DW used it one time in twenty years as snow birds.
The hospital billed the insurance company but when we got home we got a bill from the MD. We turned that in to the insurance company and they paid the bill. We will not cross the border with out out of province health insurance. We have known people that were presented with very large bills from US health providers.
Our DD and family live in the USA and when we see what they play even after there insurance we are not willing to the chance. We work with a broker that that has a number of companies that they work with and have a good reputation for service.
