DO I NEED PRIVATE HEALTH CARE COVERAGE WHEN TRAVELLING WITHIN CANADA?
The portability criterion of the Canada Health Act requires that the provinces and territories extend medically necessary hospital and physician coverage to their eligible residents during temporary absences from the province or territory. This allows them to travel or be absent from their home province or territory and yet retain their health insurance coverage. Within Canada, the portability provisions are generally implemented through a series of bilateral reciprocal billing agreements between the provinces and territories for hospital and physician services. This generally means that your provincial/territorial health card will be accepted, in lieu of payment, when you receive hospital or physician services in another province or territory because the rates prescribed within these agreements are host-province/territory rates. These agreements ensure that Canadian residents, for the most part, will not face point-of-service charges for medically required hospital and physician services when they travel in Canada because the province or territory providing the service directly bills your home province/territory.
Sometimes there is a requirement for patients to pay “up front” and seek reimbursement from their home provincial or territorial health insurance plan. This still satisfies the portability criterion of the Act as long as access to a medically necessary insured service is not denied due to the patient’s inability to pay. Private health insurance plans are prohibited from duplicating coverage for health services provided in Canada which are insured under the Canada Health Act.
In addition, the provision of “additional benefits” (e.g. prescription drugs, ground and air ambulance services) that provinces and territories may include under their respective health insurance plans are generally not portable outside one’s home province/territory. Most private health insurance plans provide coverage for ambulance services, prescription drugs and other additional benefits provided outside the home province/territory. Therefore, you may wish to purchase private insurance for such services before you leave your home province/territory, to ensure adequate coverage.