Travel health insurance: What you need to consider according to two experts

Who’s already covered, when you need additional coverage, and why pre-existing conditions are a big deal.

Who’s already covered, when you need additional coverage, and why pre-existing conditions are a big deal

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Taking a trip soon? Then now is the time to look into whether or not you need to purchase travel health insurance before you leave. "If you plan to go abroad, even on a day trip to the United States, you should purchase the best travel insurance you can afford before you leave Canada," a spokesperson from Global Affairs Canada told CBC Life via email. (Also, while an inter-provincial agreement exists to provide coverage to Canadians travelling within Canada, residents of Quebec should check their plans for limitations.)

But it's important to note that the "best" travel coverage means the plan that suits your needs — and that not everyone will need to purchase additional health insurance in the first place (more on that later!). What's more, coverage from most insurers can only be purchased in advance of a trip and not during your travels, although a handful of companies offer limited after-departure products, so it's helpful to get informed as soon as you can. 

To help answer the most common questions about travel medical insurance, we talked to two industry experts — Joan Weir, director of health and disability policy at the Canadian Life and Health Insurance Association (CLHIA), and Will McAleer, executive director of the Travel Health Insurance Association of Canada (THIA) — to find out what exactly you need to know before leaving Canada. 

What does travel health insurance cover? 

Travel health insurance helps cover the costs of unexpected, emergency medical care while you're travelling. "The costs can be significant in the event of a medical emergency, whether that be an accident or [getting] sick while you're away," says McAleer. An insurer can also help you access local health services and, if necessary, offer medical repatriation and evacuation benefits. "It's making sure that you have access to get back home in the case that you become in need of longer-term care," he explains.

Don't worry if you didn't get the recommended vaccines for your travel destination. That doesn't affect your coverage, says Weir. "If you don't get the recommended shots and come down with a disease, you will still get emergency healthcare at destination. Keep in mind, though, that a lot of diseases that you could be vaccinated against may not develop until you return to Canada."

Does my provincial health plan offer any coverage while I'm abroad?

There is some coverage for an overnight hospital stay and a physician visit while abroad, says Weir, but the coverage differs between provinces and has its limits. "The problem is that when you're traveling, and particularly [in] the U.S., the prices are much higher than [your coverage limit]. And then you add in what isn't covered, which may be diagnostic tests, laboratory tests … there are other things that might not be covered through the provincial health plan," she says. And Ontarians should note that starting on Jan. 1, 2020, OHIP's Out-of-Country Travellers Program will be eliminated completely.

According to McAleer, the maximum amount a provincial medical plan might pay for a hospital stay is about $400 a day, whereas an intensive-care stay in the United States "can cost, if not $10,000 a day, $10,000 an hour for significant, life-saving treatment." 

Do I already have sufficient group coverage? 

If you have group insurance coverage through an employer or travel insurance coverage through a credit card (many premium cards offer this benefit when you pay for your flight using the card, although rules, exclusions and maximum benefit amounts can vary significantly), you might not need to purchase individual travel insurance, says Weir. However, even in those cases, she still recommends that you look into your plan's parameters and find out exactly what you're covered for. "Some people might have a maximum that is quite low, and those people might need to look into purchasing additional coverage," Weir explains.

"Oftentimes, those [group plan] programs are quite good," says McAleer. "[But] you certainly want to make sure that you understand what coverage you do have, and you want to do things like request a 'certificate of insurance' so that you can see it. Then you can see whether or not there are any limitations or exclusions on that policy, such as the time at which a medical condition will be considered 'stable' — do [you] have to have 90 days' worth of no changes in medication or symptoms in order to be covered?" 

For coverage certainty, McAleer recommends calling your insurer's toll-free number ahead of your trip to go through anything that's unclear. With credit cards, he notes that some policies will provide coverage for the cardholder and their family, while others will not. Some might also restrict family coverage depending on the age of your dependants or spouse. It all depends on the specific terms of the cardholder agreement, says McAleer. 

Do my vacation plans affect my coverage needs?

"Know your trip" is one of the tips that McAleer and the THIA recommend. "Are you taking a trip where you're just going to go and sit by the pool for the winter? Or are you going to go hike a mountain in Peru or do bungee jumping?" says McAleer. "Some policies will allow cover for that, others will say you need to buy a little added protection for that activity, and others will straight up say you can't do this or the other thing on your policy. Understanding what your policy is in conjunction with what you plan to do while you're on vacation is really important." 

If you're on a trip and already have insurance but are looking to extend your time abroad, Weir notes that you can sometimes buy top-up coverage — but only if your plan-insurer offers it. 

Where can I buy individual travel health insurance?

Weir thinks that online aggregators can be useful at a glance to get a ballpark idea of what's out there. "But," she says, "you might want to take your research a little bit more in-depth and go specifically to some insurer websites. The other option is to go to a broker or a licensed seller of travel insurance — who is knowledgeable and asking the right questions, particularly about health — to see whether this product or that product is better for you." Travel agents are another option, Weir notes.

"There are very knowledgeable individuals selling this insurance across the country, whether they be in a travel agency or an insurance broker or in a specialist sector," says McAleer. He recommends looking for someone who can help you answer any questions and help find the right plan or coverage for your personal needs.

Am I eligible to purchase individual coverage?

Not everyone is eligible for individual travel health insurance. "Online, you can check out coverage from a number of different insurers. Make sure that you read the eligibility requirements — not everyone is eligible to purchase it," says Weir. "For instance, people who need dialysis, with active cancer [or] that have daily oxygen [may not be] eligible to purchase individual travel insurance." 

Another requirement is that you must currently be eligible for provincial health coverage. "When you're at destination and something bad happens, certainly you get in touch with [the insurer], and the hospital and all of that is taken care of," says Weir. "But we'd like to bring you back to your province as soon as possible, [and] we can only do that if you've got provincial health coverage."

Why do some people have to fill out a medical questionnaire? 

If you're over a certain age — depending on the insurer, this could be 60, 65 or even 80, notes Weir — you will have to fill out a medical questionnaire before you can purchase individual travel health insurance. "It depends on the risk appetite of the insurer when they want to start gathering that information about health," she explains. Weir emphasizes the importance of being honest and clear about your health status. "Don't hide anything, because that's where people sometimes tend to get big surprises when something happens. And read your policy — [even] the big, long, multi-page disclaimer." 

According to McAleer, one THIA survey found that seven and a half per cent of people who answer incorrectly on a medical questionnaire "do so simply to get a better premium." He advises that you be accurate and forthright with your responses. "It simply isn't worth taking a risk to try to get a lower premium."

What about pre-existing conditions?

Whether you have existing coverage or need to buy additional insurance, Weir says that you should be "aware of the interplay between pre-existing conditions and stability of health." Having a pre-existing condition, such as diabetes or something that requires taking certain medications, doesn't automatically make you ineligible for coverage. "It's just your condition has to be stable for a period of time before you travel — by 'stable,' we mean you haven't had to have a test, your medication remains the same, the dosage hasn't changed, you haven't had an episode of fainting, or something like that, [which] might suggest there's something going on," says Weir. "Typically, that's 90 days. It could be more or less depending on the coverage you have." 

You need to know your health well, and that could mean confirming with your doctor that your condition is stable. McAleer even recommends calling the insurer — especially if you've bought a plan online — to ask specific questions about your pre-existing condition and confirm that you'll still be covered under that particular plan. "When you call in, these types of interactions are, if not all the time, very often recorded. So there is a record of it," he notes. "The discussion that you've had on [any questions you have], the insurers do certainly stand by the advice that's given." And be sure to read the fine print of your insurance (again, the "certificate of insurance," if it's a group plan) so you can see it all in writing, suggests McAleer. 

Truc Nguyen is a Toronto-based writer, editor and stylist. Follow her at @trucnguyen.