Referrals for Services Outside of Canada

Obtaining Pre-Approval

If a BC specialist physician recommends medical treatment in another country, the specialist must request provincial coverage.

The referring specialist may complete the Out of Country Health Services Funding Application (the Application) or send a written request for coverage, for out of country medical treatment.

The specialist must include medical documentation with the Application to detail the medical necessity for out of country medical treatment and the specialist must confirm the appropriate standard of care is not available for the patient in BC, or anywhere in Canada.

Provincial coverage for out of country medical services will consider the following:

  • treatment is medically required
  • the out of country service would be an insured benefit, if performed in BC
  • the service is provided by a licensed physician or oral surgeon
  • in-patient hospital services are provided in an accredited, acute care general hospital
  • appropriate, acceptable medical care is not available for the patient in Canada, or a delay in medical treatment will have medically significant, irreversible medical consequences for the patient
  • the service is generally accepted by the medical profession in B.C. to be non-controversial and a worthwhile treatment for the patient's medical condition

Please note on the Application if patient requires urgent out of country medical treatment.

The Provincial coverage is detailed in the:

Please note:

Provincial coverage for medical treatment does not include any financial assistance for non-medical services, such as travel or accommodation expenses, take-home/out-patient drugs or services provided by non-physician practitioners.

Benefits for outpatient dialysis provided in a hospital or other approved facility and day-care surgical services are paid at a set rate. For the current rates, please contact Out of Country Claims.

Beneficiaries should review coverage with their extended health care plan or private travel insurance companies to confirm the terms of their extended coverage. Policies usually do not cover pre-planned medical services, outside of the country.

Urgent Requests

Applications for urgent medical treatment can be faxed to the Authorization Coordinator, Out of Country Claims: 250 405-3588.

Please note the telephone or fax number where the referring specialist can be contacted.

Approval for Immediate Care After Regular Hours

If a patient needs immediate life saving care and admission to an acute care hospital, please contact BC Patient Transfer Network for assistance.

BC Patient Transfer Network assists physicians and other health care providers with patient transfers for acute and critical care services. BC Patient Transfer Network manages medical transfers within and outside of BC.

BC Patient Transfer Network contact information:
Vancouver: (604) 215-5911
Elsewhere in B.C.: 1-866-233-2337
http://www.bcptn.ca/