Will US Health Insurance Cost Crisis Affect Canadian Visitors?

As of November 1, 2016, the US media will be inundated with horror stories about historically high spikes in the cost of health insurance for millions of middle class Americans forced to buy their coverage from  marketplace exchanges.

The stories will be generated because November 1, 2016 is the opening date for the 2017 healthcare insurance enrolment period, and the prospect of double digit increases in premiums and deductibles (those are the fees patients must pay before their coverage benefits kick in) may force families to cut back on routine services and reroute them from their family physicians to hospital emergency rooms for urgent care.

If you’re visiting the US during the forthcoming snowbird season and you need urgent or emergent services, the health cost spike should make little immediate difference, so long as you are properly covered by private travel health insurance. Your basic provincial health insurance will not be sufficient.

But you do need to understand some basic rules.


Where to go for emergency care?

All general emergency care hospitals—not-for-profit, or private for-profit institutions–are required by federal law to treat you for a medical emergency whether you have insurance or not. But they will bill you or your travel insurer for the service. Ultimately, you are responsible for payment, so make sure you have proof of insurance coverage, and if at all possible, call your insurer and alert them of your need ahead of time. They may direct you to a service provider in your area.

If your emergency appears to be life-threatening and every minute counts, get to the closest hospital first, and call your insurer once the emergency is being taken care of. In such a case, it doesn’t matter if it’s a non-profit community facility or a for-profit institution. Your coverage would apply equally, and your level of care would not be substantially different.


Serious but not immediately life-threatening

Private, free-standing Urgent Care Centres, many open 24 hours and staffed by medical professionals, have become commonplace in virtually all communities and they are excellent alternatives to hospital emergency rooms if you consider your emergency serious but not life-threatening. They are usually close by, far less expensive than hospital ERs, less crowded, equipped with state-of-the-art diagnostic equipment, and are generally marketed on their ability to get you treated and back home in a matter of minutes rather than hours. And if you need a higher level of care, they can get you into an appropriate nearby hospital quickly.

Some Urgent Care Centres are owned by hospitals and are used as triage centres, some by private healthcare companies, many by groups of physicians, but virtually all accept health insurance, including travel insurance, although in some cases you may be asked for a deposit, which normally would be covered by your insurer.


In time, you too will pay

One of the indirect consequences, to you, of the current health insurance cost spike is that as it becomes less affordable, the overall costs of hospital and medical care will continue to increase. According to the healthcare economists who track these cost spirals, there appears no remedy for that increase in the immediate future.

As those costs increase, Canadian travel insurers will have to factor them into the prices they charge for out-of-country premiums. And they must factor those increases prospectively, that is, by trying to predict cost levels many months in advance.

Adding to that uncertainty is the Canadian dollar in contrast to the US dollar. It makes setting premium prices a high risk enterprise.

All the more reason for frequent travellers to the US to  put a reasonable share of funds in US dollar accounts, now offered by all major Canadian banks. But when it comes to taking financial advice, talk to your professional financial advisor or banker.

Despite the economic uncertainties facing American hospitals and doctors, you can expect the care you receive to be top quality, and the service and access to appropriate technology to be much quicker than you might be used to.

But then, that’s what you’re paying for.


Flying south this winter? Time is almost running out. Get your insurance today.

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