What You Should Know About Emergency Travel Medical Insurance Coverage
Leading up to spring travel season, we regularly get inquiries about Emergency travel medical insurance coverage. Now is a great time to remind your employees how this coverage works, especially with the recent outbreak of COVID-19 (aka Corona Virus).
COVID-19 and your Emergency travel medical insurance
With the recent outbreak of COVID-19, it has undoubtedly raised questions around Emergency Medical Travel coverage. Our advice to anyone leaving Canada is to ensure travellers know before they go. Travellers should understand their emergency out-of-Province/Canada medical coverage and if not sure should review their policy/benefit booklets. They may wish to also contact the insurance company directly for coverage verification prior to leaving their province of residence.
When contacting the insurance company, ensure to provide the call centre with your policy and ID numbers and that the response is specific to the traveler’s policy versus general questions and comments. Insurance Companies offer many types of policies which include travel insurance and each can differ significantly. At times like these, travelers should seriously consider their travel plans with the stated travel advisories as set out by the Government of Canada. This is not the first, nor will it be the last issue impacting travel around the world and understand your plans coverage details and limitations will help protect you from any surprises.
Emergency Services covered under this benefit typically include:
- Services and supplies while in hospital
- Outpatient and physician services
- Ground ambulance service to the nearest hospital
- Transportation to the employee’s home province for medical treatment, as appropriate
Every insurer uses a global travel assistance provider that coordinates care and provides concierge services in the case of an emergency:
- Referral to physicians, pharmacists and medical facilities
- Confirmation of the coverage and benefits
- Facilitation of payments to a hospital or medical provider whenever possible
- Monitoring of the medical situation if an employee or one of their family members is hospitalized
Additional support services may be provided for the employee and/or family members in the event of a medical emergency but it is important to check these details within the plan booklet:
- Hotel accommodation and meals if the return trip is delayed by a medical emergency
- Replacement transportation tickets if the original ticket is unusable due to an emergency
- Return of remains in the event of death
- Return of personal or rental vehicles
It’s important to advise employees that while travelling at any time, they should carry their emergency travel medical card with them. If an employee does not have a card, it can be ordered from the insurance carrier and, in many cases, printed off the insurer’s website, or they are often available on the insurance carrier’s app.
In the event of a medical emergency, while travelling, the employee or their travel companion should contact the emergency assistance number (as indicated on their benefit card) immediately or as soon as they are able; alternatively, they should have someone they are travelling with do so on their behalf. The travel assistance provider will be able to guide them through any concerns they may have, as well as confirm with hospitals or other medical professionals the coverage available to avoid any delays in treatment. If they are admitted to a hospital, the travel assistance provider will discuss treatment and arrange for payment with the hospital directly. In some instances, the travel assistance provider may also recommend transfer to a different medical facility based on the circumstances.
Employees can expect that, if they see a doctor for minor treatment, they may have to pay for services up-front and then they can submit the receipt for reimbursement when they return home. Upon their return home, employees should expect to receive a package from the insurer with the appropriate forms that will require completion and signature for filing with the provincial plan as well as confirming expenses incurred with the submission of any receipts, invoices, and/or discharge documentation provided. It is important to note that there are timelines for submission of these documents and employees should pay immediate attention to these documents.
There are many instances whereby someone may not be provided with or be eligible for an employer-sponsored Extended Health Care benefit, including Emergency Travel Medical insurance (i.e., over-age dependents, elderly parents, travel duration exceeding stated limit in contract, contract lifetime maximum being reached). If additional insurance is necessary, ZLC Financial can help to arrange the purchase of coverage as needed. When looking to purchase additional insurance, there are some provisions to consider:
- Pre-existing condition coverage – as long as individuals meet the requirements for stability of any medical conditions, they may purchase coverage.
- Individuals over age 60 – they are required to answer a medical questionnaire. If they fail to answer the questionnaire with 100% accuracy due to, for example, something like a childhood illness, claims could end up being declined, thereby leaving them with medical bills in the hundreds of thousands of dollars. Coverage may be available that will cover claims in the event there was an issue with the medical questionnaire, with a $10,000 deductible over and above the regular policy deductible, rather than leaving the entire claim to be paid by the claimant.
- Deductibles – these can keep the overall cost of the insurance low, but individuals need to keep in mind that the deductible will be an out-of-pocket expense for them.
- Plan maximums – these can start as low as $250,000, but medical costs can quickly add up, so it is important to consider a reasonable maximum.
Each organization’s needs are unique and warrant a customized solution. We would be pleased to discuss your specific situation with you to identify the best strategy with respect to your employee benefits program. Should you have any questions on the above, please don’t hesitate to contact me or a member of our team.
At ZLC Financial we are one of the fastest growing employee benefits advisors in Western Canada and we are fortunate to have the best people, resources and clients. We provide value to you by leveraging one of the most skilled benefits teams – collectively almost 300 years of experience within our team of 16 employee benefits specialists. We have been working with businesses ranging from 3 to over 70,000 plan members for over 30 years.
This information is designed to educate and inform you of strategies and products currently available. As each individual’s circumstances differ, it is important to review the suitability of these concepts for your particular needs with a qualified advisor.
This article has been updated from a previous version.