Home » Blog » #insurance » Things to Know About Medical Emergency Insurance in Canada

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Canada has always been a wonderful place to live, work and visit. Although the recent pandemic had a significant impact on the ability to travel the world, Canada still retains its spot on the hottest tourist destinations lists.

However, similar to the United States, visiting or moving to Canada requires certain preparations in order to get the best experience possible. With that said, we would like to go over one of the most important, albeit less exciting points on the traveler’s list – medical insurance.

Emergency medical insurance is an insurance product that covers you if you incur medical expenses i.e. you fall sick or get injured. It works just like car insurance – if you get into an accident you will be covered for treating the damages.

Some policies allow for preventive care – check ups, doctors visits and tests before you get sick.

 

Emergency Medical Insurance Basics

Emergency medical plans don’t always cover all of your costs. Some things might be excluded from the coverage or you might have to pay a portion of your expenses yourself. After you pay that portion the insurance kicks in and pays the rest, whether it is direct billing method or on a reimbursement basis.

The most common ways of splitting the bill is deductible amount. We will discuss this method below.

Most emergency medical plans will include medical care, hospitalization and repatriation as part of their benefits.

 

Why do you need Emergency Medical Insurance?

Anyone who is planning to travel to Canada or is currently residing in Canada should buy an Emergency Medical plan, unless you qualify for provincial insurance coverage as a temporary resident.

Healthcare in Canada isn’t cheap and the bills might just be too high if you decide to go without coverage and pay out of pocket. Some types of visitors are mandated by the government to have a valid Emergency Medical plan prior to entering Canada for the whole duration of their stay.

 

Emergency Medical Insurance offers Family Plans

You should know that families can have significant savings when shopping for their Emergency Medical plan. A typical family of two adults and their children can have their kids covered free of charge.

It doesn’t matter how many children they have, there will be no costs to cover them. The rate you have to pay will be based on the rate of the oldest adult in the family multiplied by 2.

This kind of plan needs to be properly set up so it’s best to seek help of a professional insurance advisor. Make sure you shop with a broker that has access to multiple insurance providers to be able to get the best plan at an affordable price.

 

Emergency Medical Insurance for Students

International students and students who move provinces to study might need to get themselves an Emergency Medical plan as well.

In certain cases, international students in Canada are required by the government to have an insurance policy that will cover them for the duration of their studies and beyond.

Be advised that special Student Plans are available that are more affordable and have better coverage than standard plans. You would need to provide your student ID and the name of your educational institution to be able to buy this plan. Your education institution must be on the list of approved Designated Learning Institutions (DLI), so make sure to check with your insurance agent.

Additional coverage is available to students that may cover non emergency treatments such as check ups, eye checks, dental cleanings. Students might also be able to take advantage of a Student Family plan, if they have kids and for their spouses.

As long as one spouse is a student the whole family is eligible to be on the plan together to avail significant savings.

 

Emergency medical insurance if you are pregnant or planning to get pregnant

If you are already pregnant there is a limited coverage available up to 31 weeks of pregnancy that covers medical treatment of bleeding, abdominal pain, miscarriage and premature birth.

The plan also covers you for illnesses and injuries that are unrelated to pregnancy under its Emergency Medical Plan benefits. It’s best to use the plan if you are only in Canada for this 31 week period or if you are planning on getting your provincial health care coverage within that period. Otherwise you might become uninsured. In that case it’s better to return or stay in your home country until giving birth so that you don’t have to pay such costs out of pocket.

 

Insurance plan for people planning to get pregnant

On the other hand, travelers to Canada who are not yet pregnant are eligible to apply for a special Visitors Insurance plan that includes a reimbursement of up to 80% of all approved pregnancy related costs.

Such expenses include pre-natal care, treatment of pregnancy complications as well as childbirth.

Moreover, newborn babies at 15 days of age can also be covered by that plan for possible medical emergency situations.

Please note that the upper limit for the above Maternity insurance is $10,000 CAD per policy.

In order to qualify for this type of coverage, each applicant must:

– Purchase the initial policy for 12 months / 1 year (the absolute majority of the coverage period must be physically spent in Canada).
– Have the expected delivery date more than 10 months after the start date of the insurance policy.

It is recommended that the insured person DOES NOT get pregnant for at least 2 months following the effective date of the insurance policy.

 

Some of the key characteristics of Emergency Medical Plans

In order to figure out what to look for when shopping for the best insurance plan, it’s important to focus on the key features such as insurance premiums, benefit limits, coverage exclusions as well as deductible.

– Premiums:

Premiums is how much you have to pay either on a monthly or a annual basis to be able to use the benefits the insurance provides.

In vast majority of cases with Visitors to Canada insurance plans, your premium will represent a single payment for the number of days you will be staying in Canada. It is also recommended that you purchase your policy for the entire period of your stay in Canada prior to your arrival in order to avoid a waiting period.

With that said, a Waiting Period is a number of days that you are unable to use your insurance coverage, which would range depending on the insurance provider you choose to purchase your policy from. In case you fall sick of get injured during that period, you will not be able to claim these expenses under your policy. That is why, buying your insurance at the right time, before you start traveling to Canada is important.

– Benefit Limits:

While benefit limits are relatively straightforward, it is important to note that certain benefits may have combined coverage limits. Therefore, you should carefully study the Policy Wording before you make your policy choice or speak with an experienced insurance advisor for assistance.

– Coverage Exclusions:

Similarly to benefit limits, visitors and travel insurance plans do not cover everything. In order to understand what your policy does and does not cover you should consult the Policy Wording or speak with an insurance broker to clarify any questions and concerns you may have.

– Deductible:

In its most simple sense, Deductible is an unchanging amount of money that the insured person is obligated to pay out of pocket for a covered medical service before the insurance provider will cover any expenses related to that particular insurance claim.

It’s worth nothing that deductible affects the price of the insurance policy. The higher deductible you select, the lower the price of the policy you will need to pay. Yet, it is not recommended to go over a $1,000 deductible since you may end up covering the majority of your medical expenses yourself, unless the bill exceeds the deductible option you have.

An Example: An insured person has a sore throat and a policy with $250 deductible. After visiting a doctor and doing some tests, the bill is $300. In that case the person must pay $250 deductible him/herself before the insurer pay the rest ($50) is paid out by the insurance company.

In most cases, it is a much safer bet to go with $0 deductible in order to save yourself a hustle of having to pay out-of-pocket.

 

Must-have benefits to look for in your Emergency medical Insurance plan

Some of the most important benefits that you should be looking out for:

– Ambulance Transport
– Emergency health and medical care
– Hospitalization for surgery, overnight stays, and other conditions
– Prescription drugs
– Coverage for pregnancy, delivery and prenatal care as well as pregnancy complications
– Follow up visits to a doctor
– Lab services such as X-rays and ultrasound coverage
– Emergency dental care and dental pain coverage

 

Finding an affordable plan

We suggest you enlist the services of an experienced insurance agent. They can make the process of shopping for insurance quick and painless.

Here are some of the ways you can save money:

If you are healthy and have no health issues?
– Higher deductible can help you lower the costs. But beware, as we’ve mentioned before the savings don’t always outweigh the risks of paying more than you would have with a lower deductible.

You have a history of health issues that are stable now but might recur?
– Go for higher coverage amount and low deductible to save you money if it comes time to a claim.

Are you a student or have a family with you?
– Ask your broker for plans specific to your needs. Both have significant savings as opposed to a standard Emergency Medical plan.

 
 
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