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Globetrek Travel Insurance Summary of Benefits

Emergency Medical Expenses Sum Insured: $5 Million or limited to $20,000 if insured is not covered under a government health insurance plan (GHIP)

Hospitalization Hospital accommodation up to the semi-private room rate (or an intensive or coronary care unit where medically necessary)

Physician’s Fees Medical treatment by a physician

Diagnostic Services Laboratory tests and x-rays prescribed by the attending physician due to an emergency. This policy does not cover magnetic resonance imaging (MRI), cardiac catheterization, computerized axial tomography (CAT) scans, sonograms, ultrasounds and biopsies unless such services are approved in advance by Global Excel

Paramedical Services Services of a licensed chiropractor, chiropodist, osteopath, podiatrist or physiotherapist, including x- rays, to a maximum of $300 per profession listed, when approved in advance by Global Excel

Prescriptions Drugs, serums and injectibles that can only be obtained upon medical prescription, that are prescribed by a physician and that are supplied by a licensed pharmacist when required as a result of an emergency. Limited to a 30-day supply per prescription, unless you are hospitalized

Ambulance Services: Licensed ground ambulance service

Medical Appliances Minor appliances such as crutches, casts, splints, canes, slings, trusses, braces, walkers and/or the temporary rental of a wheelchair

Private Duty Nursing The professional services of a registered private nurse to a maximum of $5,000

Emergency Air Transportation:

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    air ambulance; or

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    transport on a licensed airline with an attendant; or

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    the fare for additional airline seats to accommodate a

stretcher; or

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    . up to the cost of a one-way economy airfare

Qualified Medical Attendant Return economy airfare and overnight lodging and meals (where necessary).

Transportation to Bedside Round-trip economy airfare from Canada and up to a maximum of $1,500 for out-of-pocket expenses

Treatment of Dental Accidents Reimbursement of the cost of emergency treatment:

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    at trip destination as the result of an accidental blow to

the face;

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    upon return to province or territory of residence, to a

maximum of $1,500;

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    at trip destination for other emergency dental treatment,

to a maximum of $350

Out-of-Pocket Expenses $500 per day, to a maximum of $5,000

Remote Evacuation Up to $5,000 for emergency evacuation from a mountainous area, the sea, or other such remote location

Preparation and Repatriation of Remains Cost incurred for return of the deceased’s remains including:

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    preparation of the remains to a maximum of $5,000; or

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    cremation at place of death to a maximum of $2,500; or

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    $3,000 for preparation of the remains plus $2,500 for

burial at place of death

Global Excel Management Inc. Assistance through Global Excel is available 24 hours a day, 7 days a week. In the event of a Medical Emergency while on his/her covered trip the insured must call Global Excel Management Inc. immediately.

Global Excel will work closely with the insured to:

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    recommend an appropriate physician or hospital;

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    monitor the insured’s care to ensure that his/her medical

needs are met;

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    contact the insured’s family and physician on his/her


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    pay hospitals, physicians and other medical providers

directly, whenever possible;

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    provide multilingual interpreters to communicate with

physicians and hospitals.

This is a brief summary of benefits. Please refer to the insurance policy for complete details.

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