RETIREES AND SURVIVING SPOUSES. Eligible benefits are limited to a maximum of 180 days per trip commencing with the date of departure from your province of residence. If you are hospitalized on the 180th day, benefits will be extended until the date of discharge.
RETIREES AND SURVIVING SPOUSES. Eligible benefits are limited to a maximum of 180 days per trip commencing with the date of departure from your province of residence. If you are hospitalized on the 180th day, benefits will be extended until the date of discharge. Hospital services and accommodation up to a standard xxxx rate in a public general hospital. Medical/surgical services rendered by a legally qualified physician or surgeon to relieve the symptoms of, or to cure an unforeseen illness or injury. Emergency Transportation Land ambulance to the nearest qualified medical facility. Air ambulance - the cost of air evacuation (including a medical attendant when necessary) between hospitals and for hospital admission into Canada when approved in advance by your provincial government health plan or to the nearest qualified medical facility. Referral services include hospital services and accommodation up to a standard xxxx rate in a public general hospital, and/or medical surgical services rendered by a legally qualified physician or surgeon. Prior to the commencement of any referral treatment, written pre-authorization from your provincial government health plan and Green Shield Canada must be obtained. Your provincial government health plan may cover this referral benefit entirely. You must provide Green Shield Canada with a letter from your attending physician stating the reason for the referral, and a letter from your provincial government health plan outlining their liability. Failure to comply in obtaining pre-authorization will result in non-payment. Services of a registered private nurse up to a maximum of $5,000 per calendar year, at the usual and customary rate charged by a qualified nurse (R.N.) registered in the jurisdiction in which treatment is provided. You must contact Green Shield Canada for pre- approval. Diagnostic laboratory tests and x-rays when prescribed by the attending physician. Except in emergency situations, these services must be pre-approved by Green Shield Canada. Reimbursement of prescriptions by Green Shield Canada for drugs, serums and injectables, which require a prescription by law and are prescribed by a legally qualified medical practitioner (vitamins, patent and proprietary drugs are excluded). Submit to Green Shield Canada the original paid receipt from the pharmacist, physician or hospital outside your province of residence showing the name of the prescribing physician, prescription number, name of preparation, date, quantity and total cost. Medical...
