How to make a claim (Out Province)

Wednesday, October 09, 2013
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Insurance Basics, How to make a claim

About Out-of-Province and Out-of-Country Coverage

Before you leave the province, it’s important that you understand what is covered under your health plan and the impact a large claim could have.

If you have an individual plan, please consult your benefits booklet or contact us. Individual health plans typically do not provide emergency out of country coverage.

If you have a group plan, please consult your benefits booklet, contact your plan administrator, or contact us. Generally, group health plans provide coverage for emergency medical expenses incurred for you and your dependents while traveling outside of Canada, but there may be limitations such as the number of days outside the province. Unlike many other insurers, and with the exception of some retiree plans, most of our group plans provide coverage for pre-existing health conditions.

Do you need additional travel coverage?

Individual plan members are always advised to purchase travel coverage, and those with a group plan also benefit from purchasing additional travel coverage to ensure they’re fully protected.

Here are some examples of expenses not generally reimbursed by the out of country coverage in a group plan:

  • Diagnostic procedures
  • Elective treatments
  • Follow-up visits or routine care
  • Baggage insurance
  • Trip cancellation
  • Repatriation of deceased
  • Subsistence allowance (child care if parent is hospitalized etc)

To better understand the limits of your group plan coverage, we have put together this comparison to illustrate the differences between out-of-country coverage in your group health plan vs. additional travel coverage available from Pacific Blue Cross.

You can purchase travel insurance any time of day or night online at www.pac.bluecross.ca/travel/ or by calling 1 800 873-2583 during normal business hours. Please note travel insurance must be purchased prior to departure from your province of residence.

You can also download our mobile app available for iPhone and Android. In addition to enabling you to purchase coverage on your phone, it also gives you access to your policy while you travel in case something unexpected happens.

How to Claim Out-Of-Province/Out of Country Medical Expenses

The following instructions relate to claims for out-of-province and out-of-country expenses, for our Travel Plan holders, or for Group or Individual Plan members with coverage for out-of-province or out-of-country emergency medical expenses.

If you live in BC and experience a medical expense in any other province or territory, other than Quebec, please download, fill-in, and submit the Pacific Blue Cross Out of Province claim form from Step 1 below.


If you live in BC and experience a medical emergency in Quebec or outside of Canada, please submit the following documentation to Pacific Blue Cross:

Step 1
  • Complete a Pacific Blue Cross Out of Province claim form
  • You must indicate the nature of illness for each medical expense. 
  • The member (policy holder) must sign the claim form. 
Step 2
Step 3
  • Complete a "Schedule A" form 
  • The patient or legal guardian must sign this form.    
Step 4
  • Attach all the paid in full original receipts or invoices that you received for the services/items rendered.  If receipts/invoices are in another language it is the member's responsibility to translate these documents.
  • Ensure you take copies of your receipts/invoices, prior to submission, for your records.


If you live outside of BC and experience a medical emergency in another province, territory or in another country:

Step 1
  • Contact your local Provincial/Territorial medical plan to obtain their claim forms.
Step 2
  • Submit the original receipts along with their completed claim form to your provincial/territorial plan office for consideration.
  • Ensure you take copies of your receipts/invoices, prior to submission, for your records.
Step 3
  • Await the reply from your provincial/territorial plan.
Step 4
  • Upon receipt of the statement of payment or denial from your Provincial/Territorial medical plan please complete a Pacific Blue Cross Out of Province claim form. You must indicate the nature of illness for each medical expense. The member (policy holder) must sign the claim form.
  • Attach all the paid in full original receipts or invoices that you received for the services/items rendered. If receipts/invoices are in another language it is the member's responsibility to translate these documents.
  • Ensure you take copies of your receipts/invoices, prior to submission, for your records.
  • Submit the statement of payment or denial, the claim form and original receipts to our office for review.

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