A Montreal woman who survived a polar bear attack in northern Manitoba last year is warning others not to assume their provincial or territorial health plan will fully cover them while travelling within Canada.
Erin Greene, 30, said she faces more than $13,000 in medical bills from the Nov. 1 attack, which happened as she was walking home early in the morning from a Halloween party in Churchill, Man.
The polar bear grabbed Greene, who wrapped her arms around her head to try to protect herself. It thrashed at her, severing three arteries and tearing her scalp and a piece of her left ear.
Greene was airlifted to a Winnipeg hospital, where she received 28 staples, several stitches and some blood transfusions.
Now back in Montreal, Greene told CBC News she received bills totalling $13,159 in the mail last week. The bills were for expenses not covered by Quebec's health insurance program.
"I was a Canadian citizen and in my own country, so I didn't actually think I was going to be paying anything," Greene said in an interview.
Charged for air ambulance flight
All of Greene's expenses from her hospital stay in Winnipeg were covered by her health plan in Quebec, but her air ambulance flight from Churchill to Winnipeg was not.
Are you covered?
Manitobans are entitled to the same range of hospital and physician benefits when in another province in Canada that they have coverage for in their home province.
That means Manitoba residents do not have to pay out of pocket because of reciprocal billing agreements between the provinces, according to health officials.
However, Quebec is the only province in Canada that does not have an agreement for physician services.
As a result, Manitobans needing to see a doctor in Quebec have to pay those costs upfront, then take their bills to Manitoba Health for reimbursement.
That flight cost Greene $11,944, accounting for most of her expenses. She was also charged $1,215 for ground ambulance services.
Greene said she was told those expenses would have been covered if she was in her home province, but the coverage would not follow her when she crossed provincial borders.
"Because in Canada we're not responsible for out-of-pocket payment for our hospital and medical bills, sometimes Canadians tend not to think about that," said Gayle Martens, Manitoba Health's director of insured benefits.
Martens said under the Canada Health Act, provinces and territories have no obligation to cover emergency transportation.
As a result, different provinces have set up their own coverage plans, she said.
For example, a Manitoba resident who needs an emergency airlift within the province would be covered by provincial health insurance, but not covered upon leaving the province.
In Manitoba, ground ambulance services are not covered by Manitoba Health.
Get travel insurance, says official
Martens said Manitobans should purchase private travel insurance before they leave the province, even if they are staying in the country.
In provinces like Manitoba and Quebec, an appeal process exists for those wanting to dispute financial matters, including coverage, in the health-care system.
Since 2012, the Manitoba Health Appeal Board has heard six appeals filed by residents who incurred medical expenses in other provinces.
Four of those appeals were denied, one was approved, and one was partially approved.
"If they travel to Kenora for the weekend and something happens that they need to be airlifted back to a big facility in Winnipeg, they are going to be responsible for the cost," she said.
But Greene said health coverage should be consistent no matter where in the country she is.
"As a Canadian, you should be covered, regardless of what province you're in," she said.
Her friends held a social in Winnipeg in December to help pay her expenses, and they have also started an online fundraising campaign. A total of about $2,000 has been raised to date.
Despite the attack and the bills, Greene said she can't wait to return to Churchill someday.