Your coverage may not cover you the way your think READ the fine print
Some of the most popular and a few key phrases to look for in your Medical coverage.
- “only if you can’t be treated locally”
- “to the nearest facility”
- The transport is helicopter, no “fixed wing”. Don’t need fixed wing because they aren’t going far.
- NO MEDEVAC HELICOPTERS in Mexico.
- RV return is if the partner can’t drive it, so your husband has had a stroke, but you are licensed to drive that big rig, so guess what?
- The member will only be moved to another hospital when care at the first hospital is not adequate.
- Hospitalized for more than seven (7) consecutive days will bring whoever you want to your bedside.
- Arrange your return another medical facility nearby.
- First payer (The first of primary payer is the one that pays up to the limits of coverage)
- “Primary” means that the plan pays any bills first, without having to go through your home health insurance provider; “secondary” means the plan will only cover whatever you owe after you’ve filed a claim with your health insurance provider. You’ll typically get a bit more coverage per dollar with a secondary plan—but you’ll have to deal with more paperwork if you file a claim.
- IMPORTANT INFORMATION The following info is from a Travel Insurance questionnaire. Did You Know…If you do not disclose your medical history accurately and in-full as asked on the Health Option Questionnaire, and you have a claim totally unrelated to the undisclosed medical information, your claim will NOT be honoured. It is seen as a misrepresentation of your medical history, therefore putting you in a plan you otherwise would not have been eligible for at the time of purchase. The consequence of medical misrepresentation is your policy will rendered as null and void and no claim be honoured, regardless of the claim amount and medical emergency. EXAMPLE: You fall, break your leg, your past medical history shows you have a heart problem… but you did not answer ‘yes’ to the heart question. As a result, any charges relating to your broken leg will not be covered.
VERY GOOD INFO TO BE AWARE: The insurance company has pre-authorized the surgery but will not pay directly to the hospital since it is not in the USA. The hospital requires a guarantee of payment or payment in full before discharging patient.
The patient cannot walk and must be kept lying down therefore she cannot travel due to severity of the break (needs screws bars & other hardware). Her insurance says she needs to pay out of pocket for the surgery then submit bills when she returns to Las Vegas.
Needless to say she does not have $15-18,000.00 U.S. dollars for the surgery not does she have Medical Evac Insurance.
Trip cancellation coverage is what you need to qualify for a refund if something happens before the start of your trip
- Trip interruption coverage is what you need to qualify for a refund if something happens after the start of the trip.
- Be aware of the maximum benefit under your policy and the currency. Many travel insurance companies offer limited coverage in Canadian dollars, whereas most travel claims are settled in U.S. dollars.
- Every travel insurance policy has limitations and conditions. Ensure you understand the Pre-existing Condition Clause of your policy, and note that these conditions usually apply before your departure date, NOT when you purchased the policy. If you purchase an annual plan, these conditions apply to the departure date of each and every trip.
- Pre-existing conditions most insurance companies use one of two definitions to identify such conditions. Under the “objective standard” definition, a pre–existing condition is any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan
- Copay: Your copay is a predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.
- Coinsurance: Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, after your deductible has been met. For example, if you have a 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.
- Arrange: We can arrange for a transfer to a more appropriate medical facility, even if an air ambulance is required.” Note that it says “arrange for,” not “pay for.” What you get is help in making arrangements; the cost of those arrangements goes right on your credit card bill, unless moving you is deemed “medically necessary.
- What is a Stability Clause? Most standard insurance policies have what is commonly referred to as a “stability clause”. This clause requires any pre-existing medical conditions to be stable for a specific period prior to applying for insurance coverage. To further complicate matters, the term “stable” can be misleading, as it usually applies to any change in your medical condition, whether it is negative or not, and often includes things you may not normally consider to be “changes”, such as increases or decreases in medication doses, stopping a medication and scheduled appointments and tests for possible medical issues that have not yet been diagnosed. In addition, many travellers aren’t aware that an exclusion from coverage doesn’t just apply to the excluded condition; it also applies to any medical treatment for a condition related to that condition, which means that you may unexpectedly be denied treatment coverage for a medical issue you didn’t anticipate would be excluded.
- What Is Cancel For Any Reason Insurance? Typically, the “any reason” coverage is in addition to the traditional coverage that is limited to “covered reasons” for cancellation enumerated in the policy.
- The new exclusion will be listed as the last exclusion in the plan document. It contains this verbiage:
What does the exclusion say?
Any claim in any way caused by or resulting from:
Coronavirus disease (COVID-19);
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);
Any mutation or variation of SARS-CoV-2; or
Any fear or threat of 1, 2, or 3
- Free Look Period – Refund Policy. All travel insurance plans have a free look period that starts when the plan is purchased and lasts between 10 and 15 days (see the plan details). This free look period gives you time to review your policy and return it for a refund within the time period.
- What’s the Difference Between Travel Insurance and Travel Medical Insurance? Travel insurance serves to insure a financial investment in a trip. The core benefit of travel insurance is the trip cancellation benefit, which provides reimbursement for non-refundable prepaid expenses if you must cancel your trip due to a covered reason. Many travel insurance plans provide additional benefits related to other travel expenses as well. Coverage for medical expenses may or may not be included depending on the plan. Travel medical insurance provides coverage for unexpected health expenses you might incur while outside of your home country. Your regular health insurance may not cover you abroad, and there’s always a chance you could get injured or fall sick and need medical care during your trip. Travel medical insurance typically provides additional coverage for various travel scenarios but does not include a trip cancellation benefit.
- Repatriate means take you to your country of origin. Expatriate means that you no longer live in your country of origin.
- An “Acute Onset of a Pre-Existing Condition” is a sudden and unexpected outbreak or recurrence of a Pre-Existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires immediate care.
The Acute Onset of a Pre-Existing Condition must occur after the effective date of the policy.
A Pre-Existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset.
- Travel Medical Insurance, if our designated assistance provider and the local attending medical practitioner consider you stable enough to be medically repatriated, without endangering your health, and you refuse repatriation, We will continue to pay medical expense benefits incurred after the date repatriation was recommended only up to the amount that would have been payable for the medical repatriation, subject to policy maximums and limitations.
- All of the plans cover COVID-19 except if it is a pre-existing condition. Otherwise it is treated as any other illness under the plans. The plans state that COVID-19 is covered in the policy language.
- What exactly is “medical necessity” generally speaking, if you are admitted to a facility that offers “acceptable” medical care, then it can be very difficult to prove the “medical necessity” of getting them moved to a hospital at home. This is where most travel insurances fall short.
United States residents or those with a USA mailing address
For American/Canadian & NO age restrictions
Don’t we always say, “Read the fine print?”
Traveling? What to do when facing a medical emergency?
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