The question: After hearing the story about the Australian couple facing hefty medical bills after their baby was born prematurely in Canada, I called my insurance company. I’m told I cannot buy out-of-country medical insurance for a baby that has not yet been born. To me, this means I can’t travel outside Canada after about 26 weeks without risking being stuck with a very large medical bill, because a baby born after that time might be viable and would require extensive neonatal care. From what I understand, my care would be covered but the baby’s wouldn’t be. Should I be looking for better insurance or is this always the case?
The answer: You are right to stick close to home – or at least in Canada – when pregnant. I checked and there is no insurance that will fully cover a premature baby. Insurance is all about risk; the risk of a million-dollar neonatal bill is not something any company is willing to take.
That’s what the parents of Piper Kan discovered. Born at 26 weeks gestation last August in Vancouver, she required 90 days of care at a cost of $707,000; labour and cesarean delivery tacked on another $19,000. The baby’s Australian parents Rachel Evans and John Kan bought insurance, believing the baby’s care was covered. It wasn’t.
So here is what you need to know: When seeking travel insurance as a pregnant woman, you will be subject to a health assessment and if you are deemed as having a high risk pregnancy, most insurers will not provide coverage. You will also have to fill out a health declaration in which you are required to disclose your medical history.
Most insurance will cover the care of a pregnant woman while travelling, up to eight weeks before the expected date of delivery. For example, if you have to go to emergency, or your blood pressure spiked and you required treatment, you would be covered, according to Patty Faith, director of communications for Medavie Blue Cross. For most women, their care is covered up to 32 weeks gestation – but not the baby’s.
So while pregnancy as a condition is covered, the actual product of that pregnancy – a baby – is not.
Now, as a Canadian, some of that money can be retrieved , but not nearly enough.
Typically, if a parent is a Canadian citizen and is eligible for provincial coverage, a child born out of country is also eligible. But the rates are low for patient and baby – $200 per day from the Ontario Health Insurance Plan. That fee rises to $400 per day for the baby’s hospital services if born and the hospital or physician can document the infant requires care in the neonatal intensive care unit for an extended period.
As you can see, that amount barely makes a dent in the cost of a intensive care unit bed. The daily self-pay rate at BC Women’s Hospital and Health Centre, where Piper was born, was $8,120.
While travelling might seem like a good idea, it can be incredibly risky.
The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to firstname.lastname@example.org.