How to avoid health insurance horrors on vacation

Travel Objects

The Question

My husband and I do a lot of travelling. We know we need private health insurance to cover medical emergencies when we’re outside of our home province. But I’ve heard horror stories about people who bought insurance and then had trouble collecting on a claim. How do we make sure we are properly covered?

The Answer

It’s a good idea to think about what type of health insurance you need well in advance of a trip.

“Don’t buy at the last minute. You need time to consider your options. Making a mistake can be devastating financially,” says Susan Eng, executive vice-president of the Canadian Association of Retired Persons (CARP).

It’s certainly true that you can invalidate your insurance policy by incorrectly answering a question or leaving out an important detail on the application form.

Will McAleer, vice-president of the Travel Health Insurance Association of Canada, says the vast majority – 95 per cent – of people who make claims are able to successfully collect on their insurance. But you don’t want to be among the 5 per cent who run into problems.

There are many different insurance plans. To know which policy is right for you, it’s important to consider two things – your current state of health and what you plan to do on your vacation.

Your Health

If you have a “pre-existing” medical condition – such as high blood pressure or chronic lung disease – then that needs to be declared up front. Many insurance companies will provide coverage in such cases – but the medical condition usually needs to be stable for a certain length of time. That can mean no recent changes in the medications used to treat the condition. The stable period can vary from a few months to a year, depending upon the policy, McAleer says.

If the condition changes between the time that you buy the policy and leave on vacation, then you must notify the insurance provider, even if it’s a change for the better.

Furthermore, you can’t delay diagnostic tests or fail to collect test results as a way of feigning ignorance of your medical condition. If a doctor has ordered tests for you, then this can affect your eligibility for insurance whether the tests have been done or not.

McAleer advises people to consult with their doctors if they have any doubts or uncertainties about their health. “Once you have that information from your physician, then you can have an informed discussion with the professional who is setting up your travel insurance.”

Vacation Plans

If you are planning on doing specific activities during your vacation – such as scuba diving or ziplining – make sure they are covered under your policy.

“A lot of Canadians go away on vacation and do things that they might not normally do at home,” McAleer says. Some policies may exclude certain activities like bungee jumping or parasailing. But, he warns, you need to be careful about the wording of the policy. “At what point does walking up the side of a volcano turn into mountain climbing, which may be an excluded activity?”

Most Canadians know they need private health insurance when they are visiting a foreign country. However, fewer people realize they may also require it when travelling in another part of Canada.

Various inter-provincial agreements make sure that your basic medical bills are covered if you need to be seen by a doctor or visit a hospital emergency department in another province. But any extras – such as an air ambulance flight back home – are not necessarily picked up by your home province. Those bills can be quite substantial.

McAleer says it’s critically important to know what’s in your policy. “Ask questions of the person selling you the insurance,” he suggests. If you’re not satisfied with the answers, then contact the insurance company directly. “All insurance companies and providers will have a toll-free number to call,” he explains. “Ask the company the same questions – and be an informed consumer.”

You can now buy health insurance from a wide range of sources including brokers, travel agencies, directly from the insurance firms and even online. By shopping around you might be able to find polices at cut-rate prices. But both McAleer and Eng say don’t pick a policy based solely on its price.

“If you can afford the vacation, then you can also afford the extra cost of an insurance policy that will properly protect you against unforeseen medical emergencies,” Eng says.

Paul Taylor is a patient navigation adviser at Sunnybrook Health Sciences Centre. He is a former health editor of The Globe and Mail. You can find him on Twitter @epaultaylor and online at Sunnybrook’s Your Health Matters.