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TERRACE BAY NEWS PAGE 23 AUGUST 2I, I974 w= lllaway from home? Travelling outside the province or country? Here is a capsule account of the extent of your coverage under the basic Ontario health insurance plan (OHIP) and Blue Cross medical/hospital insurance plans if you should become ill out- side Ontario. 1. Hospital Costs under OHIP Hospitalization in another province: OHIP will pay to the per diem rate accepted in Ontario at the standard-ward level inclusive of standard-ward room, meals and most services. Remember each Canadian province recognizes the other's rates. Hospitalization in the United States: Claims are settled by OHIP on two different bases depending on the individual's case. (i) OHIP will pay 75% of standard-ward rate charged by the hospital plus the extra charges for insured services covered by the plan. This is for elective or non-emergency admissions. (ii) The Plan will pay 100% of the charges for emergency (un- expected) admission, such as care following a car accident or heart attack. Points to remember for U.S. hospitals: ® Most U.S. hospitals charge room rate plus the cost of services such as operating room, blood, drugs and x-ray. ® Room rates plus the cost of "extra services vary greatly, from $25.00 per day to more than $100.00 per day for a room alone. ® Very high cost areas are New York, Boston and San Francisco. ® OHIP pays most U.S. hospitals directly. . OHIP coverage in all other foreign countries: In most cases the patient hos- pitalized outside North America must pay his hospital bill and then seek reimbursement from OHIP. - OHIP will refund the hospital costs to the subscriber upon pre- sentation of evidence of his hospitalization. OHIP pays all hospital charges at the standard-room level for care in countries where these charges do not exceed Ontario's, e.g. Britain, Spain, France, Italy, China, Russia, and Israel. (A good idea is to check out hospital/medical costs in the country in which you wish to travel.) Only when the subscriber is un- able 'to pay the hospital's bill on the spot does OHIP pay it direct- ly. Arrangements for OHIP mak- ing the payment must be made by the subscriber. 2. Other Hospital Costs under OHIP (i) Psychiatric and tuberculosis care: Benefits are limited to 60 days of care if an insured Ontario resi- dent must be admitted to a tuber- culosis sanitorium or psychiatric hospital outside Ontario. (ii) Ambulance service: OHIP will pay 75% of the charges if the amount is not more than "that charged for the same service in Ontario. To obtain re- imbursement the patient should show a receipt showing the num- ber of miles transported and a certificate signed by a doctor stat- ing that ambulance services were justified. : 3. Doctors' Costs under OHIP : OHIP will pay doctors' fees in foreign countries exactly as it would in Ontario, i.e. 90% of On- tario's accepted schedule. 4. Blue Cross Plan All Canadian provinces are in agreement that Canadians plan- ning to travel abroad should take out "a private short-term health insurance policy, like the Ontario Blue Cross Plan. It is called the Health Plan While Outside Canada and it supplements basic OHIP coverage. This Plan pays for hos- pital accommodation and doctors' fees charged in excess of OHIP coverage, private duty nursing, ambulance service and others. Coverage is available for indi- viduals and families for six dif- ferent periods of stay abroad--14, 21, 28, 40, 60 and 120 days. There is no age limit and no medical examination is required. For further information on the Health Plan While Outside Can- ada, contact The Director, Ontario Blue Cross, 150 Ferrand Drive, Don Mills, Ontario, M3C 1H6, telephone (416) 429-2661. medical fee