Medical Service Plan

[KrisB]

Out of province but still within Canada you are still covered 100% for treatments because of the Medical Reciprocal Program (except for Quebec).

I've heard of people having issues when they're in Alberta -- not sure how reliable the stories are, but needless to say, they are circulating.

 

[sciguyman]

Out of province but still within Canada you are still covered 100% for treatments because of the Medical Reciprocal Program (except for Quebec).

Are you? My understanding was that you were only covered one province over, except for emergeny care. I may be wrong though

 

[nadwidny]

Are you? My understanding was that you were only covered one province over, except for emergeny care. I may be wrong though

Except for Quebec, the MRP applies to all provinces and territories. Problems may arise when someone goes out of province for elective procedures but didn't pre-clear it with their own provincial health plan (note that elective is not the same as cosmetic. Cosmetic is things like bigger boobs, nose jobs, etc. Elective includes things like hip replacements, cataracts and such.). One of the reasons for the need to pre-clear is that some provinces will insure certain elective procedures while others don't.

 

[nadwidny]

To better explain the MRP I found this blurb on the NF health plan site which is the best I could find with minimal searching. This applies to all Canadians covered by a provincial health plan, except for Quebec. I have no idea what they do since I've never had to do a billing for a resident of Quebec that received treatment here in Alberta. If you need to for clarity, insert your province name where ever Newfoundland and Labrador show up in the following text:

Insured medical services obtained in other provinces and territories are payable at the rates established by the medical care plan in those jurisdictions. Physicians in other provinces or territories submit claims to their local medical care plan for services provided to residents of Newfoundland and Labrador. MCP will be invoiced for the cost of those insured services under the Medical Services Reciprocal Billing Agreement.
The Hospital Reciprocal Billing Agreement enables Canadians to access hospital services when traveling between provinces and territories. Under the Hospital Insurance Plan, hospital coverage is
Based on the fact that the service is provided at an approved, accredited hospital and the services are insured. The hospital providing the insured service will invoice their provincial/territorial Ministry of Health in accordance with policies, guidelines and rates established under the Agreements. The Ministry of Health for the host hospital, in turn, will invoice the Department of Health and Community Services for the insured hospital services.

 

[nadwidny]

While I'm at it, this is from the Alberta health care website:

Claims while travelling within Canada

Except for physician services in Quebec, claims for insured medically required physician, osteopath and hospital services received elsewhere in Canada are usually billed to the Alberta Health Care Insurance Plan through the Medical and Hospital Reciprocal billing process that exists between jurisdictions. Claims are paid at the standard rates of the province or territory where the services were obtained.
You must pay directly for insured dental services received outside Alberta. You can submit a claim and receive benefits at the same rate as payable in Alberta. Some specific dental and oral maxillofacial surgical services performed by a dentist are fully covered. This does not include routine dental care such as cleaning, fillings and the extraction of wisdom teeth.