Out of Territory/Country Coverage
When traveling outside of the Northwest Territories, you will be asked to produce a valid NWT health care card before you are able to receive health care services. If you are unable to prove that you are covered under our plan, you may be required to pay for the services received.
If you receive medical services outside Canada, normally, you will be required to pay for the services up front.
If you have paid for medically necessary services, obtain the original copy of a detailed receipt that includes:
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your full name, current address and health care plan number
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detail of the service provided (in English)
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date of service
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doctor's name and address
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name and address of hospital
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diagnosis or itemized claim
Photocopies are not accepted. Include proof of payment and send the receipt to the Health Services Administration Office. If you do not have the original detailed receipt, reimbursement will not be provided.
Please Note:
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All services are not eligible for reimbursement.
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Only services considered medically necessary under the NWT Health Care Plan would be reimbursed.
Most doctor visits and hospital care for medically necessary services will be billed directly to the NWT Department of Health and Social Services. However, you may be required to pay up front for physician services in Quebec. Some physicians in other provinces/territories may also request payment up front for services provided. If you receive medically necessary services within Canada and are required to pay up front, you may apply for reimbursement. Follow the procedure described under General Information.
If you are in an accident or become ill while traveling outside the NWT and need air or ground ambulance services, please note that your NWT Health Care Plan does not provide coverage for these services, or for the cost of any related services such as hospital transfer, escorts, and return transportation charges. Therefore, it is important that you consider additional medical insurance through a private insurance company before you leave the NWT.
Travel must originate in the NWT in order to be eligible for medical travel benefits.
Travel Outside Canada
In some countries, physician and hospital costs are much higher than in the NWT. Medically necessary services received outside Canada are reimbursed at NWT rates. You are responsible for any additional costs. For example, if you need medically necessary physician or hospital services outside Canada that cost $1,000, and the NWT rate for the same service is $250, you are responsible for the $750 difference. If the service you receive outside Canada is not medically necessary, you will be responsible for paying the full amount.
If you receive medical services outside Canada, you may be required to pay for the full cost of the services received up front. To apply for reimbursement, follow the procedure described under General Information.
It is important that you consider additional medical insurance through a private insurance company before you leave Canada.
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Last Updated: November 08, 2006 |
