Travel insurance

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No price appears on this page, and none is sent by email. What a contract costs depends on the person and the design, and no honest figure can be produced from three answers.

What decides a travel claim

• Single trip and multi trip cover different shapes of travelA single trip policy runs from one departure to one return. A multi trip policy covers repeated departures across a year, with a cap on how long any one trip can last.
• Stability before departure is the test for a known conditionA condition already diagnosed is measured against a stability period written into the contract: no change in treatment, medication or symptoms for a set number of months before you leave. A change inside that window can move the condition outside the coverage.
• Emergency is defined in the contract, and cancellation sits apartThe medical side pays for care that is sudden and unexpected, not for treatment arranged before departure. Trip cancellation and interruption is a separate coverage with its own list of reasons that set it going.

What travel medical coverage actually is

Travel emergency medical insurance is coverage a Canadian resident buys before leaving their province, to pay for a medical emergency that begins while they are away. It is a short contract with a narrow purpose, and it is one of the few insurance products where the whole of the value shows up in a single week of a person’s life or never shows up at all.

It is not health insurance. It does not pay for a check up in another country, a prescription refill for something already known about, dental work, or a procedure somebody travelled in order to have. It pays for an emergency: something sudden and unexpected that requires immediate treatment.

Two words in that sentence do all the work. Sudden and unexpected. A condition a person already had is not, on its face, sudden or unexpected, which is why every one of these contracts carries a clause about conditions that existed before departure. That clause, and not the coverage amount, is where most declined claims come from, and it has a section of its own further down.

The reason the product exists at all is that a provincial health plan is a plan for treatment inside that province. Cross a provincial boundary and the plan changes. Leave the country and it very nearly stops. Most Canadians know this in outline and underestimate it badly in practice.

What your provincial plan pays once you have left

Inside Canada, outside your own province, most provinces have reciprocal arrangements that cover physician and hospital services at the host province’s rates. It is not complete. Ambulance service, prescriptions filled at a pharmacy, and some services are typically outside the arrangement, and one province has historically stood outside the physician side of it, so a traveller can be asked to pay a doctor directly and claim afterwards. Travel coverage for a trip inside Canada exists for that gap, and the gap is real even though it is smaller than the one abroad.

Outside Canada the picture is different in kind, not in degree. A provincial plan will reimburse emergency care received abroad only at the rate it would have paid for that care at home, and hospital care in some countries is billed at a multiple of that rate which most households would find hard to imagine until they see the invoice. The traveller is responsible for the difference, and the difference is nearly the whole bill.

It is worth being concrete about what generates the bill. An air ambulance home with a medical escort. A stay in an intensive care unit. A helicopter off a mountain. A surgery followed by days of recovery before a person is fit to fly. None of those are exotic events and all of them produce numbers that do not fit inside an ordinary household.

The rates a province reimburses, and the arrangements between provinces, are set by each provincial plan and they change. Confirm what your own plan pays outside its borders on that plan’s own website before you rely on any of it. Nothing on this page is a statement of what your province pays today.

The stability period, and the definition that decides the claim

This is the clause that matters. Travellers compare policies on price and on the coverage amount. Insurers decide claims on the pre existing condition clause.

The mechanism is a stability period: a defined stretch of time immediately before the coverage takes effect, or before the date of departure, during which any condition the traveller already has must have been stable. If it was stable throughout that window, a sudden emergency arising from it is generally covered. If it was not, it is generally excluded. The length of the window is set by the contract, it differs between contracts, and it commonly gets longer as the traveller gets older. This page does not print a length, because the only length that matters is the one in the policy in front of you.

Stable is a defined term and the definition is exacting. It commonly means no new diagnosis, no new symptom, no new treatment, no hospitalization, no test result that led to a change, and no change in medication. A change in medication includes a change in the dose, and in many contracts it includes stopping a medication as well.

The practical effect surprises people who consider themselves healthy. A traveller whose blood pressure medication was adjusted a few weeks before the trip may have a condition that is not stable within the meaning of the contract, even though they feel well and their doctor is pleased. A traveller who had a test done as a precaution, with a normal result, may still have triggered something the contract cares about depending on how the clause is written.

So the comparison between two policies is really a comparison of three things: how long the stability window is, how the contract defines stable, and at what age the window lengthens. A policy with a shorter window and a plainer definition can be worth more to a household than a larger coverage amount, because the amount only comes into play once the claim is admitted.

Two consequences follow. Answer the medical questions from the actual records rather than from memory, including the medication that was adjusted. And read the clause before departure rather than after the ambulance.

One trip, or a year of trips

A single trip policy covers one departure and one return. It is bought for that trip, it is priced on that trip’s length and the traveller’s age and health, and it ends when the traveller comes home.

A multi trip annual policy covers every trip taken in the year, and it carries a limit on the length of each individual trip. That limit is the whole of the product and it is the part travellers forget. A person with an annual plan who stays away longer than the per trip limit is not partly covered for the extra days. In most contracts they are uncovered from the day the limit is passed, and a claim that arises on a later day is a claim on a trip that fell outside the policy from that point onward.

Where the trips are short and frequent the annual plan is usually the simpler arrangement, because there is nothing to remember before each departure. Where one trip in the year is much longer than the rest, the household is normally looking at an annual plan for the short trips plus something arranged separately for the long one, or at a top up that extends the per trip limit where the insurer offers one.

Two more mechanics are worth knowing. Some annual policies are underwritten once at purchase and some ask the traveller to confirm their health before each departure, which is a materially different contract wearing the same name. And on any policy, the stability window is generally measured against each departure date rather than against the day the policy was bought, so a health change in month seven of an annual policy can affect coverage on the trip taken in month eight.

The long absence, and what it does to provincial coverage

A Canadian who spends part of the year in a warmer place has a second problem on top of the insurance one, and it is a larger problem because it is not about a claim, it is about eligibility for the public plan itself.

Provincial health coverage depends on residency, and every province defines residency partly by physical presence: a person must be in the province for some portion of the year to remain eligible. Stay away longer than the province allows and coverage can be interrupted or ended, and getting it back can involve a waiting period on return. This page does not print the required period for any province, because it differs by province and it changes, and because the consequence of relying on a wrong figure is losing public coverage entirely.

The interaction with travel insurance is where households get caught. Travel coverage is written for a person who is covered by a provincial plan. If provincial eligibility has lapsed because of a long absence, the travel policy may not respond either, and the traveller who thought they had two layers of protection discovers they have none.

Some provinces allow an extended absence on application, for a stated purpose and for a stated period, and some allow it only once in a defined number of years. That process exists to be used and it usually has to be arranged before leaving rather than afterwards.

The step that avoids all of this takes one phone call. Before a long absence, confirm with your own provincial health plan how long you may be away and still remain covered, and whether an extended absence has to be requested in advance. Get the answer from the plan itself. Nothing on this page substitutes for that call.

Trip cancellation and interruption is a different contract

Emergency medical coverage and trip cancellation coverage are sold together, described together, and are entirely separate protections that respond to entirely separate events.

Emergency medical pays for treatment. Trip cancellation reimburses the non refundable money a traveller loses when a trip does not happen, for a reason the contract lists. Trip interruption covers the additional cost of getting home early or of a delay, again for a listed reason. A traveller can have either without the other, and buying the medical part does nothing at all about a deposit lost to a cancelled trip.

The listed reasons are the substance of the cancellation contract. They typically include the traveller’s own illness or injury, and commonly the illness or death of a close family member at home, and often a small set of other events. They typically do not include a change of mind, a change of plan, or a situation that was already known when the coverage was bought.

That last point deserves emphasis because it decides so many of these claims. Cancellation coverage responds to events that were unforeseen at the time of purchase. A parent already seriously ill when the trip was booked, a warning already issued about a destination, a labour dispute already announced: those are generally known events, and a policy bought afterwards generally does not respond to them. This is also why cancellation coverage is usually bought at the time the trip is paid for rather than in the week before departure, and why some benefits are available only if the coverage was arranged within a short window after the first deposit.

The coverage attached to a credit card, read honestly

Many cards include travel emergency medical coverage, and it is genuine coverage. It is also written with limits that a household should know before treating it as the answer, and the limits are in the certificate of insurance rather than in the marketing.

The three that matter most. First, an age limit: card coverage commonly reduces or ends at an age stated in the certificate, and it frequently does so at exactly the age at which a traveller starts to need it. Second, a trip length limit: the coverage runs for a stated number of days per trip and the number is often short, and it can be shorter for an older cardholder. Third, the same pre existing condition clause described above, sometimes with a longer stability window than a purchased policy would carry.

There are usually conditions attached as well. Some cards require the trip to have been paid for with that card, or that the cardholder be the primary holder, or that the account be in good standing on the date of the emergency. Coverage for a spouse or for dependent children may be included or may not.

The way to use card coverage well is to read the certificate of insurance before the trip, find the age limit, the days per trip and the stability window, and then decide whether the trip in question fits inside all three. Where it does, the coverage is real and free. Where it does not, the household is arranging something else, and the worst outcome is the one where nobody checked and everybody assumed.

The condition that quietly voids claims: call before treatment

Almost every emergency medical policy requires the traveller, or somebody on their behalf, to contact the assistance line before receiving treatment, or as soon as reasonably possible where the emergency makes a call impossible first.

This is not administrative. The assistance company approves the treatment, directs the traveller to a facility it can deal with, and arranges direct billing so that the hospital invoices the insurer rather than the traveller. Where the call is not made, many contracts reduce what they will pay, and some reduce it substantially. A traveller who handles the emergency themselves, pays, and submits receipts on the way home can find that the policy pays a fraction of what it would have paid had the line been called first.

The number is on the policy card and it operates at every hour. Save it in a phone before departure, and give it to whoever is travelling with you, because the person most able to make that call is often not the person having the emergency.

A second condition sits beside it in most contracts, and it is worth knowing for the same reason. Once the insurer has determined that a traveller is medically fit to return home, continuing to stay abroad can end the coverage for that condition. A household that wants to wait for a better flight or a more convenient date is making a decision with consequences it should read about first.

What to do in the first hour

Call the assistance number on the policy before treatment is given, or have somebody call it, or call it as soon as the emergency allows. Everything else on this list is easier once that call is made.

Give the hospital the policy number and the assistance company’s details, and ask the hospital to bill the insurer directly. Direct billing is what the assistance company arranges and it is the difference between a household advancing an enormous sum and a household advancing nothing.

Keep everything, in the original. Itemized invoices, the admission and discharge records, the diagnosis, the physician’s notes on what was treated and why it could not wait, pharmacy receipts, and receipts for transport. A claim assessor is deciding whether the event was sudden and unexpected, and the documents from the hospital are what answer that.

Do not authorize a transfer home, an air ambulance or a medical escort without the insurer’s agreement. Repatriation is generally covered only when the insurer has approved and arranged it, and a family that organizes it independently, in distress and in a hurry, may be paying for it independently as well.

Tell the insurer about any complication, any change of facility, and any extension of the stay while it is happening rather than afterwards. The file stays open, the approvals stay current, and nobody is reconstructing a week of events from receipts two months later.

The four things people call travel insurance

The phrase covers several different contracts that pay for different events. They are frequently bundled and they are not interchangeable.

The line to carry away: emergency medical and cancellation are different contracts responding to different events, and a household that bought one and believes it has both is exposed on whichever one it does not have.

Where this coverage earns its cost, and where it does not

It earns its cost on any trip outside Canada, at any age, for any length. The gap between what a provincial plan reimburses abroad and what a hospital charges is the largest uninsured exposure most households will ever carry, and it is carried by people who would never leave their house uninsured for a fraction of the amount.

It earns its cost on a trip inside Canada as well, though less dramatically, because the reciprocal arrangements leave real gaps around ambulance service, prescriptions and one province’s physician billing.

It earns its cost most of all for a traveller with a managed condition, and that is exactly the traveller most likely to be excluded by the stability clause. The resolution is not to skip the coverage. It is to read the clause, answer the questions accurately, and where a condition falls outside the window, find out what the contract will still cover, since a policy that excludes one condition still responds to everything else that can happen on a trip.

It does less than people expect for somebody whose trip is short, whose employer plan already includes a travel benefit, and who has read that benefit’s day limit and found the trip fits inside it. That household may already have what it needs, and the work was in the reading rather than in the buying.

And it does nothing at all about the reasons a household actually loses money on a trip that goes wrong at home rather than away. A lost income, a serious diagnosis or a death are answered by disability insurance, critical illness insurance and term life insurance, and by none of them accidentally.

The mistakes this page exists to prevent

Assuming the provincial plan covers care abroad. It reimburses at what it would have paid at home, which abroad is close to nothing against the invoice.

Comparing policies on price and coverage amount while ignoring the stability window and the definition of stable, which is where the claim is actually decided.

Answering the medical questions from memory. A dose adjusted shortly before departure is the detail that decides the file.

Staying away longer than the per trip limit on an annual policy, and believing the coverage stretched with the trip.

Letting a long absence run past what the province allows without confirming the rule with the provincial plan first, which risks the public coverage and the travel policy at the same time.

Getting treated first and calling the assistance line afterwards, which many contracts penalize and some penalize heavily.

Buying emergency medical coverage and believing the trip deposit is protected, or buying cancellation coverage and believing the hospital is.

Questions people ask

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