Travel: Getting ill abroad

What to do if you get sick in a foreign country.

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by Julie Cazzin
May 1st, 2009

From the May 2009 issue of the magazine.

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When we travel, we seldom think we’ll get sick. But these, days with swine flu and other viruses becoming more prevalent in favorite Canadian tourist destinations like Mexico, it pays to do a bit of research before you leave the country. You want to make sure you have health insurance that guarantees you’ll get the best medical treatment possible out of the country with little or no costs to you.

Here are some tips to ensure you’ll be well taken care of when you cross Canada’s borders:

1. Err on the side of caution. If you’re running a high fever, or suffering chest pains, don’t assume the symptoms will go away by themselves. If you have travel insurance, call the 1-800 number written on the back of your insurance card. A customer service rep will direct you to the nearest clinic in your area. If you don’t have travel insurance, call the front desk of your hotel or call your tour guide if you’re part of a group.

2. Not confident about the advice you’re getting? Then call the nearest Canadian embassy or consulate. If you can’t find where that consulate is, phone Canada’s Foreign Affairs department. Its 24-hour, seven-day-a-week help desk is at 1-613-996-8885 and, yes, you can dial collect. Foreign Affairs staff can often direct you to a clinic in your area. They can also arrange for money to be wired to you from home and, in emergencies, will even advance you a short-term loan to get back to Canada.

3. If you fall sick in the U.S., realize that there is a big distinction between state-funded public hospitals and private hospitals. Public hospitals are required by law to treat everyone who needs medical assistance, even those who can’t pay for it. These hospitals will stabilize your condition if your illness is life-threatening, but they won’t do much more than that. And because of long line-ups and chronic underfunding, the attention you get at these hospitals may be very limited.

You’ll get better care at a private hospital, but only if you can pay. These institutions are expensive — $4,000 a day is typical. If you show up at the doorstep of a private hospital with a heart attack in progress, don’t be surprised if the first question you get asked is about finances, not symptoms. You usually have to show an insurance card or hand over a credit card to be taken seriously. Otherwise, you will be diverted to a public hospital.

4. A bit of organization can speed your diagnosis. Before you leave for the clinic, put all your prescription medication, with labels on, in a clear plastic bag. Show it to the doctor who examines you. This allows your caregiver to see at a glance what you’ve been taking and can alert him or her to your medical issues, especially if you’re too ill to respond or don’t speak the language.

5. If you’re feeling less than perfect, but not really sick, and don’t trust the local facilities, head to the nearest Internet cafe. Web sites such as www.webmd.com allow you to research what your symptoms may mean. If you want more tailored information, visit www.justanswer.com/medical. For a fee, one of the site’s doctors will answer your personal questions, usually within minutes.

6. Build a paper trail. Keep all receipts and ask for a copy of your hospital bill. Even if you don’t have travel insurance, you may be able to claim for partial repayment of your expenses from your provincial health plan. So long as you can document your diagnosis and your care, your provincial health plan will usually cover the amount that equivalent treatment would have cost in Canada. This may fall far short of the actual cost of your care. For instance, a one-day stay in a hospital in France or Britain will set you back about $2,000. In most provinces, you would be reimbursed for only about $400 — what a day in hospital would have cost back in Canada.

7. Buying travel health insurance is a good idea. It protects you if you should happen to break your leg or develop a bad case of food poisoning while traveling. But be aware that this form of insurance has a reputation for odd exemptions and strange conditions. It pays to examine the fine print of whatever policy you buy. Ifyou’re relying on your health coverage at work, read the conditions: many policies have strict limits on how long coverage lasts. If you think you have coverage through your gold or platinum credit card, double check the details: most credit-card insurance doesn’t cover you if you’re over 65 and some cards require you to phone in and pay a fee to activate coverage.

In addition, some policies require you to pay up front for all your foreign expenses, on the promise that you will be reimbursed when you return to Canada. If the bill you’re facing is high — and an emergency heart bypass operation in a U.S. hospital can set you back $200,000 or more — you may have to post security before getting medical treatment, even though you are insured.

8. Travel insurers have built an unfortunate reputation for rejecting claims — even claims that would seem to be covered. Develop a blood clot while on the beach in Spain? Suffer a stroke while vacationing in Florida? You may find thatyour insurer won’t cover the cost of your care if it can argue that your medical crisis was the result of a “pre-existing condition,” such as the high blood pressure that you had before leaving home. “The term pre-existing condition is very vague,” says Moshe Milevsky, a professor at York University in Toronto and author of Insurance Logic: Risk Management Strategies for the Canadian Consumer. “Insurance payments can be subjective and an insurer may deny one claim and accept another for reasons that aren’t entirely clear.”

Your best protection is to nail things down before leaving home. “If you have a chronic condition, such as cancer or diabetes, don’t take a customer rep’s word for it — get it in writing from your insurance company that your condition is covered,” says Robin Ingle, chairman of Ingle International, a Toronto company that provides seminars on travel and health-care issues.

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