International Health Insurance Forms

Please find below the International Health Insurance (IHI) forms:

• Health Insurance Claim Form - Extended Health Care Benefits
  To be used to claim reimbursement after having paid for eligible medical expenses. Original receipts must accompany this form.
• Health Insurance Claim Form - Medical Expenses
  To be used when health care provider has agreed to bill Medavie Blue Cross directly for eligible medical expenses. The student has not incurred an expense related to the claim.
• Health Insurance Pre-Authorization Form
  To be used when the physician has recommended surgery that may or may not require hospitalization. The patient must present the form to their attending physician, ensure that the form is completed and return it to Medavie Blue Cross. Medavie Blue Cross will provide the doctor/medical facility with an answer (confirmation of coverage or refusal) within 5 working days. Except in cases of emergency, it is essential that this form be processed before surgery. Failure to do so will automatically result in a refused claim.


• Version française:  Formulaire de pré-autorisationFormulaire de pré-autorisationFormulaire de pré-autorisation