Snowbird FAQs is a forum where we provide answers to some of the most common and interesting questions we receive from Snowbird Advisor members that we feel will be of interest to other members.
I’ve heard that when OHIP stops coverage for out-of-country medical expenses, my private travel insurance policy won’t cover me either because one of the eligibility requirements is that I need to be covered by OHIP for out-of-country medical expenses.
This doesn’t seem right. Is it true?
The short answer is no, this is NOT true.
Private travel medical insurance plans simply require you to be covered by OHIP (or the Government Health Insurance Plan in your province of residence). They do not require OHIP to cover you for out-of-country medical expenses.
You can find more detailed information here about how this rumour may have started and what the facts are.
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.
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.