as well as dependents) Low balance may want to purchase additional coverage
8 Factor #3: Do you have other coverage? Do you have coverage under your spouse s plan? Do you have a credit card that provides coverage for outof-province/country medical expenses? Read the fine print Call to confirm coverage Under Coordination of Benefit rules, you may receive reimbursement under all plans you are covered for The plan you contact first is the first payor
9 Factor #4: Pre-existing conditions or pregnant? If you have a pre-existing condition: You can still travel and have coverage as long as your doctor has cleared travel Pregnancy: Up to 36 th week of pregnancy: covered for emergency medical expenses related to birth of child No coverage beyond 36 th week
10 Factor #5: Exclusions/Limitations Covered 365 days from the date you leave BC. Hospital coverage is limited to 90 days, will be extended if it is dangerous to transport you back home. If Sun Life (based on medical information) determines that you can be transported back to BC for medical attention and you elect not to return home. Non-emergency services: services that are not immediately required or which could reasonably be delayed until you return to BC. Illness or injury resulting from the hostile action of any armed forces (military or police), insurrection, riot, civil commotion or terrorist activity that you participated in. Participation in a criminal offense. No coverage for trip delay, cancellation or lost luggage. Full list of exclusions/limitations on UBC Travel Benefits website
11 Situational Examples 1. Rebecca is in Peru hiking the Inca Trail to Machu Picchu. While on the hike, she falls and breaks her leg. She needs to be airlifted to the nearest hospital for immediate medical attention. Is this an emergency? Will the air ambulance be covered? Will the hospital services be covered? 2. Sam is in Hong Kong for a conference. He takes daily medication to control his high blood pressure. He was extremely busy prior to his trip and did not have the time to refill his prescription. He has run out of pills and needs to visit a doctor. Is this an emergency? Will the doctor s visit be covered? Prescription drugs?
12 Decision to Purchase Additional Coverage Sun Life reviews each situation as it arises. Coverage depends on whether it is considered a medical emergency, cost of services obtained, whether you have a high enough balance, etc. After considering the 5 factors: If you are comfortable with the UBC coverage, you may decide not to purchase additional coverage If you have a low Extended Health balance, pre-existing conditions, pregnant, or lower tolerance for risk, you may wish to purchase additional coverage for peace of mind
13 What documentation should I bring with me?
14 Bring the following: BC Care Card/BC Services Card Sun Life Coverage Card can download from the Sun Life website Letter from UBC Human Resources (if required for tour company) Medi-passport brochure Also see Preparing for Travel Checklist for helpful tips
15 What should I do in the event of a medical emergency?
16 If you experience a medical emergency Call Europ Assistance, Sun Life s travel benefits provider as soon as possible (or a travel companion can call for you) Europ Assistance can: Refer you to physicians, pharmacists and medical facilities Confirm your coverage and benefits Facilitate payments to a hospital or medical provider, where possible Monitor your medical situation, if you are hospitalized Coverage for other services, such as a visit by a family member if you are hospitalized, replacement ticket if you miss your return flight home due to a medical emergency, repatriation, etc.
17 How do I make a claim?
18 Making a Claim Complete an Extended Health Claim Form, attach your original receipts (if possible, translated in English and in Canadian funds) and mail it to Sun Life. Be sure to take a copy. Europ Assistance will send you additional forms that you will need to complete in order for them to coordinate payment of your claim with MSP. For more information, please visit the UBC Travel Benefits website.
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