I’ve always thought of November as the bleakest month. The skies are leaden most days, there’s a damp chill in the air, and the trees are stark and bare.
No wonder so many of us start thinking about a winter get-away around this time. Sunshine, crystal water, sandy beaches, pina coladas – what’s not to like?
The cost of medical care if something happens, that’s what.
Every year millions of Canadians head south for some part of the winter. Florida’s official tourism agency reported that a record 3.6 million of us spent time in the Sunshine State in 2012. That’s more than 10 per cent of our entire population!
What’s worrisome is that about one-quarter of Canadians going abroad will have no medical insurance, says Isabelle Forget, Head of Travel Insurance for RBC Insurance.
“If something were to happen, it could cost you $50,000 or $100,000 if you don’t have protection,” she warns. “The cost of U.S. health care is one of the highest in the world.”
I can confirm that. A few years ago, my late wife took ill in Florida and spent several days in hospital. It was a terrific facility, more like a luxury hotel with MRIs and operating theatres, and the staff were friendly, attentive, and highly competent. The bill was consistent with the quality – something in the vicinity of $40,000 when all the costs were added. Fortunately, we had coverage and paid nothing.
So why do people run the risk of financial ruin if something goes wrong? There appear to be two main reasons.
The first is that they think they have coverage through a credit card, workplace benefits plan, or retirement health care program. Ms. Forget’s advice is to check it out.
“Credit card policies may limit the number of coverage days for older people,” she warns.
The same may be true of workplace benefits and retirement programs. She suggests calling the employer’s human resources department or the company that underwrites the policy for clarification.
“The older you are, the more likely it is you’ll need extra protection,” she says.
While you’re on the phone, ask how the bills will be paid in the event of a medical emergency. The best insurance plans have all costs billed directly to the underwriting company – you pay nothing up-front. But some policies require you to pay the expenses yourself and then submit a claim for reimbursement. That can create a huge financial burden if the cost runs into the tens of thousands of dollars, which it easily can. A U.S.-resident friend told me he recently spent four hours in his local emergency department with heart attack symptoms. Fortunately, it was a false alarm but the tab was $10,000 nonetheless.
The second reason for failing to obtain coverage is cost. Let’s face it, travel medical insurance is expensive and the older you get the more pricey it becomes. There are cut-rate policies out there but be careful. Low-cost providers may limit the amount of coverage and/or take a harder line than usual on prior medical conditions.
Unless you are willing to pay through the nose, most policies specify that no claims will be approved if they relate to a pre-existing condition. This is why it is so important to complete the application form fully and accurately. If a claim is made, the insurer will often go to great lengths to verify all the information on the form. Even if you have made an honest mistake, your claim could end up being denied.
Ms. Forget advises going over the form in detail with your physician or an insurance company adviser. “If the doctor is resistant because of the time involved, be insistent,” she says. “It’s your right.”
Be aware that any changes in your medical condition can also affect coverage. This can include things people might not even think of as a “change”, such as a modification in an existing prescription. Even if the dosage is reduced because your doctor believes the condition is improving, the insurer may require 90 to 180 days of “stability” before approving a policy.
Ms. Forget contends that the denial rate on health insurance claims is “very low” despite some highly publicized cases in recent years and a controversial report on CBC’s Marketplace that zeroed in on the plight of some people who had seen their claims rejected because of technicalities and were struggling with the financial fall-out.
“If you don’t complete the questionnaire properly, yes the claim could be denied,” she agrees.
The bottom line is that if you are going to shell out hundreds or thousands of dollars for travel medical coverage, don’t cheat on the form. It could come back to bite you.
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