Travel Medical Insurance
The first challenge faced by long-term travelers and expats alike, is that they generally do not qualify for medical insurance coverage under their home, private or public insurance plans.
Medicare (barring a few exceptions) does not cover citizens of the United States when traveling outside the U.S.
As a rule of thumb, Canadians can only be away from their home province for 6 to 7 months of the year to continue to qualify for coverage under their Provincial system. During this period, the coverage provided is extremely limited even while traveling in other Canadian Provinces.
There are two primary types of travel medical insurance available to long-term travelers, comprehensive travel insurance with health care coverage and international medical insurance.
Comprehensive Travel Insurance
This is the type of policy most people think of when it comes to travel insurance. Comprehensive insurance also goes by the names of vacation, trip or just plain travel insurance.
Comprehensive insurance packages are popular as they provide not only health care coverage but also trip interruption and cancellation, lost or stolen baggage and other coverages to meet the needs of most travelers or vacationers.
Generally, the individual components of packaged travel insurance policies can be purchased as separate stand-alone policies. A notable exception is trip cancellation – see credit card insurance.
The Upsides of Comprehensive Travel Insurance
The benefits of comprehensive travel insurance include:
- Coverage for a comprehensive set of travel risks in a single package
- Most packages can be tailored for the travelers individual requirements
- Some plans cover children for “free”
- Some plans provide optional coverage for activities typically excluded, such as hang gliding, sports activities, pre-existing medical conditions, identity theft etcetera
- One optional coverage allows you to ’cancel for any reason” meaning you can cancel for reasons not normally covered (like changing your mind)
The Downsides of Comprehensive Travel Insurance
The challenges posed by these types of policies for the long-term traveler include:
- Typically, you are required to apply while you are in your country of residence and before you start traveling
- Most comprehensive travel insurance policies are secondary policies. This may be a problem if primary insurance is not in place
- These plans are generally for travelers who are planning to be abroad for a year or less
- Not all policies allow you to extend the policy while you are out of the country or for more than one year
- You have to pay covered expenses out of pocket and will only be reimbursed once/if your claim is approved
Important Considerations for Comprehensive Travel Insurance
If you are planning to travel for more than a year, make sure that you can extend the policy while you are out of the country.
You need to understand if they are primary or secondary policies.
You can use these secondary policies for long-term travel. However, you need to understand the ramifications of not having a primary policy in place. In Canada, for instance, some secondary travel health policies will allow you to purchase their policy, however, they will not cover the portion of any claim that your Provincial Medical Sendees plan would pay if it were still in place.
If you are traveling as a couple or a family, is your insurance still valid for everyone and for the full period if someone in the group has to return home?
If you buy a single trip policy and return home early is your insurance automatically voided? If so, can you claim a refund for the unused portion?
TIP: Planning an extended trip outside of Canada? Check with your provincial plan to see how long your basic coverage is good for and whether you can arrange continued coverage, if necessary.
Note: Supplementary policies often require your provincial plan’s coverage to be in place.
TIP: Having a Primary Travel Medical Insurance plan does not mean that the insurance company will pay directly. Be prepared to foot the bills before your insurance pays you.
FACT: Travel health insurance plans cover emergency care. Routine or elective treatment is usually not covered. Check your policy.
International Medical Insurance
The second main type of travel medical insurance is International Health Insurance, also known as International Travel Insurance or World Medical Insurance.
These plans offer worldwide medical coverage and are typically primary policies. The core focus of this type of insurance is inpatient emergency medical’ covering you for essential hospital stays and treatment.
International health insurance policies typically cover the following:
- Unexpected medical costs arising from emergency medical care
- Unexpected dental costs arising from accidents
- Emergency medical evacuation or transportation
In addition to the core coverage, many companies provide optional coverage for the following:
- Outpatient care that may cover specialist consultations, drug prescriptions, physiotherapy, osteopathy, and chiropractic care
- Health and wellbeing care, which may cover screenings, tests, examinations, and counseling support
- Vision and dental care, which may cover routine eye examinations, pay cost of glasses and lenses as well as preventative, routine and major dental treatments
These policies may also include repatriation coverage, accidental death, and dismemberment or term life insurance benefits.
Available policies include, single trip, multi trip policies for 3, 6 or 12-month terms or indefinite coverage for long-term travel.
This type of insurance is priced for a specific geographical coverage. Options include:
Worldwide – This provides worldwide coverage and is one of the more expensive options.
Lower premium policies excluding high cost healthcare jurisdictions:
- Worldwide excluding US, Canada and/or Japan
- Europe only
- Asia (excluding Japan)
- Pacific (including Australia)
- Australia only
The Upsides of International Medical Insurance
You can travel internationally without gaps in coverage.
You can travel in countries where there are limited medical facilities and still have coverage for health care in nearby countries.
Having a primary travel health insurance plan can make the claims process much quicker and efficient.
Many international policies allow evacuation to the nearest center of ‘medical excellence’ in the case of a medical emergency.
The Downsides of International Medical Insurance
Generally, an international health insurance policy will not cover the policyholder once they have returned to their country of residence.
Can be very expensive depending on the coverage selected, the applicant’s age, health history and where they are traveling.
Here are a few sites with comparison tools for comparing International Health Insurance.
- BrokerFish website: www.brokerfish.com/internationaI-health-insurance
- Global Insurance Net website: www.globalinsurancenet.com
- InsureMyTrip website: www.insuremvtrip.com
- InternationalInsurance.com website: www.internationalinsurance.com
- Medibroker website: www.medibroker.com
- SquareMouth website: www.squaremouth.com
Alternatively, you can perform an Internet search for ‘International health insurance quotes”
Pre-existing Medical Condition Coverage
Travel insurance plans DO NOT cover emergency medical costs while traveling if the costs are the result of a pre-existing medical or dental condition.
A pre-existing medical condition is any medical or dental condition, illness or injury known to the traveler and for which the traveler has received medical consultation, diagnosis and/or medical treatment prior to the commencement date of a covered trip.
Many companies offer the option to purchase ‘pre-existing condition coverage’, as an add on to their emergency medical insurance, trip cancellation, trip interruption or rental car insurance.
Unless the condition is medically stable, the standard travel medical insurance policy is not valid. Medically stable means NOT having symptoms, NOT seeking diagnosis, NOT having medical treatment or NOT having new medications or a change to your existing medications within a specified period.
Different insurers have different definitions of medical stability (or look back period) which can range from two months to one year depending on the insurance and the age of the applicant. Unless you have a clean bill of health and an amazing memory combined with medical training – it is wise to consult your physician when taking out insurance. Insurance companies have been known to use any excuse to avoid paying out a claim.
With this type of optional coverage, the insurer agrees to cover the travelers emergency medical expenses, trip cancellation, trip interruption insurance, or auto rental insurance, even with a pre-existing condition that was not stable prior to the start of the trip up to a specified limit.
Important Considerations for Pre-Existing Condition Coverage
If you are not medically stable when you purchase your insurance, you can purchase the optional pre-existing coverage insurance. Typically, the maximum benefit or coverage for events relating to the condition is much lower than the benefit offered for regular Emergency Medical Insurance.
For example: Michael’s pre-existing condition coverage for any deep vein thrombosis related event is $200,000, which is only 2% of our maximum coverage of $10,000,000. Note: the cost to purchase the coverage was an additional 25% of the regular premium.
Disclosure of Medical History
The insurer probably doesn’t care that you had measles or your tonsils removed when you were a child. However, they have been known to deny claims resulting from prior surgeries or more serious medical conditions.
For example if you had knee or hip surgery years ago—although considered medically stable under most policies—if your knee or hip gave out causing a fall and injury, some insurers may not honor your claim if you have not disclosed this prior condition.
If you disclose prior surgeries and conditions and the insurer underwrites your policy regardless, they are agreeing to cover any events related to these prior conditions, although it may increase your premium. A good broker should be able to assist you in ascertaining what conditions need to be disclosed.
Medical Evacuation & Repatriation Coverage
This particular type of travel insurance provides; evacuation to a medical facility, medically equipped flights back home, bringing a family member or friend to your location or in the worst-case scenario bringing your mortal remains back home.
It is important to note that this type of insurance is to cover costs of transportation if medically necessary.
If you become seriously ill or injured while traveling the insurance provider will determine the ’appropriate” medical facility and arrange to transport you for treatment.
Some insurers pay the costs to bring a friend or family member to the treatment facility and/or cover the cost of returning dependents to a location of your choice.
Medical evacuation insurance can also cover the costs of returning you to your primary residence or location of your choice, or to a medical facility near your home.
In the case of death, repatriation coverage will cover the costs to arrange the return of the insured’s body home. Note this type of insurance does not typically cover the cost of funeral, cremation or burial expenses.
Important Questions to Ask about Travel Medical Insurance
The following are important questions to ask your insurer or broker:
- When does the coverage start? Are there any coverage delays?
- Is there an age limit for policy owners?
- Does the plan cover regular doctor’s visits or strictly emergency care?
- Will the policy terminate if you come home?
- Does the company have to preauthorize payments?
- Will the policy cover you for the entire duration of your travels?
- Can the policy be extended and how? Does it renew automatically or only at the company’s discretion?
- Does coverage cease at a certain age?
- What are the restrictions or limitations?
- Does the policy allow for pre-existing medical conditions?
- Is there a toll free number for emergency assistance anywhere in the world?
- Are there any exclusions regarding certain sports activities or substance abuse?
- What are the deductibles? Are they annual or on a per claims basis?
- Do co-payments apply to the policy?
- What are the maximum benefits?
- Does the plan pay up front? Hospitals expect full pavanent prior to discharge! Some insurers wall pay the hospital directly, others expect you to pay out of pocket and then reimburse you later.
- What is the claim procedure and what documentation is required?
- If you are traveling with others, does each individual need a separate policy, or can one policy cover all travelers? If one traveler has to go home is the policy still in force for all of the other travelers?
- Are there certain locations/countries not covered under the policy?
- Does your policy pay for emergency medical evacuation?
Note: a good broker should know the answers to these questions. However, even the best broker may only be making assumptions. The only way to know for sure is to read the fine print and if necessary phone the insurer for clarification.