It’s January! The hubbub of Advent and Christmas is finished, and the days are dark and cold. A trip to a warmer, sunnier place can be an appealing idea at such a time. Vacations or travel to conferences can offer a real boost to mental health and expand your horizons. Before you book your tickets, you may want a quick refresher about your travel benefits.

What Exactly Is Covered?

The coverage in the group benefits plan is HEALTH coverage. This means the plan covers costs related to your medical care. This coverage does not include trip cancellation. If you would like that coverage, you will need to arrange for additional insurance with another provider.

The number for making general inquiries to GEM before your trip begins is 1-800-268-6195.

Medical Care while Travelling

If you require medical care while travelling, it is critical that you contact GEM before seeking treatment. The Canada/U.S. toll-free or collect numbers are printed on the back of your benefits card (1-800-265-9977). There are also special dedicated numbers for certain countries like Mexico, Dominican Republic, Cuba and a few others.

Their caring and experienced in-house medical team is ready to help you 24/7.

Emergency Assistance Specialists will

• guide you to the most optimal healthcare solution based on your condition and location,
• arrange payment on your behalf whenever possible, and
• share important information and next steps related to your claim.

In a life-threatening medical emergency, get to a hospital immediately and have a family member or friend call GEM on your behalf within 24 hours of admission and before any surgery is performed.

GEM will ask some questions about your emergency and any potentially related medical history. Providing accurate information will help ensure that you receive the right help and information about your coverage.

What Happens in a GEM Call?

GEM is our travel administrator only; they do not have direct access to plan member information. You will be asked to provide personal and policy information at the time of case opening.

Depending on the nature of the incident, medical records from a Plan Member’s Canadian medical providers may be required, as well as from the medical provider who was seen during the medical emergency. You may be asked to provide your authorization to access these records.

Here are a few things the GEM representative will ask:

• Details about the incident and the type of assistance you require.
• Our full name (ELCIC Group Services Inc.), group plan number 29835, plan member certificate number (available on your benefits card).
• The patient’s name and confirmation of provincial health insurance coverage.
• Details about you, your symptoms and location to provide guidance on next steps and identify the appropriate care for your situation.

Billing and Payment

GEM will attempt to arrange direct billing with the medical provider so you’re not out of pocket. Acceptance of billing information is solely at the discretion of the medical provider, so at times members may be required to provide the up-front payment. Ensure you obtain an itemized invoice and medical records for your claim submission.

Some policies have a Small Claims Filing Clause, which means that if the total cost of treatment is less than $200 CAD, you will pay up front. To claim these expenses, you would:

1. Submit the receipt to your government health insurance, who will provide partial reimbursement, then
2. Submit the remaining amount to Manulife.

Collection Notices

Sometimes medical providers involve collection agencies to recover overdue payments. Call GEM immediately if you receive a call or collection notice related to your out-of-country emergency claim. GEM will work directly with the medical provider or collection agent to resolve the issue.

Claims Processing

Travel claims can take longer to process than regular health and dental claims.

When you call GEM and start the claims process, you’ll be sent the required forms. As soon as GEM receives these forms, they can begin to collect the information necessary to process your claim.

What about Out-of-Province Travel?

Travel insurance can be helpful when travelling out-of-province as well as out-of-country. Provincial health plans cover different things; your benefits plan may cover the difference between what your provincial plan pays and what the other province charges. If approved as Medically Necessary, it could also cover transportation for the patient from a medical facility in the other province to your home province.

Being aware of how to access GEM Emergency Travel Insurance is therefore wise even if you are travelling within Canada.

Other Travel Tips

Do not surrender your passport. If asked to surrender your passport due to a medical incident or emergency, refuse to do so and contact GEM immediately.

If you are planning to take your cell phone out of the country, please ensure your phone is set up to do so before you travel, including enabling roaming. This preparation will prevent possible issues when you are trying to use your cell phone during an emergency.

Before you travel, contact your cellular provider for more guidance. ESIMs are a popular option now for travel, but often those are data-only. Have a plan for being able to phone GEM if you end up needing it. Landlines are a reliable option; GEM offers toll-free long distance in many countries.

“What to Carry” Checklist

• Passport (original and photo/scan)
• Benefits card (original and photo/scan) with GEM toll-free/collect call numbers
• Provincial health insurance card (original and photo/scan)
• Proof of out-of-country travel health insurance if needed