How much Out of Province Medical Insurance is reasonable?

Relax

Well-known member

How much coverage do you think is reasonable? There are plans for $1M, $5M, $10M, and unlimited. I have no idea how much medical care costs in the US, but I've heard horror stories about how people in the US go broke because of it.
 

How much coverage do you think is reasonable? There are plans for $1M, $5M, $10M, and unlimited. I have no idea how much medical care costs in the US, but I've heard horror stories about how people in the US go broke because of it.
Friend had her leg shattered in a t-bone incident. She had to sell her home to settle the bills due to insurance fiasco that took years to settle.

I would opt north of 1mil
 
The biggest problems I have seen were that most travel medical does after-event underwriting and uses that to deny most claims. Your coverage amount doesn't matter if they pay zero. I've seen a claim denied for a death due to meningitis because of undeclared herbal supplements on the application. They had asked their doctor months before about interactions and doc said no issues and charted the discussion. Insurance company latched on and paid zero.

Try to find a company that will do underwriting up front (I don't even know if such a company exists).
 
The biggest problems I have seen were that most travel medical does after-event underwriting and uses that to deny most claims. Your coverage amount doesn't matter if they pay zero. I've seen a claim denied for a death due to meningitis because of undeclared herbal supplements on the application. They had asked their doctor months before about interactions and doc said no issues and charted the discussion. Insurance company latched on and paid zero.

Try to find a company that will do underwriting up front (I don't even know if such a company exists).

They were denied because they were taking herbal supplements? Is that considered medicine? Sounds more like having your vegetables. Does this mean we have to declare multi-vitamins?

As far as I can tell, no questionnaire required for the companies I've been looking at unless I'm above a certain age.
 
As far as I can tell, no questionnaire required for the companies I've been looking at unless I'm above a certain age.
That's exactly the problem. The application often includes a grey statement about "any conditions that may affect your health" and then after a claim opens, you have to provide them access to all of your medical records and they dig for anything. I would rather pay $1000 up front, have them look through the files now and tell me I am covered if I need it. Like I said, I don't know if any company does this.
 
That's exactly the problem. The application often includes a grey statement about "any conditions that may affect your health" and then after a claim opens, you have to provide them access to all of your medical records and they dig for anything. I would rather pay $1000 up front, have them look through the files now and tell me I am covered if I need it. Like I said, I don't know if any company does this.

Oh, you mean the insurer interpreted the previous visit to the doctor as a pre-existing condition leading to the meningitis?
 
Oh, you mean the insurer interpreted the previous visit to the doctor as a pre-existing condition leading to the meningitis?
The company wasn't required to link the pre-existing condition to the condition requiring coverage. It was sufficient to say that the application was fraudulent as it was not fully truthful and therefore they didn't have to pay. As the victim (or their family), how much time and money do you have to fight against a heartless giant? They are staring at a 1M bill, denying you costs them almost nothing. Other than ethics, they have little reason not to deny every claim.
 
The company wasn't required to link the pre-existing condition to the condition requiring coverage. It was sufficient to say that the application was fraudulent as it was not fully truthful and therefore they didn't have to pay. As the victim (or their family), how much time and money do you have to fight against a heartless giant? They are staring at a 1M bill, denying you costs them almost nothing. Other than ethics, they have little reason not to deny every claim.

I'm so confused. So if there is no questionnaire, but I went to the doctor for a cold last month that's documented, then I go on a trip an develop meningitis, that makes my application fraudulent?
 
I just found this. Interesting to see some of the estimated costs:

There was a recent story of an Ontario guy that had a heart attack in the US. Bill was 660K iirc and denied. Writing was poor but his cardiologist may have told him not to travel and he did it anyway as he thought insurance would cover him. Defibrillator charge was $80k. Wtf. How many defibrillators can I buy for $80k? He needed access to it for an hour. $80k/hr rental rate seems excessive.
 
I'm so confused. So if there is no questionnaire, but I went to the doctor for a cold last month that's documented, then I go on a trip an develop meningitis, that makes my application fraudulent?
Read the fine print. My dad has multiple co-morbidities that make health insurance complicated. He buys through a broker and needs underwriting up front. One time broker sent him an executed policy and my dad read the fine print. No bueno. If he had needed coverage it would have been denied (I can't remember the clause that was an issue, I think they required an excessive time since visiting a cardiologist [more than a year IIRC]).
 
The key thing with health insurance policies is that you're entering into a contract baed on the info you supply. Aside about issues related to pre-existing conditions any inaccurate or incomplete info you provide can well result in them simply cancelling your policy vs. "denying" your claim.

If you are riding and have an accident you'd think you'd be in the clear and covered, but the adjuster would then focus on the application to try and find a way to cancel the contract.

Hospitals can charge what they want and they slam individuals. Insurance companies negotiate with the hospital based on their prior claims and other data they have. You can also hire firms to negotiate on your behalf for a cut of the "savings".
 
The key thing with health insurance policies is that you're entering into a contract baed on the info you supply. Aside about issues related to pre-existing conditions any inaccurate or incomplete info you provide can well result in them simply cancelling your policy vs. "denying" your claim.

If you are riding and have an accident you'd think you'd be in the clear and covered, but the adjuster would then focus on the application to try and find a way to cancel the contract.

Hospitals can charge what they want and they slam individuals. Insurance companies negotiate with the hospital based on their prior claims and other data they have. You can also hire firms to negotiate on your behalf for a cut of the "savings".
But if there is no questionnaire on the application other than your personal information (name, age, address, destination), then this shouldn't be a problem, right? I had to answer a bunch of invasive medical questions for my life insurance, but not for this.
 
But if there is no questionnaire on the application other than your personal information (name, age, address, destination), then this shouldn't be a problem, right? I had to answer a bunch of invasive medical questions for my life insurance, but not for this.
Link to application? Is there a footnote that says although there is no questionnaire you have a duty to disclose relevant conditions?
 
But if there is no questionnaire on the application other than your personal information (name, age, address, destination), then this shouldn't be a problem, right? I had to answer a bunch of invasive medical questions for my life insurance, but not for this.

Yes, you may be correct for your circumstances, my comment was a general one. If you're young enough that you can purchase medical insurance without answering a detailed questionnaire then you're lucky. Enjoy while you can.

Also, most premium credit cards will provide medical, accident, trip interuption, rental car, etc....... travel insurance at no additional charge. This could work for you as well. Medical drops off if you are 65 and over.
 
The only questions I've been asked for my quotes have been along the lines of:

Your current health​

Please review the health conditions below and select all that apply.


Note:You must check off this question if any of the conditions below apply to you.
  • I have been advised by a physician not to travel at this time or I have been diagnosed with a Terminal illness or Metastatic cancer
  • I have Kidney disease requiring dialysis
  • I have been prescribed or used home oxygen during the 12 months prior to my date of application



None of the above

I confirm none of the above conditions apply to me
 
I will say that so far, Blue Cross seems to have the best web site for quoting and informing you of all the options and specific coverage without having to search for the actual insurance documents to figure it out. Of course, you still want to read the fine print, but it's one less hassle when doing the initial price comparison.
 
I will say that so far, Blue Cross seems to have the best web site for quoting and informing you of all the options and specific coverage without having to search for the actual insurance documents to figure it out. Of course, you still want to read the fine print, but it's one less hassle when doing the initial price comparison.
I looked at Blue Cross and they basically can deny coverage far any failure to disclose. They are very up front on that.

Check ups are procedures. That Rx you had XX years ago? Does dental work get listed as medical?

You don't even need to be grounded by an M.D. There is usually a clause "when a medical opinion would have recommended against travel"

My choice is CAA. Their literature states that in the case of failure to provide correct info at the time of application there will be a surcharge of what the rate should have been and a maximum of $5000 deductible.

However, in an extreme case, they could say your policy should have been $200K and you get hooked for that plus the $5K deductible because you lied about your organ transplant. No one touches those.

What about a skin graft? Your skin is an organ.

OHIP used to cover you anywhere many decades ago but it got abused so instead of closing some loopholes they slammed the door on everything.

The straw that broke the camel's back was someone who signed into a posh rehab spa way down south and OHIP ate the large six figure bill.

In their typical governmental con game OHIP and the medical profession hide numbers.

What coverage does OHIP actually offer? There is some but they shuffle numbers and deal from the bottom of the deck.

What difference does it make if I break my arm in Ontario or Ohio? OHIP actually benefits from you having your problems outside of Canada. The last time I tried to track numbers down broken arms were relatively cheap, around $3K.

How it should work and how most insurers handle the issue.

1) It is EMERGENCY medical insurance for unforeseen events. It doesn't cover known pre-existing acute problems, COPD with oxygen, rehab, cosmetics, chronic conditions, people on their death beds wanting to see Florida again to say goodbye etc.

When a medical emergency occurs step one is stabilizing the patient and getting them to the appropriate care. Immediately after the 911 stuff the insurer is notified and they arrange the most economical procedures. Assuming the event is in the USA the cheapest route is to get the patient back to Canada where provincial coverage takes over.

If a for-profit US hospital can log you in, they will option you bankrupt if they think you have insurance or wealth. However an insurer case worker will have you shuttled to hospital motel six ASAP. An ambulance ride north to Canada could solve a lot of issues. Insurance companies negotiate discount rates with hospitals.

Why can't OHIP do that? Oh wait, then the treatment comes out of their budget instead of the patient's or the patient's insurer. Bas****s.

In the event of a vehicle crash I don't know what our big ticket medical benefits do for us, out of province.

Most doctors don't understand the insurance forms or the repercussions of using the wrong word so can't be trusted. Sorry but we have to use the insurer's interpretations, not a doctor's.

The most disgusting part of this is that no one is doing anything about it.
 
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