MEDOC® TRAVEL INSURANCE PLAN - Johnson Inc.

III.
MEDOC PLAN BENEFITS
EMERGENCY MEDICAL INSURANCE
The MEDOC Plan covers reasonable and customary expenses arising from a
medical emergency, up to the amounts specified and a maximum aggregate of
$5,000,000 per insured per illness or injury, while on an insured trip which are in
excess of any deductible amount specified on your confirmation of coverage.
Eligible benefit payments are in excess of any medical expenses payable by your
Provincial and/or Territorial Health Insurance Plan, or any other insurance plan,
for emergency treatment medically required while on a trip.
You must contact the MEDOC Claims Assistance Centre before you seek medical
attention. If you are unable to call because you are medically incapacitated
someone else (such as a relative, friend, nurse, physician, or medical provider)
must contact the MEDOC Claims Assistance Centre on your behalf as soon as is
reasonably possible. If you (or someone else) do not call the 24-hour MEDOC
Claims Assistance Centre or if you choose to seek care from a non-recommended
medical service provider, your coverage will be limited to 70% of eligible
expenses payable under the Emergency Medical Insurance coverage.
IMPORTANT: The MEDOC Claims Assistance Centre must pre-approve
and arrange eligible expenses and benefits (items # 1 to 8) in advance. To
receive reimbursement for eligible expenses or benefits (items # 9 to 13), you
must submit original receipts at time of claim. All expenses and benefits
under this insurance are subject to the Exclusions and Limitations including
the Medical Stability Clause outlined in Section IV.
Eligible expenses include:
1. Emergency Medical Expenses - This benefit covers the cost of emergency
treatment for the following:
a) Hospital room and board, including an intensive care or coronary care
unit, charges for standard ward accommodation, semi-private room, or
private room charges when a private room is certified as medically
necessary by the attending physician;
b) Other hospital services and supplies;
c) Medical, surgical or anaesthetic treatment by a licensed physician;
d) X-rays and other diagnostic tests;
e) Use of an operating room, anesthesia and surgical dressings;
f) Cost of licensed ground ambulance service;
g) Outpatient emergency room charges;
h) Prescription drugs or medication prescribed by a physician limited to a
30 day supply;
i) Rental cost of a wheelchair, or the rental or purchase of minor medical
appliances such as crutches, braces and other necessary medical
appliances.
Effective – Sept. 1/10 9 GROUP A