Your employee benefits program provides valuable out of country emergency health protection. While the coverage offers great value, it is important that you understand what is covered.
Each year many claims are denied. This is mainly because many people do not understand what their travel insurance covers. While less than 6% of group travel insurance claims are denied and the most majority paid, it is important to understand the limits and restrictions of your coverage.
Understanding The “Fine Print”
Many plan participants believe that their group travel coverage entitles them to the same treatment they would receive while at home. Most group travel plans are there to protect you against emergency health issues. Be aware that if you visit a doctor while travelling outside Canada to treat a minor illness or chronic pre-existing condition you may be paying the bill yourself.
Common travel health exclusions you should be aware of:
- Pre-existing conditions:
Anyone with a pre-existing medical condition may not be covered should a complication arise while abroad due to the condition (i.e. heart attack resulting from an ongoing medical condition). Check with your carrier before leaving on a trip to ensure any pre-existing conditions that are treated and stable are covered.
- Stable medical history required:
If you are on medication or receiving ongoing treatment for a medical condition, you may be covered while abroad provided there has been no change in the condition or treatment for a specified time before travelling (i.e. Diabetics whose condition is controlled and stable). The amount of time deemed to be stable varies by insurance policy/carrier, and it is important to know what your carrier’s policy is. Furthermore, if you have been advised not to travel by your doctor then you would not be covered if you choose to travel anyway.
- Travel Advisory:
Travelling to a country or region where DFAIT (Department of Foreign Affairs, Trade and Development) has issued a travel warning can void your coverage.
- Dangerous Activity:
A claim resulting from injury while engaging in dangerous activities and sports such as scuba diving, parasailing, or while under the influence of drugs or alcohol could result in the claim being denied.
- Length of stay:
Travel insurance is usually good for up to 60 days of travel depending on the policy. However, if you are planning to be out of the country for longer than your maximum coverage amount it is recommended to purchase top-up insurance to cover the difference before you leave. This can be especially important for employees who travel frequently or for extended periods of time for work in other countries.
- Group Travel Coverage and ‘Active Employment:
To be eligible for group travel coverage you must be both a permanent resident of the province you reside and actively employed. Active employment means working at least 20 hours a week, employed as of the effective date of travel, and a listed member of a class shown in the group benefit schedule. If the above requirement is not satisfied, then individual travel insurance must be purchased.
- Take the Time to Understand Your Coverage
It is important to read and understand your travel coverage and its limitations before travelling. This will ensure you will be adequately protected for any emergencies should they occur. Understanding some insurance carriers have recently changed the terms and conditions for their out of country coverage, it is recommended to contact the insurance company that administers your plan and verify that you will be protected based on your travel circumstances. If you require coverage specifically for a medical condition you may need to purchase additional individual travel insurance.