Did you ever wonder why, after a lifetime of paying taxes and premiums for your comprehensive, universal, and so-called portable health insurance coverage, your government health insurance benefits stop at the border? Why do all provincial health plans urge you to buy private insurance if you plan on crossing the border to visit relatives for a day, or go shopping, or take a vacation?
It’s because several years ago Canada’s provincial governments saw a way to save money, even though that meant exploiting you. They stopped paying for medical emergencies you may have while travelling, even though the Canada Health Act obligated them to pay at least as much as they would spend if you had that emergency in your home province. Now, most provinces disregard that obligation and the federal government does nothing about it. The provinces pay so little of your out-of-country health bill, you’d hardly notice.
British Columbia pays $75 a day (Canadian) to reimburse you or your travel insurer for an inpatient hospital stay, even though the actual charge will more likely be $2,000 or $3,000 or more per day. And it’s not only American hospitals that will charge that much. Hospital care is expensive everywhere in the world. A foreign visitor to Toronto who needs emergency hospital care will end up being charged at least $4,000 or $5,000 per day. And though BC is the stingiest, other provinces are not far behind. Alberta, Saskatchewan, Quebec, and New Brunswick will pay only $100; Ontario $200 for a regular hospital room and $400 for the ICU; Nova Scotia up to $525; Newfoundland $350 per day for a general hospital and up to $465 for a specialized, teaching-centre level hospital; and Manitoba and Prince Edward Island will pay the equivalent of average standard ward charges within their provinces.
In addition, the provinces pay little or nothing for out-of-country outpatient or clinic services, ambulances, out-of-hospital drugs—and they pay nothing for air ambulance repatriation to a hospital close to your home, or for bringing your body home if you die, or for dozens of other common charges that are a part of emergency health care. This is all left to private travel insurance, and the bigger the gap between what foreign health providers charge and your government plans pay, the greater the costs insurers have to cover. That’s why you buy insurance and that’s why foreign hospitals and doctors are now demanding proof that you have private travel insurance that they recognize, and why they are verifying to see that it’s up to date and will cover the services you need. This verification is not a mere formality and provincial health insurance cards are not accepted.
If you don’t have acceptable private insurance you will be expected to pay a deposit before services are rendered and the balance on leaving the hospital—by cash, credit card, or in some cases by promissory note. And understand that the border does not offer protection against hospital collection agencies.
Without travel insurance you are rolling the dice in a very expensive bet.