Travel Insurance Not a Way to Jump Canada’s Health Queue

Recently I have seen and heard of increasing numbers of Canadian travellers using out-of-country travel insurance to avoid Canada’s long waiting lists for medical treatment. In some cases this is deliberate; in others, it is a matter of not understanding what travel insurance is about.

Example: a client with signs of a heart attack is admitted to a California hospital for emergency treatment. The diagnosis is atrial fibrillation and doctors suggest the patient needs more extensive cardiac artery surgery in the near future. They treat the fibrillation, stabilize the patient, and discharge him in good condition. The emergency is over and the patient’s insurer tells him they will pay for the emergency, but not for any follow-up or recurrence of his heart condition. The insurer suggests he may want to return home for continuing treatment and the surgery he needs.

After checking with his Canadian family physician, he is told he would have to wait at least three months, maybe more, for a visit with a specialist who can do the procedure. He elects not to return, but to take his chances and stay on in California, where after a few days he is readmitted to hospital with the same symptoms he had previously. His insurer denies his claim on the grounds that he was covered for emergencies, not for follow-up care or recurring conditions.

When he appeals the denial he claims the waiting list in his home province was too long, that he was put at risk by such a long wait, and that he could have had the procedure done in the US within days.

It’s becoming an old story. But travel insurance—no matter who the insurer—is there to cover emergencies only. If it were meant to be a substitute for your provincial health plan, the premium prices would have to be many multiples higher than they are and probably would be out of reach for the majority of travellers who now purchase travel insurance routinely. This is not a fine-print issue. All travel policies in Canada clearly label their product as emergency coverage. They all clearly prohibit coverage of medical services that are known ahead of time and for which the traveller specifically seeks treatment outside of the country. Similarly, they all prohibit coverage for any condition that can wait until the patient is able to return home by the next available means of transportation.

Canada’s problem with waiting lists is not an issue that can be solved by travel insurers.

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