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Our office and phonelines will be closed on July 17th and July 18th.

International Health Insurance Forms

Except in cases of emergency, it is essential that the pre-authorization form be processed before surgery. Failure to do so will automatically result in a refused claim.

International Health Insurance Forms
Form Details
Health Insurance Claim Form - Extended Health Care Benefits
  1. To be used to claim reimbursement after having paid for eligible medical expenses.
  2. Original receipts must accompany this form.
Health Insurance Claim Form - Medical Expenses
  1. To be used when health care provider has agreed to bill Medavie Blue Cross directly for eligible medical expenses.
  2. The student has not incurred an expense related to the claim.
Health Insurance Pre-Authorization Form
  1. To be used when the physician has recommended surgery that may or may not require hospitalization.
  2. The patient must present the form to their attending physician, ensure that the form is completed and return it to Medavie Blue Cross.
  3. Medavie Blue Cross will provide the doctor/medical facility with an answer (confirmation of coverage or refusal) within 5 working days.
  4. This form is also available in French.

In addition to the information above, please also review ISS' FAQs page.

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