EHO requires pre-certification, which simply means that you must contact the Plan Administrator as soon as possible before a planned hospitalization or surgical procedure, within 48 hour of an emergency hospital admission, or within the first 90 days of pregnancy. Pre-certification allows us to establish contact and make payment arrangements with your providers, negotiate discounts which will benefit both you and us, pre-arrange future care, and plan for your claim. Pre-certification helps us help you.
 
Filing a claim is easy. When the Application is accepted, the client will receive a kit which contains the Claimant’s Statement and Authorization Forms and a toll-free Claims Number. The Claim Form and Claims Number can also be accessed here.
  • In an emergency go immediately to the nearest treating facility—and then contact Claims.1
  • Your doctor makes the diagnosis and treatment recommendations.
    • Call Claims when your doctor requires diagnostic imaging or a second opinion or other diagnostic or treatment planning assistance. 
    • Client Worldwide Hospital & Physician Referral, Claims & World Service Centre (Customer Service) are available to you 24 / 7 to assist in your treatment plan.
  • Be sure to complete your Claim Form entirely.  If you have incurred direct expenses, attach original, itemized bills and receipts. The Plan Administrator evaluates the claim. If you are a U.S. citizen you may be asked to prove you live outside the United States for at least 6 months within each Certificate Period. (Be sure to include on your Claim Form a time and location for Claims to contact you in the event questions arise.)
  • Payment of eligible expenses is made directly to your hospital or physician when possible. Otherwise, eligible expenses are reimbursed to you2.
1 Note: Not all Emergency Room visits are covered.  See Exclusions and Limitations
2 Remember, you are responsible for the deductible, coinsurance, and any ineligible charges.
 

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Contact CAPCO

161 Bay Street, 27th Floor
Toronto ON M5J 2S1 Canada

  1-888-775-5757

Fax:  416-352-0047

  executivehealth@capco.ca

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A Little About Us

We develop and deliver top quality health and related insurance products for the Canadian marketplace, and starting from the Canadian market, our products have found their way to an international clientele.