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Travellers who purchase token medical insurance plans may discover that the plans they purchased are inadequate or do not cover them when they need hospital and medical treatment. Your bargain medical insurance may be instead a simple trip cancellation or flight accident insurance policy. Many of you have heard stories of Canadians who were forced to mortgage their property or worse in order to pay for US medical expenses. The purchase of proper travel insurance not only reduces financial risk, but provides peace of mind as well.

Many people purchase travel protection as a supplement to their provincial medical plans, before heading south for the winter. The typical insurance plan has an expiration date of less than six months. If travellers covered by these plans wish to stay longer than six months, they either go without coverage or have to return to Canada and convince their insurance carriers to give them extended coverage. Premiums have become quite costly, and a typical married couple aged 65 can expect to pay between $2,500 and $5,000 for a six-month policy, depending on the company and the deductible chosen. Numerous travel insurance plans are available through travel agencies, insurance companies, the Canadian Automobile Association, the Canadian Snowbird Association, and premium credit cards. The types of coverage and premiums can also vary widely.

Most plans have benefit limits of $1 million to $5 million for covered medical expenses, although some plans have no dollar limitations on benefits. Terms may range from 24 hours to a maximum of one year. Premiums are based on the age of the travellers - usually with categories for those over age 65 and those age 65 or younger -and may also depend on the number of people in a party. Nearly all carriers require you to purchase your coverage before you leave Canada. Don't automatically assume that the association in which you are a member has the best medical plan for you. More often than not, you will get better coverage through a travel insurance broker, who can give you quotes from many companies as well as provide you with information on the claims-paying experience. Many associations change underwriters every year, so claims paying can vary greatly from year to year. Several associations tend to make the sale of travel insurance a key source of annual income, so they may tend to pressure members into thinking they must get the travel insurance from them even when they know there are better policies elsewhere.

A very positive development in the travel insurance industry, with all this new competition, has been a much better choice of plans with deductibles ranging from $50 to $10,000. Choosing a high-deductible policy can reduce annual travel insurance costs by 50 percent or more without a significant increase in risk. (See Appendix F for a listing of the names, addresses, websites, and phone numbers of the major Canadian travel insurance providers.)

Not all policies are alike, and you often need to work through a maze of costly options to ensure coverage for all major travel hazards. Here are some pointers to help you through that maze:

• In general, you get what you pay for. Buying the lowest premium may get you inadequate coverage. However, just because a plan is expensive doesn't mean it won't have gaps in its coverage. Premiums alone should not be the sole criterion for purchasing travel insurance.

• Check with your credit card company: some gold or premium cards will provide limited medical coverage for travel stays between two weeks and sixty days. These are sometimes included in the annual credit card fee. We must caution you to check out this type of coverage carefully, since many plans are inadequate. All major Canadian banks have cut back the maximum age for any travel coverage to 65, and they continue to add restrictions.

• Look for a policy that covers all of the expenses that your provincial plan does not, with no limitations on standard doctors' fees or daily hospital expenses.

• Check the upper limit of the policy. Many policies have total benefit limitations as low as $25,000, so you'll have to pay any costs beyond that amount that your provincial plan doesn't cover. Even a brief emergency stay in a US hospital can exceed this limit. Claims paid recently by travel insurance companies for hospital stays in the US have been over $750,000 (for claims such as heart bypass operations with complications). So as long as your upper coverage limit is higher than this amount, you should be okay.

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