OUT of COUNTRY surgery....AHC pays.....

Out-of-country out-patient hospital services are paid at a daily maximum of $50 Canadian. Only one out-patient visit is payable each day. In-patient hospitalization services are paid at a daily rate of $100 Canadian. These fees include ALL the services provided to a patient by the hospital such as bed, nursing services, in-hospital medications, laboratory services, x-ray services, etc. Therefore, if you become ill and need to be admitted to hospital and remain thee for ten days (example only), you would be reimbursed $1000 Canadian towards the hospital bill. This is regardless of the amount you are billed. Insured physician services received out-of-country are paid at the same rate than an Alberta physician would be paid for the same or similar service. For instance, in Alberta an emergency physician is paid $35.67 for an ER visit. This is the amount you would be reimbursed regardless of his/her charges. On the other hand, an Alberta physician is paid $29.30 for an office visit, which would be your reimbursement in the event of this situation. If you choose to go to Mexico, then the reimbursement will be at the same rate that the Alberta physician would be paid to do this surgery in Alberta. Your reimbursement would be $826.00 for the surgeon and $378.00 for the anesthetic (estimate only). Once again, no payable benefits for private facilities. If this service in Mexico is an acute care hospital, our coverage is $50 per out-patient service and $100 per day (all inclusive) for in-patient hospitalization. I email AHC yesterday and that was the response...doesn't look like it will cover much

Hi there: Thanks for all the info. Do you know what constitutes a hospital and what's the definition of a private clinic? I'm thinking of getting the Gastric Sleeve Surgery in Mexico and the facility is called a hospital but I think it is run by one doctor and his team. Do you know if AHC would cover it? Thanks again and good luck! Deb

Did you ever get paid by AHC? And who exactly did you speak to there? Cheers, Deb