How do travel medical insurance claim payments work?

03/13/2019
Question:

If I need medical treatment while travelling, will I have to cover the expenses out of pocket and claim them later, or will my travel insurance provider pay them directly? I have heard conflicting information about this.

Answer:

First and foremost, whenever possible you should contact your travel medical insurance provider before seeking medical treatment, as they will want to ensure the treatment you are seeking is covered, send you to an approved treatment provider, help coordinate your treatment, and where possible, arrange for direct billing with the treatment provider.

Obviously, in an emergency situation contacting your insurance provider before seeking treatment may not be possible. In such situations, you should contact your insurer or have someone contact them on your behalf as soon as possible after seeking treatment.

With respect to who pays for the costs up-front, it depends on the situation.

In general, if you go to a hospital for treatment and contact your insurance provider prior to or during your hospital visit, your insurance provider will arrange for direct billing, so you won’t have to pay your expenses out of pocket. However, for minor visits to a hospital emergency room, you may need to pay your bill and have your travel insurance provider reimburse you.

Alternatively, if you receive medical treatment at a doctor’s office or clinic, you will generally need to cover your medical expenses up-front and make a claim to be reimbursed by your insurance provider. However, in some cases, your insurance provider may be able to arrange for direct billing with the doctor’s office or clinic.

In either situation, it’s important to keep all of your receipts and get copies of your treatment records in case you need to provide them to your insurance provider at a later date.

Disclaimer: The material provided on the SnowbirdAdvisor.ca website is for informational purposes only and does NOT constitute legal, tax, accounting, financial, real estate or other advice, and should not be relied on as such. If you require such advice, you should retain a qualified professional to advise you.