Tips & Resources

Travelling Within Canada: What Could a Medical Emergency Outside of My Province Cost Me?

By James Daw, Contributing Writer

Gaps in public health care could prove costly to Canadians visiting another province. One of the largest potential costs could be transportation to the nearest hospital, particularly if the only hospital capable of dealing with your injury or medical emergency is a long distance away. Costs could mount into the thousands of dollars if you need to be transported home by air, under the watch of medical personnel. As Alberta warns its citizens: Always make sure “supplementary health insurance or travel medical insurance will assist with the cost of ground or air ambulance services.”

What will it cost if I need an ambulance out of province?

It could cost an out-of-province traveller more than $700 for a ground ambulance in Nova Scotia, and in Ontario $240. The cost of an air ambulance could cost $2,700 an hour in British Columbia, and nearly $3,000 per hour in Quebec. Other provinces may have similar charges, but they are not generally disclosed on government websites. Ontario’s Ministry of Health and Long-term Care simply warns visitors they could pay the “actual cost” in some circumstances, without saying what a fully staffed air ambulance could potentially cost.

Intrepid 24/7's Senior Manager (Assistance) Mike Vallee offers further information: "From one coast of Canada to the other, the cost of an air ambulance with a full team (i.e., doctor, nurse, and respiratory therapist) can be as high as $48,000. And if an Ontario resident needs an air ambulance back from Quebec, for example, it can cost up to $15,000."

Are ambulance services ever paid by public health care?

There are sometimes free rides and partial subsidies, but the rules vary by province. It is quite common for visitors to be charged more than residents.

Oddly, the provider of helicopter air ambulances services in Alberta, Saskatchewan, and Manitoba charges no one for its services. STARS (Shock Trauma Air Rescue Society) Air Ambulance), which raises money from public donations and government grants, sees everyone as a patient, says spokesperson Cam Heke. But visitors to those provinces get no subsidy when transported by airplane.

In Ontario, free rides are available to both residents and visitors when transferred from one hospital to another, and from Ontario to a hospital outside of the province. But charges range widely in other provinces.

How rules and charges vary across Canada

Alberta - Costs for are not disclosed on the government website.

British Columbia - Visitors and residents without a BC medical card pay:

  • $530 flat fee for ground service
  • $2,746 per hour for a helicopter ambulance
  • $7 per statute mile for an airplane ambulance

Manitoba - Costs are not disclosed on the government website.

Newfoundland & Labrador - Non-residents are charged on a “cost recovery basis” for air ambulance transport.

New Brunswick - Visitors and residents without a valid health card pay $650 for an ordinary ambulance and $6,500 for an air ambulance.

Northwest Territories - A government brochure warns that the average cost of an air ambulance from Yellowknife to Alberta’s capital city is $10,000. The patient could also be responsible for ground ambulance service, the cost of a nurse or physician for the flight, and the cost of travel home after discharged by the hospital.

Nova Scotia - Canadian visitors pay $711.60 for an ordinary ambulance, while non-Canadians and new Canadians pay $1,067.35. Costs for air ambulance are not disclosed on the government or the Emergency Health Services (EHS) LifeFlight website.

Nunavut - This northern territory warns out-of-province visitors that health care there can be very expensive, and an air ambulance evacuation could cost up to $40,000 depending on your location, the location of the nearest medevac plane, and the location of the nearest centre where treatment is available.

Ontario - Ontario charges $240 for land transport if you are a visitor from another province with a Canadian health card, or a resident without an Ontario card. The full cost of an air ambulance applies to visitors and residents without an Ontario health card, residents transported into Ontario, or for a reason that is not deemed medically necessary.

Prince Edward Island - Visitors and residents without a valid health card pay:

  • $600 for an ordinary ambulance within the province
  • $691.95 for a one-way trip to Moncton, NB
  • $1,080.50 for a one-way trip to Halifax NS, or Fredericton or St. John, NB 

Non-resident Canadians will be billed $12,000 for air-ambulance services, and non-Canadian visitors can expect a bill of $18,000.

Quebec - Quebec stands alone in offering a cheap way to fly on a stretcher—if you have the foresight to pay in advance. Residents and visitors may buy a type of membership card directly from the local company Airmedic. The annual membership fee rose to $120 per person ($250 per family) in early 2013. Policyholders of vehicle insurer La Capitale General Insurance could pay only $45 per person. “We also have coverage for tourists or residents who travel to remote areas,” says Jolyane Pronovost, director of public relations for Airmedic. “For seven days, the cost is $25.”

Saskatchewan - Depending on a resident's location, they will pay from $245 to $325  for a basic call pick-up. Rural residents also pay a fee of $2.30 per kilometre for transfers into larger centres; however senior residents are expected to pay no more than $275. Costs for visitors are not disclosed on the government website.

Yukon - Yukon’s Ministry of Health and Social Services covers medical travel services for residents requiring certain services—but not visitors. The potential cost to visitors is not discussed on the ministry’s website.

Will my emergency medical insurance pay for an air ambulance?

You should check with your insurer to be sure, and read your contract carefully. Policies will not pay the cost of emergency transportation services unless the service is “pre-approved and arranged by the insurer.” So be sure others travelling with you are aware of the need to contact the insurer if you are ill or injured. Carry the telephone number of the insurer’s emergency assistance service with you at all times.

You should also be aware of other exclusions that may apply to ambulance and other emergency medical services. The policy may exclude coverage for motorized speed racing, mountain climbing, and other sports, as well as illegal activities, impairment due to drugs or alcohol, and recent medical issues. If the language of the policy seems vague, and you have specific sporting activities in mind, always call your insurer and ask for a written reassurance.

Is there a limit on what my insurance will pay?

Canadian travel medical policies do not usually include a separate limit on the amount of coverage for ground and air ambulance. However, insurers typically require that transportation via air ambulance be pre-approved and arranged by their assistance provider so that they can make sure that the transportation is medically necessary and that the cost is limited to the customary amount for such services.

A Canadian traveller without medical coverage could be charged far more for an ambulance or other medical services than an insurer could negotiate on his or her behalf. Intrepid 24/7's Mike Vallee warns that travellers without insurance could face higher costs due to delays in arranging for transfers back to their home province when beds in hospitals may be in short supply.

What would it cost to protect myself while travelling in Canada?

It will be much less expensive for medical insurance for travel within Canada than to another country. But, unlike the cost of an air ambulance membership card in Quebec, the price will vary by age and plan. One plan for travel within Canada would charge as little as 36 cents a day for a person aged 54 or younger, and about 3.5 times as much for someone age 65 to 69. Even past the age of 85, it would be cheaper to buy four days of coverage than pay for a seven-day air ambulance card in Quebec.