Hlth 2814-2026

The document is an Out-of-Country Medical Claim form for British Columbia residents seeking reimbursement for medical expenses incurred while temporarily outside the province. It includes sections for patient information, claim instructions, and details on provincial coverage limitations for emergency and elective medical treatments abroad. The form requires signatures and authorizations for processing claims and outlines residency requirements to qualify for benefits.

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Click ‘Get Form’ to open hlth 2814 in the editor.
Begin with Section A, where you will input the patient’s information. Fill in the last name, first name(s), birthdate, gender, and personal health number. Ensure all details are accurate.
Continue by providing contact information including home and work phone numbers, mailing address, and residential address if different. Confirm residency by answering whether the patient has lived at the provided address for six months prior to departure from BC.
In Section B, carefully read the claim instructions. Attach original receipts and ensure your claim is complete before submission.
For claims related to medical attention, proceed to Section C. Document each physician visit by entering their name, specialty, amount paid, and type of visit.
If applicable, complete Section D for in-patient hospital charges. Provide details about the hospital stay including admission and discharge dates.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (57 Votes)
2013	4 Satisfied (39 Votes)
2008	4.3 Satisfied (70 Votes)

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