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Education Centre |
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Snowbirds |
Are you a Canadian Snowbird?
Do you go south for the winter?
Do you travel on business outside Canada? Do you take day-trips
across the border?
Anytime you leave Canada without travel health insurance—even
for just a few hours—you’re taking a risk. If you
get sick unexpectedly or have an accident while you’re
away, health care providers outside Canada will charge you much
more than your Canadian Government Health Insurance Plan will
pay. You will be responsible for paying any difference in cost,
potentially thousands of dollars, unless you purchase travel
health insurance. Even your young family members are at risk
when travelling on a vacation or school trip. Some out-of-country
hospitals won’t even admit you without proof of proper
health insurance.
Canadian Provincial Health Insurance
Programs
Your medical insurance in Canada will not cover all or even
most of the costs you can incur for medical services in the
United States; moreover if you require treatment in the US,
it is likely that you will have to pay for services in advance.
Canadian provincial health insurance programs provide limited
coverage during trips outside of Canada. This limited coverage
is provided for only three months to 183 days, depending on your
province of residence. The benefits provided are inadequate
to cover costs in most locations, especially the United States.
The reason for this is that the payments allowed for out-of-country
treatment are comparable to the fees paid by the provincial
health insurance plans to health care providers in Canada. In
some cases, a US hospital may charge several times more than
your province will pay. Hospital bills in the US can be as high
as $3,000 per day for a regular room, up to $6,000 or more per
day for ICU or specialized care (in US dollars). A medical emergency
in the US can total over $25,000 for an accidental injury to
$300,000 for a cardiac bypass (in US dollars). It is therefore
essential that you arrange for private health insurance when
you travel.
Private Travel Health Insurance
There are two types of private out-of-province health insurance
plans, which will provide you the additional insurance coverage
needed while outside your province; Travel Health Insurance
provides benefits for people who are covered by a Canadian provincial
health care plan (the private plan will cover what the government
health plan will not cover when you are outside your province
of residence). Expatriate Health Insurance provides coverage
for those who are not eligible for a provincial government health
insurance plan (an expatriate plan will pay for all of the medical
costs of a covered sickness or accident when you are living,
working or studying outside Canada).
All travel health insurance policies place some limitations
on pre-existing medical conditions and have age restrictions.
Many insurers reserve the right to repatriate you to your home
country in the event of a major ailment.
Pre-existing
conditions
If you have any pre-existing conditions these may affect your
ability to get travel insurance. Or the type and cost of coverage
available to you. A pre-existing condition is a health problem
that your doctor has already diagnosed or of which symptoms
have appeared before the effective date of your insurance. Insurers
may not pay for emergency treatment related to your pre-existing
conditions. Some examples of pre-existing conditions are: recent
surgery, stroke, heart trouble, cataracts, diabetes, kidney
disease and cancer.
You’ll find that the rules on pre-existing conditions
vary greatly from company-to-company. For example, some insurers
may not pay for emergency treatment if your doctor has prescribed
new or changed medication for a related health problem within
90 days or even 2 years before the date of your application
for insurance. Some companies may not provide any coverage at
all no matter how long you have been stable.
Read
the fine print and get the coverage in writing.
Medical Exclusions or Exemptions
Some policies do not cover emergency medical costs in specific
situations that are identified in policy clauses dealing with
exclusions, limitations or exemptions. Such clauses may apply
to the costs of emergency medical care related to:
- AIDS
- Pregnancy (especially in the last 8-10 weeks
of the pregnancy)
- Injuries caused by scuba diving, skydiving, hang gliding,
contact sports, other risky activities or participating
in professional sports
- Substance abuse
- War or civil unrest and where warning has
been issued by the government
- Travel to certain countries, or travel in
hazardous conditions
Non-emergencies
Keep in mind that travel health insurance will not pay for:
- Continuing or follow-up care after your medical
emergency has been stabilized, or any care that can safely
wait until you return to your province
- Routine health care
- Elective surgery
- Investigative or diagnostic services
Before leaving, especially when you are planning to visit the
United States for whatever length of time all Canadians are
advised to purchase Travel Health Insurance. Out-of-country
travel health insurance is available through the Ingle
Insurance Centre, insurance brokers, travel agents or directly
from insurers listed in the Yellow Pages™. Check the following
points when purchasing health insurance for trips outside Canada:
- Does the Travel Health Insurance have a toll
free or collect call, 24 hour, 7 day per week, emergency
medical and travel assistance phone number where you can
find help when away from home?
- Are foreign hospitals and related medical
costs paid directly or are you required to pay and seek
reimbursement later?
- Does the insurance cover medical evacuation
back to Canada along with any required medical escorts?
- Are pre-existing medical conditions covered?
(If the company states that they will cover your pre-existing
medical conditions get it in writing.)
- Does the company provide coverage in the area
of the world were you will be travelling?
- Does the company provide coverage for the
activities you may be involved in (biking, scuba diving,
hiking, mountaineering, hang gliding)?
- Are premature births and related neonatal
care covered? What pregnancy related exclusions apply?
- Will the insurer provide a cash deposit in
advance if a hospital requires it?
- Does the insurance cover costs associated
with a death abroad, including the return of remains to
Canada?
You should carry a copy of your insurance policy, along with
the telephone contact numbers of the insurer’s emergency medical
assistance service centre. this information should also be left
with a friend or relative at home or with your travelling companion.
If you require medical services, contact the Emergency Assistance
Group (or have a friend or relative contact them), they will
direct you to the proper medical facilities and arrange for
your admittance to the hospital if necessary. If it is a real
Emergency phone 911 if available to get immediate help. If you
receive medical treatment and have not notified the insurance
company or are in a situation were you are unable to contact
them, make sure that you obtain original detailed invoices from
the doctor or hospital before returning home (the bill should
be submitted to the insurance company with an explanation of
the medial care received and the reason it was necessary, along
with the insurance company’s claim form, keep copies of
all documents for later use).
Additional Coverage
Theft, lost luggage (ask your insurance broker for additional
coverage for baggage). Your home owners’ insurance may
provide coverage for valuable possessions under the off premises
benefit, and flight cancellations (trip cancellation insurance
must be purchased within 72 hours or immediately when booking
your travel arrangements) are frequent occurrences and can cause
major disruptions in your travels. You may wish to purchase
a travel insurance package (Comprehensive Travel Insurance Package)
that will help you during inconveniences, available through the Ingle
Insurance Centre.
Have a great time when you leave on your trip, relax and travel
safely.
Robin Ingle is the Chairman of Ingle International Inc.; Mr.
Ingle has been providing health insurance to travellers for
over 25 years.
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