Some time ago, a friend told me what had happened to her father when he crossed the B.C./Washington State border to fill up his car with much less expensive American gasoline. He had a heart attack at the filling station and an ambulance was called. Despite the man’s request, he was, of course, taken to the closest American hospital, in Blane, WA.
After being admitted through the Emergency Department, he was transferred to a bed in the Coronary Intensive Care Unit. By this time, his family had arrived from White Rock, B.C., a town on the Canadian side of the border with the U.S. Family members requested that the man be transferred back to Canada; however, he was not deemed fit enough to travel.
Several days went by before the man could be moved to a hospital in British Columbia. But before that happened, the man and his family received a shocking piece of correspondence upon his discharge. The hospital and ambulance bill totalled over $40,000.
The man had no insurance. He had thought that travel medical insurance was unnecessary as he was planning to be in the U.S. for less than an hour, just long enough to fill up his gas tank. Wrong. He ultimately had to put a second mortgage on his house to pay the medical bill.
Today, with much hospital care in the U.S. dominated by large corporations, the cost of the treatment the man received would likely be twice what he was charged at the time. And hospitals are not eager to discharge patients without a payment plan.
In fact, some hospitals will not admit a patient until a credit card is registered for payment. This is often the case even when the patient has travel medical insurance. Why? Because the hospital wants payment in full, even if it transpires that the insurance company does not accept the claim from the patient.
Travel within Canada
For Canadians who are regular travellers, the reason behind travel medical insurance is likely well-known. But for occasional travellers and those just crossing borders for a short trip, travel medical insurance is equally important.
Provincial and territorial medical plans do not cover emergency out-of-province care. If care is required in another Canadian jurisdiction, it is usually paid at the rate that would be charged in the jurisdiction providing the care. For example, should you break your arm while travelling in Alberta, your Nova Scotia medical plan will repay Alberta what it would pay to Nova Scotia healthcare providers. If the Nova Scotia rates are not as high as the Alberta ones, you will be charged the balance.
Travel elsewhere
Seasoned travellers do not usually take chances when they travel. There are many ways to purchase coverage for travel medical insurance. In some provinces, annual travel medical insurance can be added to homeowner insurance. Different amounts of coverage and a range of deductibles are available, as are different types of coverage.
In most jurisdictions, private companies like Blue Cross, CAA and other general insurance companies offer travel medical coverage. Large employers also provide this as a benefit to employees. Even some credit cards provide limited coverage.
There are exceptions, of course. The first distinction is between travel medical and trip cancellation insurance coverages. Trip cancellation coverage can be very expensive. Ironically, it is frequently a free benefit on credit cards. Reading the fine print can save hundreds, if not thousands of dollars.
Pre-existing conditions
There are other exceptions to coverage. The majority of insurance plans do not cover so-called pre-existing conditions. Travel medical insurance is for emergencies; you cannot arrange or receive care for non-urgent medical situations and expect travel medical insurance to cover your costs. The same is true if you have an episode of recurrence of a healthcare issue you have faced before.
Insurance companies seem to have armies of staff to track down any previous episodes of the condition you claim for. Their interpretation of previous events may differ from yours. For example, if at one time in your life you were diagnosed with pneumonia and you now have expenses for a serious case of bronchitis, you may be denied coverage because both are respiratory problems.
Suffice to say that even being scrupulously honest on the travel medical insurance application may not be sufficient should you register a claim.
Other restrictions
Other issues arise when seeking travel medical insurance. In addition to pre-existing conditions, many companies will not insure travellers over certain age limits, usually 70 or higher. Or if they do insure older clients, they limit the amount of coverage and/or the length of the trip.
There are also restrictions for people travelling to countries that are considered “no-go” zones. Should you have to travel to a country listed on Canada’s government travel advisories, your Canadian insurer generally will not cover you for medical treatment in the listed country.
Even if you have an annual travel medical insurance policy, the amount of time spent in a listed country will not be covered by your policy. Further, if the visit to the affected country is part of a larger trip, for example a stop on a cruise or a multi-country tour, there are still exemptions.
The author recently learned that travel to a “no-go” country in the midst of a longer trip would only be covered if other countries total 80 per cent of the days out of Canada. If the full 80 per cent is not reached, none of the trip is covered.
The solutions are to purchase travel medical insurance in the “no-go” country itself if that is the only country on the trip. If it is one country of many, there are American insurance companies that will cover the entire trip, albeit at low coverage levels, especially for older travellers.
Full disclosure
With the brutal winter descending on much of Canada, many people who do not enjoy outdoor sports in frigid temperatures plan escapes to warmer climes. The author is one of those people and, to be honest, this article is being written from southern Spain. Here, the temperature is the same as it is in Ottawa, where I live, with the exception that at home there is a negative sign in front of the number. Here on the Mediterranean coast, the temperatures show similar numbers, all positive.
Even with national health insurance from Ontario, travelling to Spain, with its own national health insurance, is a risky business, should a health emergency occur. The fabled American Express card advice “don’t leave home without it,” is even more important when it comes to travel medical insurance. I always abide by this saying and I strongly suggest that all Canadian travellers do so, as well. (One more full disclosure: the author has no financial relationship with any travel medical insurance provider).
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