Are you covered by health insurance in Canada?

Provincial insurance could save you thousands

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From the January 2016 issue of the magazine.

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In late summer, sisters Sherri Thomas and Ann-Marie Morley and their mother Cynthia Portland did what thousands of Canadians do each year and went on a road trip. Their vacation included a family wedding in New Brunswick and sightseeing in P.E.I. But instead of taking the more direct route through Maine from their homes in Cambridge, Ont., they drove the long way around through Quebec. The reason? They weren’t prepared to travel in the U.S., even for a day, without travel health insurance. Though in good shape, Blewett is 90 and age is a pivotal factor when insurers set premiums. “The cost would have been prohibitive,” says Tietz. “We figured, we’d stay in Canada. That way, we’re covered.” (Names have been changed to protect privacy.)

Actually, not necessarily. Universal health care, it turns out, may not mean what many Canadians think it does. William Shung, a senior insurance advisor with LSM Insurance Services in Markham, Ont., says few Canadians appreciate the importance of having insurance for travel within Canada. “They don’t realize they could incur very high costs should something happen when they’re in another province.”

Universal health care, it turns out, may not mean what many Canadians think it does. William Shung, a senior insurance advisor with LSM Insurance Services in Markham, Ont., says few Canadians appreciate the importance of having insurance for travel within Canada. “They don’t realize they could incur very high costs should something happen when they’re in another province.”

Two recent high-profile cases underscore just how high. In the first, a pregnant Alberta woman vacationing in Ontario went into labour two months before her due date. The hospital where she gave birth wasn’t equipped to handle such a premature baby, so the two were airlifted to a larger facility. Ontario sent her a bill totalling in “thousands of dollars.” In the second incident, an Ontario man became seriously ill while visiting Yukon and was flown to Vancouver for treatment. The territorial government billed him $18,000.

A lack of integration

The Canada Health Act may set the federal framework but delivering health care is up to the provinces and territories. These jurisdictions have reached a series of bilateral, reciprocal billing agreements so their residents can access hospital and physician services if they need emergency care wherever they are traveling in Canada. If all goes as intended, you can present your health insurance card in lieu of payment. But in actuality, it can be far more complicated.

Not only does the cost of medical services vary across Canada, provincial health insurance plans may fund supplemental services, such as physiotherapy or dental care, beyond the core services stipulated in the Act. Finally, the re- ciprocal agreements are not uniform. So there are any number of ways you can find yourself out of pocket in a medical emergency. In specific cases, you can apply to be reimbursed but your home province will only pay up to its pre-set rate for the treatment, regardless of how much you actually paid.

It’s probably not surprising then, that the federal government, as well as many provincial health ministries, have statements on their websites that recommend buying insurance for interprovincial visits. Some people may already be covered through a health plan at work, or be able to top it up for a nominal fee.

Insurance options

For those who need to purchase supplemental coverage, travel agents sell plans, as do insurance brokers. And there are many options for choosing a plan that fits your budget, notes Shung. A good starting point is the website kanetix.ca, which lets you compare quotes from various providers.

Basic premiums can range from under $3 a day for a healthy 20-year-old to nearly $40 a day for someone who is 90. For some- one aged 40 to 54, the cost will range from $26 for a four-day trip to $65 for a 30-day trip. For those who travel frequently, a multi-trip plan can often be the most cost-effective option, providing coverage for every trip you take within 12 months of buying your policy. While premiums can be half of those for international travel, eligibility requirements, notably those covering pre-existing medical conditions, are the same.

Alex Bittner, president of the Travel Health Insurance Association (THIA), cau- tions against purchasing a plan based solely on its cost. “We all need to be better consumers,” he says. “Price is secondary. Coverage is primary.” If you still think buying travel health insurance is not worth it for visiting another province, Bittner has one more thing for you to consider: “Accidents can happen to anyone, any time, anywhere,” he says. “It could be the best investment your ever make.” 

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