 | Home :
Emergency Medical Insurance - Coverage Details
The following are the details of the standard emergency medical insurance policy currently offered to teachers and ex-patriots heading overseas to work.
If you have questions about making a claim or about the insurance please feel free to contact Norfolk directly.
TOLL FREE: 1 800-672-6089
DIRECT: +1 (403) 232-8545 |
Policy Coverage - Footprints Recruiting Inc., PLAN SUMMARY GFRW1079
|
Currency of Benefits
|
- Canadian
|
|
Geographic Area of Coverage |
- Worldwide OR Worldwide Excluding North America and the Caribbean
|
Medical Underwriting |
- Evidence required for all new applicants
|
Pre-Existing Medical Exclusion |
- not applicable as each applicant is medically underwritten at the time of enrollment
|
Emergency Medical |
- refer to Medical Benefits link
|
Doctor's Visits |
- 80% coinsurance
|
Out-Patient Prescription Medication and Injections |
- optional coverage
|
Hospital Fees |
- 80% coinsurance
|
Emergency Inpatient |
- 80% coinsurance
|
Nursing at Home |
- 12 week lifetime maximum
|
Paramedical Practicitioners |
- $500 per practictioer per policy year
|
Routine Annual Check-up |
- $300 per 12 month term after 6 months of continuous coverage
|
Lifetime Maximim |
- $1,000,000
|
Maternity and Newborn Baby Care |
- optional coverage |
|
Maximum Limit: Notwithstanding the limits stated in the separate sections of this Policy, the Overall Maximum Limit for Medical Expenses shall not exceed one million dollars ($1,000,000) per Lifetime of the Insured
80% Reimbursement of eligible expenses with a $500.00 deductible per policy year.
|
Part A – Hospital Benefits: When, by reason of Injury or Sickness, an Insured Person is confined to a Hospital the Insurer will pay the Reasonable and Customary costs for room and board charges (up to semi-private room accommodation), including the costs relating to Physicians, Surgeons, nursing, operating room, prescription drugs, dressings, diagnostic services, medical appliances, and any other necessary cost made by the Hospital for In-Patient Hospital Services, Day-Patient Hospital Services, as well as costs incurred in an Intensive Care Unit. Insured Persons must obtain Pre-Authorization from The Norfolk Group or the medical assistance provider. |
Part B – Medical, Surgical and Diagnostic Services: When by reason of Injury or Sickness, an Insured Person incurs expenses for any of the following while under the regular care and attendance of a Physician or Surgeon, the Insurer will pay the reasonable and customary costs incurred for the following:
1. Diagnostic, X-Ray, and Laboratory Services.
X-Ray or Laboratory examinations under the attendance or supervision of a Physician or Surgeon for Diagnostic Services. Laboratory and x-ray services must be provided by or ordered by a Physician. This Policy does not cover magnetic resonance imaging (MRI), cardiac catheterisation, computerised axial tomography (CAT) scans for reasons considered non-emergency unless such services are Pre Authorised and arranged in advance by the Insurer.
2. Paramedical Services.
The services of a registered massage therapist, chiropractor, physiotherapist, psychologist, osteopath, naturopath, speech therapist, podiatrist or acupuncturist up to a maximum of $500 per profession, per policy year per insured.
3. Nursing at Home.
The reasonable and customary cost for the medical services of a licensed nurse in the Insured Person’s home when prescribed by a Physician and related directly to a medical condition for which the Insured Person has received or is receiving treatment covered under this Policy. This benefit is available for up to 12 weeks per lifetime. The nurse cannot be an Immediate Family Member or currently residing with the Insured Person.
4. Ambulance Charges.
Charges for licensed ground ambulance transportation to the nearest Hospital, or from one Hospital to another or from a Hospital to the Insured Person’s residence.
5. Routine Annual Check-ups.
Insured to a maximum of $300.00 per insured per 12-month period after 6 months of continuous coverage. |
Part C – Out-Patient Services: When by reason of Injury or Sickness, an Insured Person incurs expenses for any of the following while under the regular care and attendance of a Physician or Surgeon, the Insurer will pay the reasonable and customary costs incurred:
1. Physician or Surgeon’s service fees
2. Personal Aids
rental (or purchase, at the option of the Insurer) of crutches, casts, splints, canes, slings, trusses, braces, orthotics to a maximum of $200 per policy year and the temporary rental of a wheelchair when prescribed by a Physician or Surgeon, hospital-type bed, iron lung, or other approved durable equipment for temporary therapeutic use.
3. blood or blood plasma (includes the administration of blood).
|
Part D – Emergency Dental Treatment: When an accidental blow to the mouth or face results in Injury to an Insured Person, the Insurer will pay for the emergency dental treatment necessary to restore or replace permanently attached artificial teeth or sound natural teeth lost or damaged in an Accident, and for which dental treatment is initiated within 30 days following an Accident and completed within the Policy Term. Detailed medical documentation from a Physician or dentist must be provided to support an Insured Person’s claim.
All indemnity payable under this Part D is subject to a maximum amount of $2,500 per Insured Person, per occurrence.
|
Part E – Repatriation or Local Burial: When Injury or Sickness results in loss of life of an Insured Person outside his / her home country, the Insurer will pay for the preparation and the transportation of the mortal remains of the Insured Person from the place of death, or the preparation and local burial of the mortal remains. This benefit is limited to $10,000. If another insurer provides this benefit this policy becomes the second payor. |
Part F – Emergency Medical Evacuation: When, by reason of Injury or Sickness, it is deemed medically necessary to evacuate an Insured Person who has a critical medical condition as determined by the Insurer or the medical assistance provider, to the nearest Hospital equipped to provide appropriate care and facilities, the Insurer will reimburse the Reasonable and Customary cost of emergency evacuation and medical care to such Hospital. The Insurer will also reimburse reasonable transportation costs for one other Person accompanying the patient when this is deemed necessary, and will pay the cost of a one-way economy airfare back to the Insured Person’s Home or Host country. If another insurer provides this benefit this policy becomes the second payor. |
Part G – Compassionate Emergency Travel: In the event that an Insured Person suffers an Injury or Sickness and is confined to Hospital outside their Home Country for a minimum period of seven (7) consecutive days, or suffers loss of life outside their Home Country, the Insurer will pay a single round-trip economy airfare for an Immediate Family Member to attend the Insured Person and / or identify the Insured Person and arrange for repatriation of the Insured Person’s remains. This benefit is limited to $3,000 per Insured Person, per Injury or Sickness and must be pre-approved by the provider. The Insurer reserves the right to obtain written certification from the attending Physician that such attendance was medically appropriate.
|
Part H – Parent Accompanying Child: When an Insured Person under 15 years of age is confined to Hospital as an In-Patient, the Insurer will pay the reasonable and customary costs charged by the Hospital for one parent to stay with the child.
Further, if an Insured Person who is a single parent is confined to a Hospital as an In-Patient, the Insurer will pay the reasonable and customary costs for a Dependent child under 15 to stay with such Insured Person.
|
PART I - Daily Expense Allowance: A daily expense allowance while outside Country of foreign assignment of up to $100 per day is paid when treatment is received as an out-patient of a hospital or medical facility, provided such treatment is not available at the place of assignment as certified by an attending physician. The daily expense allowance is limited to a maximum of 14 days per illness or injury, and will not be paid unless receipts issued by a commercial facility are submitted. |
PART J - Medical Extension Upon Permanent Return to Home Country: Emergency medical care and maternity benefit if applicable, can be extended for up to a maximum of 90 days with premium based on geographical area of Home Country During this time, application must be made for coverage under the any Government Hospital or Medical plan for which you and your Dependents are eligible. This extended protection terminates on the earliest of 90 days or when eligible for the Government Hospital and Medical Plan coverage. |
MEDICAL EXCLUSIONS 1. Prostheses, corrective devices and medical appliances unless required as a result of a surgical procedure including glasses, contact lenses, hearing aids, dentures or dental appliances;
2. elective and / or cosmetic surgery, whether or not for psychological reasons unless required as the result of Injury incurred while this Policy is in force;
3. Acquired Immune Deficiency Syndrome (AIDS), AIDS related Complex Syndrome (ARCS) and all diseases caused by/and/or related to the HIV virus or any other sexual transmitted disease;
4. Out-patient Prescription Medication and injections
5. any Medical Expense incurred while covered under the plan but submitted 365 days following the date the expense was incurred or 90 days after coverage terminated.
Please refer to each benefit description for additional exclusions.
|
CLAIMS PROCEDURES APPLICABLE TO MEDICAL, BENEFIT The Insurer will pay Benefits provided that:
1. the Insured Person has contacted and received Pre-Authorization of any costs to be incurred as either a Day-Patient or an In-Patient. In an emergency when the claims administrator cannot be contacted in advance, then the admission to Hospital must be reported as soon as reasonably possible;
2. written details of all claims have been sent to the claims administrator as soon as possible and in any event not later than 365 days from the beginning of the Medical Treatment;
3. all documentation relating to the claim including the claim form and accounts are originals and not copies; and
4. the required premiums have been paid relative to the Insured Person making the claim.
It is understood that:
1. the insurer can ask for medical information from any Physician or Surgeon as often as required and if necessary examine the Insured Person; and
2. the insurer shall be notified of any circumstances that may lead to a claim against a third party or any other insurance; and
3. in the case of a claim in the Insured Person’s Home Country, proof of the Insured Person’s entry date into their Home Country is provided.
|
All pertinent information shall be sent to: The Norfolk Group
Suite 1100, 940 – 6 Ave. SW
Calgary, AB
T2P 3T1
|
APPLY TO TEACH ABROAD
 APPLY NOW - Teach English Abroad with a great company that will protect your interests and maximize every aspect of your experience.
|
|
|
|
