Better Safe than Sorry: Health Insurance for Canadian & U.S. Travelers

There are no two ways about it: RTW travelers tend to be a thrifty bunch, always looking for ways to cut costs and keep our travel funds as much in the black as possible. With the knowledge that a few dollars culled from one thing could easily equal an extra day on the road, those planning for a long-term trip tend to get really good at cutting unnecessary costs. Of course, the ultimate goal for all this money we have squirreled away is to start spending it, but after months—or even years—of nickel and diming every purchase, it can be difficult to switch gears and loosen the purse strings. As your departure date slowly draws near, you may be shocked to discover that your cash outflow is now exceeding the amount you are placing in savings every month; after all, plane tickets, hotel reservations, and whatever gear you might need to purchase aren’t cheap. A natural impulse might be to start looking for places where you can trim some fat from your RTW budget, and certain things that you were initially on the fence about may get unceremoniously dumped into the “unnecessary expenses” pile. For some people, travel medical insurance for while they are away may get this kind of treatment, but not for Tony and me.

Look, we have heard all the arguments for why travel medical insurance is a racket. We know we are traveling to places where routine trips to the doctor and health care can be had for little more than a song, but in case you hadn’t figured this out by now, I tend to fall into the “hope for the best, plan for the worst” camp of trip planners. I’m not so concerned about having travel insurance in case I should get a bad case of the sniffles while we are in Laos, so much as I think it might be good to have in case one of us falls off a mountain on one of the many treks we have planned in China, or we get hit by a car while trying to cross the street in Vietnam. Doesn’t matter whether you’re in New York City or Manila, if you need a medivac, that’s going to cost a pretty penny. Yes, it was a pain to try to figure out which insurance companies would work for us while we are abroad, but hopefully this post will prove useful to some other travelers out there and we’ll have done a lot of the legwork for you.

First up, because Tony is an American and I am a Canadian, we got to do double the amount of insurance research. Fun! Now, although I know there are a lot of fellow Canucks gadding about the world, I actually found it really difficult to find out about the insurance options that are available to Canadians. Given that I found this exceedingly annoying, I am going to run down the important information that is relevant to Canadians first (specifically those from Ontario, though there may be some transfer to those from other provinces… I’m not writing the final exam for you, just providing you with a cheat sheet to help you prepare to take the test yourself!).

Relevant Information for Canadians (aka, So you want travel insurance, eh?)

You would think that because Canada has government health care, it would somehow make getting travel medical insurance simpler, but you would be wrong. Because our healthcare system is under the jurisdiction of each province, whenever you travel outside of your home province, and certainly whenever you travel outside of the country, you need to get supplementary travel insurance. The reason for this is that should you need to receive medical treatment while outside of the province, it is up to the discretion of your provincial healthcare provider as to whether they will reimburse your medical costs. And even if they do agree to cover the treatment, they will only reimburse you for the amount that treatment would cost in province. So if you break your leg in Ontario and it would cost $500 for treatment, then that’s all OHIP will give you if you break your leg in Wyoming, even if you get billed $3k.

Now the tricky thing with supplementary medical insurance for Canadians, is that I found it essentially impossible to find any providers who would insure me unless my provincial healthcare was also in effect. This is so that your supplemental insurance provider can approach your provincial health provider to cover the in province costs of any claims you make, and they only have to cover the rest (so instead of the insurance provider paying a full $3k for your broken leg, they only have to pay $2.5k). The difficulty for long-term travelers is that most provincial heathcare plans only remain active if you are physically within the province for approximately 6 months out of the year… What this means is that many insurance policies will only cover you for a trip up to a maximum of 180 days. Obviously this will not work for those of us who are interested in traveling for 12 – 18 months.

Now, I did find a few insurance companies who will cover Canadians for extended (read: > 180 day) trips. HOWEVER, almost all of these companies require that you have arranged for your provincial healthcare plan to remain in effect during a prolonged absence. Sleuthing around the OHIP website, I found that for Ontarians, OHIP coverage can be maintained for absences up to 2 years, provided that you have been physically in the province for 153 days within a 12-month period for the preceding 2 years. So obviously you can’t travel for 2 years, come back for 1 month, and then leave again for another 2 years… In that case you would be traveling without a government healthcare plan, which might either make it very difficult/expensive for you to get travel insurance OR you may receive a severely capped benefits package (i.e., maximum benefits capped at $25k instead of $5million) if a provider will agree to cover you. Anyway, although no one ever really enjoys dealing with government officials, it was actually a pretty quick and painless process to get my healthcare extended. I simply had to go to a Service Ontario office and provide them with my health card, proof of my Ontario address (i.e., my drivers license) and proof of my signature (i.e., my passport). I then had to fill out a form indicating the dates I would be out of the province, and they flagged me in the system, effectively approving my trip and keeping my coverage intact. I decided to err on the side of caution and say I will be traveling until July 2014, but if I come back early (or whenever I do come back), I simply need to stop by a Service Ontario office and let them know I am back. They will then switch me back over to “conventional” coverage, no harm no foul.

With that out of the way, I narrowed down my insurance options to two providers: the ever-popular World Nomads, and the lesser-known Bon Voyage (who are partnered with RBC travel insurance and operate through Travel Cuts). Both companies had their pros, and both had their cons, which I have outlined below:

World Nomads

+covers Scuba diving

+can be purchased after your trip has already started

-expensive –> $440/6months of travel

-original trip can only be extended up to a maximum trip length of 12 months

Bon Voyage

+allows for longest trip –> can extend coverage for maximum trip length of 18 months

+variety of insurance packages (e.g., can opt for full coverage that includes things like lost luggage and flight cancellations, or just go for medical insurance… also asks you to specify whether you will be traveling in the U.S. or not and prices the plan accordingly)

+very budget-friendly: Budget Medical plan = $432/12months

-does not cover Scuba diving (unless you are already certified prior to leaving on your trip)

-policy start date must begin on same day you leave your home province

What Steph Chose

Obviously the relative weight of each of these factors will vary based on the type of trip you are taking. If you plan to engage in a relatively short trip but will be scuba diving and base jumping every other day, then World Nomads is probably a smart choice. However, given the type of trip we intend to take, I ultimately decided to go with Bon Voyage. While I do plan to scuba dive while we are away, when I weighed the relative likelihood that I would require medical attention following diving with the reality of how much diving we are likely to actually do, it didn’t make sense to me to double the cost of my insurance plan. Additionally, the fact that WN will only cover trips up to 12 months in length was a major drawback that I just couldn’t overlook. Purchasing that plan would really have made me feel like we were on a deadline.

Through Bon Voyage, I wound up purchasing two policies on their Budget Plan: 1 for 17 days that included travel in the U.S. (this is for the current leg of our trip while we are in Minnesota & Texas), which cost $34; and 1 for 405 days that covers me everywhere in the world EXCEPT the U.S., which cost $538. This second policy is good until Sept 1 2013, and I can extend it beyond that date (for another 4 months, or so) at the rate of $8/week, provided I have not made any claims prior to this date (I am assuming that if something happens that is sufficiently costly as to warrant a claim, that will likely signal the end of our trip anyway!). The Budget Plan covers everything their Comprehensive Plan does (Emergency Medical, Trip Cancellation/Interruption, Personal Accident Coverage… do not ask me about the difference between PAC and Emergency Medical) with the exception of lost baggage/personal effects, which is fine, because that is one of the perks we get with our credit card (to be discussed in a later post).

Relevant Information for Americans (aka Y’all need some insurance?)

When it comes to American insurance plans, I admit that—as much as I love Tony—I find the U.S. healthcare system so fundamentally broken and confusing that I was really less informed and motivated to figure out about what we needed to be worrying about when it came to choosing an insurance provider for him. I still have no real understanding of what HIPAA is, and the whole thing about pre-existing conditions and continuous coverage doesn’t really make sense to me… Tony assures me that at least this latter issue is less of a concern because of Obamacare (yay!). I know some people are technically working remotely when they take these extended trips so maybe they manage to have coverage through their employers that covers them while they are in the U.S., but also pay out of pocket for out-of-the-country medical insurance. I don’t know. What I do know is that as much as we value our health, there was no way we were going to pay for some kind of domestic health insurance plan in addition to one that would cover Tony internationally, because domestic health plans are really expensive. I guess we can get away with this because Tony is hearty and hale and has no ongoing/chronic medical issues that he currently needs treatment for, and again with the Obamacare thing, if something should crop up, he should theoretically be able to still have any hypothetical illness covered by a new insurance plan upon our return.

Now, despite the fact that I only have the most tenuous of grasps on the clusterfuck that is U.S. healthcare, I still did my best to try to find good options for Tony. In the end, we narrowed it down to 2 providers: once again, the ever-present World Nomads, and the Patriot travel plan through IMG.

What Tony Chose

I know that World Nomads gets a lot of business, so it’s no skin off their back that we yet again chose to go with someone else. The biggest drawback to World Nomads was the cost: 12 months of coverage would set us back $1212!!! Additionally, it was unclear to us whether this plan would offer Tony any coverage were anything to happen to him in the U.S. (apparently if he was more than 100 miles from home it would, but what if something happened overseas and he had to be transported back to the U.S. for care?). In contrast the Patriot plan through IMG was very clear: So long as Tony is out of the country for any point after the plan is in effect, he gets an automatic 2 weeks of coverage in the U.S. AND after 3 months of travel, he has the option of purchasing 2 months of domestic coverage upon his return. Given that Tony does not have any other medical coverage in the U.S., this second bit was definitely a big draw. Even better, a 12-month plan only cost $403, which includes the optional Adventure Sports rider, meaning that for Tony, Scuba is covered. The plan has a $100k maximum and a $250 deductible, and can be extended up to a maximum trip length of 2 years. Based on our comparison, the Patriot plan through IMG offers more coverage for less money ($800 less!), so on that basis, our choice was clear.

Total Costs

Combined, Tony and I have paid a grand total of $976 for our health insurance for this trip, which amounts to approximately $2.50/day for 13 months. I don’t know about you, but paying $1.25/day PER PERSON seems like a paltry sum to pay for peace of mind and for your personal well-being. We have worked really hard to save up the money needed to live this dream, and in the end, the amount we are spending on insurance only amounts to the amount we might have saved in 2 weeks or so. In the long run, two extra weeks of work to secure our year-long travel dreams is nothing.

Of course, in the end, we hope our medical travel insurance is something that we have bought but never have to cash in on, but when it comes to keeping ourselves safe and healthy (and not foolishly jeopardizing our entire travel fund), we figured this was one purchase we couldn’t afford NOT to make. I truly believe that if we left on this trip without securing medical insurance that would just be tempting fate: surely something would happen that would make us regret being too cheap to shell out a few hundred bucks at the start of our adventure. Hindsight may be 20/20, but in terms of medical emergencies, it’s foresight that is truly priceless.

To all those travelers out there, do you purchase medical health insurance when you embark for parts unknown? If so, what providers have you used? Ever had an emergency on the road when you were glad you had insurance?