5 tips on avoiding big medical bills on vacation; pre existing condition a risk

By Armina Ligaya

THE CANADIAN PRESS

TORONTO _ Many Canadians are gearing up to fly to warmer climes as the March break holiday approaches, but some may return home with hefty medical bills if they don’t read the fine print on their travel insurance policy.

One key element that can lead to your insurance claim being denied is an existing medical issue, or what’s known as a pre-existing condition.

It’s a rude awakening that some Canadians have faced over the years, such as a Saskatchewan couple who found themselves on the hook for nearly US$1 million in medical bills after their insurer refused to cover an early birth while they were vacationing in Hawaii. In another case, a B.C. man went on holiday to Las Vegas with what he thought was a bad cold, but found himself in hospital facing $140,000 in medical bills, which his insurer initially refused to pay.

“It happens more frequently than you would like it to happen, and you definitely don’t want to be someone that it happens to,” said Stephen Fine, president of travel insurance agency Snowbird Advisor.

Here are some tips to help ensure you have health coverage when you travel even if you have a pre-existing condition.

1) Look at the fine print of your policy.

Whether you are using the travel insurance from your credit card, from your employer or are seeking out a policy for your trip it is important to understand what is covered. Among the key terms to look for is the company’s definition of a pre-existing condition and how that applies to your current medical status.

Travel insurance is meant to cover unexpected injuries or illnesses, said Dan Keon, vice-president of market management with Allianz Global Assistance.

“The intent isn’t for it to be a continuation of your provincial health insurance or provide coverage for conditions that you were already being treated for before you left,” he said.

Most standard policies have a “stability” clause, which refers to a defined period of time that your medical condition must be  “stable” and unchanged before you travel in order to be covered, Fine said. The period can vary between policies, from as short as seven days or as long as a year, he added. A change can be as small as an increased medication dosage or if you have had medical tests for which you are awaiting the results, Fine added.

“That is a change in your medical condition and anything resulting from that medical issue wouldn’t be covered under your policy,” he said. “And a lot of people don’t know that.”

2) Be truthful and up front about your medical status.

Signing up for travel insurance likely includes a questionnaire about your medical history, and those selling the policy may downplay the significance of those questions, such as whether you have consulted a doctor within the last 12 months, said David Share, a lawyer who specializes in insurance claims.

When a medical claim is filed, if the insurer finds some contradicting information between your answers and health records, that may be used as grounds to leave you on the hook for hospital bills.

“If they see something that was in there chest pains you didn’t disclose you have no coverage. ‘We’re denying it because you misrepresented your health’,” Share said.

3) Call the insurer to ask about your specific situation, then get things in writing.

To clarify whether you are at risk of not being covered, experts recommend calling your insurer to tell them you are travelling and to ask questions about the level of coverage in your particular situation. Once you get clarification, request a response in writing, such as in an e-mail, Share said.

“Because in the event of a claim, a phone call is not going to be worth the paper it’s written on,” he added.

4) Seek out a special insurance policy if you need to _ but be prepared to pay.

If you have had recent medical issues but are still planning to travel, there are options which have a shorter stability period, or don’t require a person’s condition to be stable at all.

The added flexibility, however, may come with a steeper price but can sometimes be cheaper, depending on the policy, said Fine.

Generally, the price will go up as the stability period is reduced, said Keon.

5) If your condition changes before you leave, update your insurer.

Even after you have purchased a policy, you are obligated to update your insurance provider on any changes to your medical condition, Fine said. If there is a significant change, the insurance company may increase the premiums or in extreme cases cancel the policy all together, he added.

“It’s better to know that ahead of time, rather than to take a chance and leave on your trip and find out after the fact.”

Canada budget to include limited coverage for prescription drugs – sources

OTTAWA/TORONTO (Reuters) – Canada’s Liberal government will propose a limited expansion to the country’s universal healthcare system in the spring budget to cover part of the cost of prescription drugs, two sources with direct knowledge of the matter told Reuters.

The modest broadening of the healthcare program is set to become one of Prime Minister Justin Trudeau’s key campaign promises ahead of the October election, which is shaping up to be a close fight.

The government would not commit to meeting 100 percent of the cost of prescription drugs for those who have no insurance through their workplace, the sources said. That suggests the government is leaning toward a narrower, more insurance industry-friendly model of pharmacare, as it is called, than that recommended by a government health committee last year.

A spokesman for Finance Minister Bill Morneau declined to comment.

Officials have yet to decide how much detail to provide about the pharmacare system in the budget, which is expected in the week of March 18, the sources said. They may release a general commitment to boost coverage and leave the specifics for the campaign, they added.

But new information on pharmacare’s inclusion in the spring budget and its limited scope gives a first glimpse of the government’s blueprint for what has been called the “unfinished business” of Canada’s publicly funded healthcare system, called medicare.

The sources, who spoke in recent days, requested anonymity because they were not authorized to speak to the media.

Canada’s health system covers care provided in hospitals and doctors’ offices, but prescription medication remains largely the purview of private insurance, often offered through employers, and a patchwork of public plans geared primarily toward the old and the very poor.

Opinion polls consistently show strong popularity for Canada’s public healthcare system.

There have been calls for Canada to extend medicare to include prescription drugs since medicare came into existence in the late 1960s, and multiple studies have recommended its inclusion.

Surveys have found 20 percent of Canadians are either uninsured for prescription drugs or under-insured, and one in 10 Canadians goes without prescription medications because of an inability to afford them, according to the standing committee on health’s pharmacare report released in April 2018.

Manulife Financial Corp, Sun Life Financial Inc and Great West LifeCo are among the major insurers in Canada.

FILLING IN GAPS

The Liberal-dominated government health committee strongly recommended Canada adopt a universal, national pharmacare program that covers drug expenditures for all Canadians for a wide range of drugs.

That would not only improve equity and access, advocates said, but lower drug costs because there would only be one buyer negotiating with pharmaceutical companies.

The government’s budget watchdog estimated that would cost about C$20.4 billion ($15.5 billion) a year – a hefty price tag for the government, but offering an overall saving of C$4.2 billion compared with the total now spent on prescription drugs.

What the government is likely to include in its budget is a much more targeted plan aimed at filling the gaps in coverage not already filled by private insurance or existing public plans, the sources said.

That matches with the government’s finance committee recommendation late last year, which Morneau, himself a former benefits industry executive, has said he would prefer.

It is also in line with what the insurance industry has been asking for. Standing to lose business to a universal government plan, the insurers have argued that most Canadians have good private coverage and that pharmacare changes need only affect a small uninsured minority.

But the Liberals will likely face criticism from policy advocates and left-leaning political opponents for not pursuing a more comprehensive plan. Without a universal system overhaul, advocates argue, people will continue to slip through costly cracks in the coverage system.

An advisory council appointed to study the implementation of pharmacare is expected to come out with recommendations this spring.

Humania Assurance launches a new portfolio of health insurance products for Baby Boomers

Humania Assurance innovates again with a new portfolio of online health insurance products tailored for Canadians aged 55 to 75 years old. Indeed, the company noticed that there were few options available on the market for this clientele.

“When retiring and leaving their workplace, this population loses its group insurance advantages. It is then difficult for these people to cover all expenses relating to their health. This portfolio of products will allow them to reduce their financial stress and focus on taking care of their recovery” mentions Kim Oliphant, VP Sales and Marketing.

Cancer insurance: The first product from a Baby Boomers portfolio is now available.

According to the Canadian Cancer Society1, 1 out of 2 Canadians will receive a cancer diagnostic, 90% of them are aged 50 or older, and more than 68% will survive. To better understand the needs of Baby Boomers, Humania Assurance asked Léger to complete a survey with Canadians aged 55 to 75 years old2. It revealed that their views on health risks are not realistic. Indeed, 89% think they have a good health although 73% of them are taking 3.5 different medications on a continuous basis. Moreover, only 26% of this population thinks they have a high risk of being diagnosed with cancer. The risk is therefore greatly underestimated and the financial impact of it can be disastrous.

Starting November 12th, it is now possible to buy a Cancer protection with a critical illness option entirely online, in only 15 minutes, and, without any medical exam. This protection provides a payment of $5,000 to $75,000 in case of a major cancer diagnostic. In case of a non-life-threatening minor cancer diagnostic 15% of the insured amount is paid. Moreover, this protection includes a death insurance of 15% of the insured amount.

It is planned that this portfolio will be enhanced with additional protections in order to provide a complete offer to this clientele. Hospitalization, fracture and reimbursement expense protections will be added in 2019.

Clients who desire to purchase such insurance can do so by contacting a Financial Security advisor.

www.5575.ca

  1. Canadian Cancer Society, Media backgrounder: Canadian Cancer Statistics: A 2018 special report.
  2. Léger Marketing Survey completed July 27 to August 6, 2018 on a sample of 2019 Canadians aged from 55 to 75 years old.

About Humania Assurance

Humania Assurance is a mutual that has been developing health insurance products to meet the changing needs of Canadians for the last 75 years. The company designs innovative insurance protections accessible on the web, in order to simplify and accelerate the process, and this, at a competitive price.

SOURCE Humania Assurance

Mental health issues are less likely to be seen as a disability

Highlights:

  • Canadians still hold a bias toward viewing disabilities as being largely physical rather than mental in nature.
  • Yet, 30 per cent of Canadians who have taken time off because of a disability say it was for a mental illness.
  • For most Canadians, disability insurance isn’t something they think about in-depth until they need it.

Despite the rise in public awareness of mental health issues, Canadians still hold a bias toward viewing disabilities as being largely physical rather than mental in nature, according to a recent survey from RBC Insurance. While two in three view multiple sclerosis (65 per cent) and physical accidents (65 per cent) as disabilities, fewer than half feel the same way about depression (47 per cent) and anxiety (36 per cent).

“There is a misconception that disabilities tend to be catastrophic in nature, caused by one-time, traumatic events,” explains Maria Winslow, senior director, life & health, RBC Insurance. “What most Canadians don’t realize is that mental illness causes the majority of disabilities. In fact, almost one-third of group disability claims at RBC Insurance are related to mental health, and that number is higher if you count physical disabilities that lead to mental health concerns.”

Many have already been impacted
Despite Canadians’ perception of mental illness, 30 per cent of working Canadians who have taken time off for a disability say it was because of a mental illness.

“It’s important that we continue to raise awareness around mental illness and provide ongoing support so that Canadians are more comfortable speaking about their illness and being honest with their family, their friends and their employer,” adds Winslow.

Room to educate
While the majority of Canadians (82 per cent) with disability coverage feel they’re well covered through their disability benefits, many don’t fully understand the coverage they have:

  • Nearly one-in-five (23 per cent) say they don’t know anything beyond the fact that they have some sort of coverage.
  • Only one-in-three (33 per cent) who currently have disability coverage say they understand the details ‘very well’.
  • Half (52 per cent) know how their benefit plan defines a disability.

“When faced with a mental illness, the last thing you want to worry about is whether you have the proper coverage in place,” explains Winslow. “It’s important that Canadians not only ensure they have disability coverage, but that they understand the details of their policy. Find out how your plan defines a disability and what is and isn’t covered. For example, while some policies cover mental illness, others may not.”

Here are a few more tips to consider:

  • Ensure you have a trusted network in place such as family, friends or professionals you can reach out to for support when necessary.
  • Confirm you have adequate coverage. Some things to look for include how your plan defines a disability; does your plan provide valuable rehabilitation and return to work services; and if you’re covered for injury as well as illness.
  • Utilize programs and services that are available to you. For example, RBC Insurance offers their clients Onward by Best Doctors, a program that provides personal support and faster access to top mental health specialists.

About the RBC Insurance Survey
These are some of the findings of an Ipsos poll conducted between January 2nd and January 4th, 2018 on behalf of RBC Insurance. For this survey, a sample of 1,505 employed Canadians aged 18+ was interviewed. Weighting was then employed to balance demographics to ensure that the sample’s composition reflects that of the adult population according to Census data and to provide results intended to approximate the sample universe. The precision of Ipsos online polls is measured using a credibility interval. In this case, the results are considered accurate to within ±3.0 percentage points, 19 times out of 20, had all working Canadian adults been polled. The credibility interval will be wider among subsets of the population. All sample surveys and polls may be subject to other sources of error, including, but not limited to coverage error, and measurement error.

About RBC Insurance
RBC Insurance® offers a wide range of life, health, home, auto, travel, wealth and reinsurance advice and solutions, as well as creditor and business insurance services to individual, business and group clients. RBC Insurance is the brand name for the insurance operating entities of Royal Bank of Canada, one of North America’s leading diversified financial services companies. RBC Insurance is among the largest Canadian bank-owned insurance organizations, with approximately 2,500 employees who serve more than four million clients globally. For more information, please visit rbcinsurance.com.

SOURCE RBC Insurance

Time for Ottawa to discuss health insurance for tourists

It’s not fair that the Canadian system has to pay when visitors fall ill and need care.

Excerpted article was written by Dr. Charles S. Shaver Hamilton Spectator

rad Hazzard was referring to $30 million in unpaid medical expenses per year, and is proposing that all tourists to Australia be required to have health insurance. Should Canada do the same?

Increasingly, such insurance is necessary to cover tourists unexpectedly injured in auto accidents, floods, fires, bridge collapses, and in the remote event of shootings and other acts of terrorism.

Proof of health insurance is required by Abu Dhabi and Dubai, Aruba, Belarus, Bulgaria, Cuba, the Falkland Islands, Latvia, Slovakia and Russia, and possibly Thailand in the near future. It is mandated to obtain a visa to the 26 countries in the Schengen zone of Europe.

The number of overseas tourists to Canada may increase by 6.7 per cent this year. Total visitors to Toronto increased by 3.6 per cent; this included a jump in those from Mexico by 72 per cent, India by 31 per cent, Brazil by 23 per cent, and China by 9.1 per cent.

Certainly, the need for travel health insurance already exists in Canada. A bus crash on Highway 401 east of Kingston in June killed three and injured 34 Chinese tourists. A German tourist was shot in the head near Calgary in early August. Toronto now has a higher homicide rate than does New York City, and has witnessed a greater number this year than in all of 2017.

Because of the Canada Health Act and Ontario Bill 94, physicians here cannot charge wealthier patients more to compensate for those who are uninsured. With the recent dispute between Ottawa and Saudi Arabia, Canadian medical schools are losing $100,000 for each medical resident or fellow forced to leave our country. Hence, both hospitals and MDs are hardly in a position to provide free care to visitors; all should be urged to buy health insurance. Possibly, it should even be mandated by Ottawa.

Sadly, such insurance does not cover routine office visits nor complications of a pre-existing illness. The solution is much more complicated.

Many of our larger cities are now multicultural. Many new Canadians may wish to arrange for prolonged visits for parents, grandparents, etc. Yet pre-existing diabetes, cardiac disease, etc. may preclude buying adequate private insurance. Sponsors are legally responsible for medical bills incurred by their relatives. How can we be fair to the sponsors, temporary visitors, but also to physicians and hospitals?

Possibly, Medavie Blue Cross (or a similar company) — which handles the Interim Federal Health Program for refugees, as well as benefits for the military and the RCMP — could expand coverage to include these long-term visitors, under the supervision of Ottawa, with premiums to be paid by the sponsors. To reduce costs, there would be a deductible, and routine office visits and elective surgery would be excluded. It would, however, cover critical illnesses requiring in-hospital treatment. These might include a heart attack, stroke, severe infection, acute congestive heart failure, fall with a fracture, etc.

Sponsors would pay a significant premium per week. This would encourage them to keep the length of stay of relatives in Canada to a minimum; this would minimize the chance that such complications might occur.

Ottawa permits all temporary visitors to enter Canada. It follows that it now has an obligation to health providers and hospitals to ensure that they will be fairly and promptly remunerated should any visitor need unexpected medical or surgical treatment in this country.

 

Quebec’s health insurance board has the power to investigate clinics

CBC News

Over the course of two years, the number of inspections Quebec’s health insurance board (RAMQ) has done at medical clinics dropped by half, according to documents obtained by Radio-Canada.

The check-ups help uncover whether private clinics are charging illegal fees to patients, among other things.

In 2015, the RAMQ did 298 inspections and found that 35 clinics were charging patients for services that are covered by the public health insurance plan. In 2017, only 150 inspections were done; 12 clinics were found to be charging illegal fees.

A law passed in 2016 gave teeth to the RAMQ’s inspectors — before, inspections were more preventive in nature. Inspectors weren’t able to invoke laws and dole out fines.

In an email, a spokesperson for the RAMQ explained that the new powers bestowed upon the board’s 25 inspectors makes the inspection process more complicated, notably because they increased the standard of proof needed to write up lawbreakers.

The spokesperson also said the inspectors’ work was delayed last year due to the passing of a new law that forbids doctors from charging certain fees to patients. Staff had to undergo training in order to be able to apply it properly.

Worrisome drop, says watchdog

Dr. Isabelle Leblanc heads a group of Quebec doctors and medical students who work to preserve the universal nature of Quebec’s health care system.

She says the drop in inspections is cause for concern because it’s up to the RAMQ to make sure that doctors are following the rules.

“Inspections that aren’t based on complaints, just going to check out what’s going on in the clinics, are important because we know that due to the power imbalance, there are many patients who don’t want to file a complaint against their doctors,” she said.
Leblanc questioned whether the government made sure the RAMQ had the necessary resources to carry out inspections and investigations when it decided to increase their powers.

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