Snowbirds urged to purchase private health insurance

By HUB SmartCoverage Team on December 29th, 2019

As Snowbirds get ready to take flight to warmer climates, they are being advised to check their travel health insurance.

That’s because the provincial government is cancelling Ontario Hospital Insurance Plan's Out-of-Country Travellers Program effective January 1, 2020. It’s a move that has the potential to impact thousands of seniors. A report by the Canadian Trade Commissioner estimates close to 500,000 Canadian snowbirds spend their winter in Florida alone.

Currently, OHIP pays up to $50 per day for outpatient services and up to $400 per day for any hospital inpatient service that takes place in an operating room, intensive care unit or coronary care unit. Treatments must be deemed medically necessary, take place at a hospital or equivalent medical facility and be for an acute illness or situation that was unexpected and not pre-existing before leaving Canada.

Coverage minimal

That coverage may sound like a lot, but is actually quite minimal when you consider the cost of medical treatment for Canadians travelling abroad, particularly in the U.S.

The province says it’s cancelling the existing “inefficient” program because of the $2.8-million cost of administering $9 million in emergency medical coverage abroad each year. OHIP’s reimbursements also tended to offset only a fraction of the actual expenses.

“The program, which spends a third of its funding on administration alone, has not historically provided Ontarians with meaningful travel coverage,” David Jensen, spokesman for Ontario’s health ministry, told the media recently. “Furthermore, the program’s coverage is very limited with five cents of every dollar claimed.”

Under the old system, should an injury or emergency occur requiring medical or hospital care, the traveller would file a claim with OHIP that’s already been paid by private medical coverage, insurance plans or Canadian resident themselves. OHIP then would determine under its out-of-country plan who or what to reimburse, if anything

“With this limited coverage and low reimbursement rate, OHIP-eligible Ontarians who do not purchase private travel health insurance can be left with catastrophically large bills to pay,” Jensen said.

“For this reason, Ontario continues to strongly encourage individuals to purchase additional travel health insurance so they are adequately covered every time they leave Ontario to travel abroad.”

Snowbirdadvisor.ca reports the typical cost for an inpatient stay in a U.S. hospital can be $10,000 per night and, in most situations, an individual without supplemental travel medical insurance would only be able to recover approximately three to five per cent from OHIP for the cost of emergency medical treatment received outside Canada.

$3,000 hospital bill

If that’s not enough to encourage you to check your travel insurance, consider the case of Toronto resident Jill Wykes who had a health scare over a racing heartbeat in Florida a few years back. Wykes told The Toronto Star recently the $3,000 hospital bill for a two-hour visit and three tests just added insult to illness.

Fortunately, the seasoned snowbird had a comprehensive travel health insurance policy that paid the full tab.

Of note, a new provincial program will provide kidney dialysis patients with $210 toward each treatment. Actual prices in the U.S. range from $300 to $750, but travellers will be on the hook for the rest.

So, if you’re heading south for the winter, talk to your insurance broker before you leave to ensure you have comprehensive travel health coverage and are not left holding all the bills.

RELATED READING: Travel and Dialysis

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