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Your most expensive vacation ever could be the one where you got sick while away and relied on your credit card’s travel medical emergency insurance to pay the bill.

If you have a health-related emergency while travelling and you recently had almost any medical attention back home other than a checkup, your credit card’s travel medical coverage may not pay.

“At the end of the day, it’s a plastic card that has nothing attached to it,” said Marty Firestone, president of Travel Secure, a seller of travel medical coverage. “You think you have [coverage], but you may not.”

Travel medical coverage is a must at any age because being treated in a hospital while travelling outside Canada can cost you thousands or even hundreds of thousands of dollars. The cost of this insurance isn’t huge, but it will bite into your holiday budget. One insurer offered an online quote totalling $211.74 for two 60-year-olds to be away for three weeks in January.

Until you dig into the details, having travel medical insurance included as a perk on a credit card seems like a welcome cost saving. This is particularly true if you’re 65 and older, because only a small number of cards will cover you at that age. The HowToSaveMoney blog recently featured seven of these cards, each offering emergency medical coverage for three, 10 or 15 days for people 65 and older. (Note: Cards may discontinue coverage at a certain age or add restrictions.)

The problem with these and all other cards offering travel medical coverage is the way these policies are built. The process of assessing your health and its impact on your insurability – underwriting, in other words – is done when you make a claim and not when you buy coverage.

This is fairly unusual in the insurance business. Think of property or life insurance; your insurer asks questions and uses your answers to price your coverage. This helps give you some confidence that if you make a claim, it will be accepted.

If you make a claim on the emergency medical policy offered by your credit card, only then does your insurer look into your medical situation. It’s possible your claim will be denied based on what the insurer finds out in looking at your medical history (yes, they do that).

What insurers look for is a stable medical situation, and this applies to people of all ages. Mr. Firestone said industry practice is that stability means no change in medication, no medical procedures, no consultations with a doctor about a particular problem for periods ranging from 90 to 180 days.

If you have health issues, you may qualify for emergency medical coverage with higher-than-usual premiums. But you have to be pro-active to make sure your insurer knows what it’s dealing with.

Insurers themselves may take steps to find out details about your health when you apply for coverage. Wally Thompson, head of affinity (individual insurance) at Manulife Financial Corp., said people applying online for the firm’s CoverMe travel medical insurance may be asked to supply additional details based on their age and length of stay.

“Depending on the plan, if you’re older than 60, there would be a questionnaire to complete,” Mr. Thompson said. “It can be completed online, or you can call one of our licensed reps and they can walk you through it.”

Mr. Thompson said the average travel emergency medical policy sold by Manulife costs $100 for a one-week stay outside the country. Manulife’s cost for a healthy 60-year-old with no pre-existing conditions who spends November through March in a holiday hotspot would be $925.63.

To lower that cost somewhat, consider a deductible. For example, Mr. Thompson said a $1,000 deductible could cut your premium by 15 per cent.

Mr. Firestone said he recently checked into the travel medical coverage offered by his own credit card. He found that the 15-day coverage for people up to 64 fell to four days at the age of 65. It’s possible to buy a top-up of additional days of coverage from the insurance company providing the actual coverage on the credit card, but that requires the applicant to fill out a 35-point questionnaire.

You’re never free from this kind of scrutiny with travel medical insurance, whether it’s bought online or accessed through a credit card. If insurers don’t look into your health before you leave, they most certainly will if you make a claim.​

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