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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