Travel Health Insurance: Why You Need It?

Fall 2004 CSANews Issue 52  |  Posted date : May 15, 2007.Back to list

Every senior person who likes to travel south each winter contemplates the necessity of choosing a travel health insurance policy that is affordable and that will cover unexpected medical emergencies while away from home. Traditionally, insurers have provided various policies for most travellers. However, with the mounting costs of medical care, especially in the U.S., travellers are facing increased barriers to purchasing affordable insurance. As all of us age, we become more vulnerable to debilitating conditions that threaten our access to affordable travel health insurance.

There are three major factors affecting our risk and even our ability to buy:

Age: Many insurers restrict the sale of their policies to persons under the age of 75 or 80. In fact, several years ago, almost all of the gold credit card carriers ceased extending routine travel insurance as a benefit to those over the age of 65. For the more elderly travellers, merely finding an insurance policy that will give them full coverage can be challenging.

Stability of medical conditions: The stability of one's medical condition is often a measure of risk. Although most cases of instability do not by definition necessarily involve increased risk of troubles ahead, the cursory way in which travel health insurance is sold often adds the "good apples in with the bad," and coverage for that condition would either be excluded or sale of a policy would be denied altogether. For example, an increase in the frequency or intensity of angina during the stability period would be of great concern to an insurer, but a simple reduction in the dose of a blood pressure pill during that period would be immaterial to risk. Unfortunately, most policies can't determine that difference and both applicants would likely be unable to get coverage. Insurers have been gradually increasing those stability periods with many policies now extending the period to six months, a year, or longer. This translates into an increased number of travellers who are unable to purchase.

Medical Status: Many seniors are afflicted with medical problems that pose medical risks for them, as well as fiscal risks for the insurer. Generally, insurers either provide policies that don't cover pre-existing conditions or roughly "rate" the stable conditions and surcharge the premium accordingly. As health risk increases, either because of the nature or severity of the condition(s), policies become expensive and increasingly unavailable. For example, an applicant who has both diabetes and heart disease may find it difficult or impossible to find insurance.

Applying for most life insurance policies involves a careful and detailed assessment of the client's specific health status. This involves a detailed written application, an interview with a health-care professional and a physical examination, as well as blood, urine and other laboratory tests. Such a detailed, lengthy and expensive individual assessment provides the insurer with accurate data that enables the risk and premium to be established more precisely. Travel health insurance is not sold in this manner and for many reasons; such a process would be impractical. Health assessment is made through check-off applications and broad questions that group many individuals with some variance in their health status or age, "in the same kettle." Those who fall outside of the parameters have traditionally been excluded from access to insurance or offered such extreme policy limitations that coverage has been inadequate.

...air ambulance, hospital and physicians' invoices to the family totalled more than $120,000 U.S.

For example, this winter a relative of mine was sold a policy for his winter trip to Florida. Because he had had an attack of abnormal cardiac rhythm last summer, his policy did not cover him for heart problems or anything "directly or indirectly related to a heart condition." Unfortunately, he suffered a massive stroke while away, the cause being attributed to the release of a clot from his heart to his brain. Not only was the insurer not there for him for the difficult acquisition of a bed back in Canada, but when the transfer was finally made two weeks after the stroke, the air ambulance, hospital and physicians' invoices to the family totalled more than $120,000 U.S. For the very condition to which he was most vulnerable, he had no insurance! Insurance plans providing no pre-existing coverage should be purchased only by those with no pre-existing medical conditions.

But what if you are or become one of the many travellers who find themselves in these predicaments, whether it be from age, instability or medical conditions? Excluding the conditions from the policy is not the answer. In response to this need, Medipac has developed an "Individual Underwritten Plan" for many of those caught in the aforementioned situations. Upon completion of a more detailed medical application, Medipac physicians have developed a program that individually assesses a client's risk in more depth, thereby allowing a client to be rated and a policy offered, rather than to be turned away. In its first trial year, Medipac has refined the process and made available full health insurance coverage to hundreds of travellers. Many of these individuals would have travelled without proper coverage or would have had to stay home.

With the 2004-2005 season upon us, those who don't fit the box are now able to access the "closer look" program rather than be turned away. This will be a welcome opportunity for persons who have not met the stability requirements for their condition(s) or whose medical problems have not met the standard application requirements. Once insurance is offered under the underwritten plan, full coverage for all conditions applies, just as in the "off the shelf" policies.

Each year, there are those who travel without insurance. The Conference Board of Canada reports that more than 85 per cent of Canadians purchase necessary insurance or have coverage through their gold cards or place of employment. All seniors, being at higher risk for necessary emergency services, should be covered before travelling outside of Canada. While there are some advantages to having private coverage in addition to your provincial government health insurance for travel to other provinces, the major costs, all physician and hospital charges are covered in Canada by your provincial government plan. Travel health insurance will fill in the gaps, covering emergency prescription drugs, semi-private bed charges, ambulance and air ambulance repatriation if medically necessary for care. But for out-of-country coverage, the physician and hospital care, private insurance coverage is a must!

Recently, an Ontario retiree and his wife went for a day at the mall in a bordering U.S. city. Following lunch, he suffered severe chest pain and was rushed to a nearby hospital. He underwent bypass surgery that same day. When he was able to travel the 150 miles to return home six days later, the total charges had surpassed $100,000 U. S. He had not purchased insurance! He was only going for a day!

So how can you prepare for ensuring that you meet the stability clause without the extra trouble of a supplementary application process? Be sure to book your annual health assessment at least four months prior to your expected departure. This way, your doctor has the opportunity of ordering any special tests and initiating prescription drugs or drug changes without jeopardizing your 90-day stability. Physicians in general are not mindful of these important criteria of travel health insurance policies and need your input. If you do attend a doctor within the 90-day period and the physician suggests a new test or change in your medication, be sure that this is indicated. Even a trivial change, which would ordinarily be of no consequence, could affect your coverage. Last year, for example, a client had a slight flare-up of back pain secondary to his chronic disc problem, quickly relieved by an injection of cortisone just seven weeks before his departure. While in Texas two months later, he again experienced severe distress, was seen in the emergency department, had an MRI ordered and a consultation with an orthopedic surgeon. Although he settled with conservative measures, limiting the invoices to $4, 700 U.S., he had disqualified himself from coverage by not fulfilling the 90-day requirement prior to departure. In the past, to ensure coverage, his only option would have been to try and postpone his holiday, hoping that he would be eligible. With the new Medipac underwritten policy, the 90-day stability period would have been waived and full coverage allowed for departure on the originally planned date.

Last autumn, another client suffered increasing angina, necessitating a coronary angioplasty. Recognizing the policy requirement that there be at least a 12-month interval prior to departure for any insurance, he applied for the individual underwritten policy and was on his way within two weeks after application and just four months after his heart surgical procedure.

When a 69-year-old widow had required a gall-bladder operation just three months before her usual trip to California to be with her daughter, she thought that she would have to cancel her trip. But with a new application and very few additional dollars in premium, she was again on her way at the time of her usual departure with her usual complete protection.

And remember, the peace of mind you have when you're fully covered will not be the expensive medical payments alone. The experienced nurses, physicians and trained case managers at Medipac Assistance are always there for you and your family by co-ordinating your care in centres of excellence, authorizing necessary procedures and operations, communicating with your family, physicians and home doctors, and acquiring a bed in your own province for repatriation for follow-up care.

Last year, an adventurous senior took an Antarctic cruise, slipping on the frosty deck of the cruise ship when five days away from the nearest medical facility. Being too far away for helicopter access, the assistance personnel worked with shipboard professionals, family, air transfer nurses and an orthopedic surgeon in Hamilton, Ontario. Through this unusual ordeal, the client was successfully stabilized on board for his fractured hip, transferred to a hospital in Argentina six days later and subsequently repatriated with nurse accompaniment via first class for his planned surgery in Hamilton.

While such stories are upsetting, imagine the same experience without insurance and the experienced medical people to assist. So now with Medipac's new underwritten plan, many who would otherwise be unable to get insurance will have an opportunity to purchase the same full coverage and continue their winter holidays in the sun.