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Multi-Trip Annuals

Annual Trips Have Great Potential — But They Need Explaining
By Milan Korcok, Health Issues Writer

With many senior snowbirds shortening and diversifying their winter vacations, and millions of baby boomers coming into the leisure travel market, annual, multi-trip health insurance can only become more popular.

Buying 30, 60 or 90 days of coverage, and using it any number of times throughout the year, for one annual fee and with no repeat paperwork, is an attractive alternative for the customer who wants flexibility and the convenience of being able to travel on the spur of the moment.

But as convenient and cost effective as the annual plan is, it also has some conditions that customers—particularly those in imperfect health– need to be told about. The main one is that though the insurance contract is written for a full year, any sickness or accident that occurs during one trip segment, can become a pre-existing condition for the next. For example, if a customer dislocates a knee or passes a kidney stone during the first 60-day coverage period, knee problems or kidney stones would have to be underwritten in order to activate coverage for the next 60 days. The annual plan does require that no single trip exceeds the number of days purchased (unless a top-up is added) and the traveller must return home to Canada for at least one day before activating the next trip.

Another point to disclose clearly is that if travellers claim for out-of-country medical services, they may be required to prove that those services occurred during one of the covered travel periods, that is within 30 or 60 or 90 days of their last departure from home. For example, if they have a 60 day multi trip plan, they must be able to prove that the medical expenses for which they are claiming were generated within 60 days of their last leaving Canada, and not on the 61st.

There are plenty of ways to verify where an individual is at any given time. Signed credit card slips, bank or postal receipts, ATM slips, passport or customs stamps, all can be used to validate that a traveller really was in a certain location on any given day. It’s not difficult, so long as customers are warned that if they claim for medical services while under the annual, multi-trip plan, it will be their responsibility to prove the services occurred during their designated coverage period. It is not up to the insurer to prove it was outside of the limit, but up to the traveller to prove it was within. A word of warning on this point can avoid a lot of anxiety later.

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Article provided compliments of Trent Health. Author Milan Korcok is a freelance medical writer specializing in travel health issues. May not be reproduced or transmitted without permission.


Read the Policy

“Well, I Didn’t Actually Read The Policy.”
By Milan Korcok, Health Issues Writer

Though denial of travel health insurance claims is rare, among the most frequent complaints heard from aggrieved clients is that they were rushed, the agent got it wrong, they didn’t read the policy, they didn’t know what they were signing. In effect, they deny responsibility for understanding the product they purchased.

For example, failing to tell an agent of a previous cardiovascular condition often becomes: “I told her I had an irregular heart beat, but she didn’t mark it down.” Yet the same client will promptly sign off the application as being correct—even without the heart irregularity being noted.

And how often will a client simply take the completed application out of the agent’s hands, grab the proffered pen and sign on the dotted line, without reading anything, or without paying any attention to the notice just above the signature line which says: “The completion on my behalf of this form by another party does not relieve me of my responsibility for the accuracy of the information provided.”

Making sure that the client does take the extra time to read and understand the application they provide and the policy they purchase is essential to a properly closed sale. Focusing their attention on certain elements of the policy that relate to their responsibilities and getting them to sign off that these elements have been explained to them can save a lot of aggravation and ill-feeling later for the agent as well as the client.

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Article provided compliments of Trent Health. Author Milan Korcok is a freelance medical writer specializing in travel health issues. May not be reproduced or transmitted without permission.


Early Birds

Early Birds Must Report Health Changes
By Milan Korcok, Health Issues Writer

Charlie Snowbird may have acted quickly and wisely in nailing down his out-of-country health insurance plan for next winter at last year’s rates. It’s what thousands of “early birds” do each summer–even though they won’t be heading South for another three or four months. They are tough shoppers, and they know that premiums after Labour Day are going to be higher, maybe a lot higher.

But snowbirds also need to be warned that by buying early, they haven’t insulated themselves against the consequences of illness or a change in their health status occurring between the time they buy and the time their policy becomes effective. That could be something as modest as a change in medication, or investigation of certain symptoms, or confirmation of a condition that has been evolving over months. And though many snowbirds think that once they have a policy in their hands its conditions are irrevocable, the fact is that if their health changes, they are required to notify their insurers so that their contract can be reviewed and altered, if necessary. Failure to do that can seriously impair, or even void their coverage.

Early bird programs can be highly effective for consumers of snowbird health policies. But they need a safety net. And every early bird sale needs to be accompanied by a warning to the customer that they need to contact their broker as soon as there is any change in their health status, or their medication, or if their doctor needs to see them for anything more than a routine monitoring.

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Article provided compliments of Trent Health. Author Milan Korcok is a freelance medical writer specializing in travel health issues. May not be reproduced or transmitted without permission.


Symptoms Count

Symptoms Count When Defining Pre-existing Conditions
By Milan Korcok, Health Issues Writer

Recently a senior Canadian traveller crossed into the United States at a highway border point and within an hour was forced to check into hospital complaining of weakness, dizziness, profuse sweating, nausea, and faintness. In the emergency room, the man’s wife told the admitting doctor that her husband had only experienced these symptoms “off and on” for a few weeks prior to their trip, and had also, recently, passed a few black stools. But other than that he had a clean medical record. The diagnosis was quick and easily made – a bleeding ulcer, otherwise known as an upper gastrointestinal bleed.

All of the classical symptoms were in place and had been for some time. The patient was relatively quickly treated, the bleeding stopped, and in a few days he was permitted to continue on his trip. But when it came time to claim for the hospital emergency, the traveller ran into a problem when his insurer denied the claim on the grounds that the man clearly had a pre-existing medical condition when he bought his travel health insurance. His broker objected and said that prior to his trip the man had never been diagnosed with a GI bleed, and unless his own Canadian doctor had recorded such a specific condition on his record, the claim could not be denied.

Well, that may have been his interpretation of a pre-existing medical condition, but it’s rarely the way pre-ex’s are defined in policy language. And that’s the governing authority – not some dictionary or random definition found elsewhere. In this case the definition of pre-existing medical condition was clearly stated as: “any symptoms or signs of an illness or disease known to the insured prior to …..” the effective date of coverage. What matters is that the client was suffering significant abnormal symptoms prior to the purchase of the policy, and they worsened and resulted in his hospitalization.

As the medical director in this case noted: “I cannot accept the argument that there must be a documented visit to a physician and a confirmed diagnosis established before benefits can be denied.” No doubt about that, according to the policy wording. Symptoms matter. They are part of the illness. And that’s important for brokers to emphasize to their clients – especially those who have some medical abnormalities, even ones that do not have clear-cut technical names attached to them.

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Article provided compliments of Trent Health. Author Milan Korcok is a freelance medical writer specializing in travel health issues. May not be reproduced or transmitted without permission.


Expatriates

Canadians Moving To U.S. Should First Establish Health Insurance
By Milan Korcok, Health Issues Writer

As health insurers in the United States cut back the availability of insurance products for individual applicants, Canadians living and working temporarily in the United States, or those seeking to immigrate, must increasingly rely on Canadian-made policies to cover them while out of the country.

Though the so-called global economy is making international business travel more necessary, health insurance in the United States is becoming increasingly restrictive, is designed primarily for large company groups, and is hard to access even for permanent U.S. residents who work for small businesses or as independent consultants. Those who are not permanent residents (landed immigrants in Canadian terminology) will find it even tougher to access comprehensive U.S. medical coverage.

A recent study by the Kaiser Family Foundation showed that though virtually all companies with 200 or more employees offer health insurance, only 58 percent of the smallest businesses (3 to 9 workers) do so, and 64 percent of small businesses with 3 to 199 workers most often cite high premiums as a very important reason for not offering health insurance.

Similarly, seniors wishing too retire close to children or other family living in the United States,, can expect to find few health insurance plans available in that country that don’t first of all require eligibility for U.S. medicare.

Thus any Canadian resident seeking relocation to the United States (temporary or permanent) needs to firmly establish comprehensive health coverage devised specifically for Canadian expatriates before leaving the country.

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Article provided compliments of Trent Health. Author Milan Korcok is a freelance medical writer specializing in travel health issues. May not be reproduced or transmitted without permission.


Short Term Renewals

Short Term “Renewals” for Visitors Require Explanation
By Milan Korcok, Health Issues Writer

With summer coming on, more and more Canadians will be buying travel health insurance policies to cover parents or relatives visiting them for extended periods. Faced with the option of paying one month at a time for “renewals”, or paying one lump sum for a six-month policy, the budget-conscious might prefer to go one step at a time.

If that’s their choice, fine. But agents owe it to their clients to make sure they understand the risks of such decisions.

They must understand that by going month-to-month they are not really purchasing “renewals”, but new policies each time. When a client buys a policy for one or two months, the terms of coverage end at that point, and the new policy is based on the client’s condition at the time that policy is issued.

For example, when a Toronto man recently “renewed” a policy for his mother, who had broken her leg shortly after arriving from the U.K. – while she was covered by a one-month visitor’s policy -, he assumed the “renewal” would cover her follow up care. After all, it was just an extension of her original policy, wasn’t it?

Of course it wasn’t. Coverage of the broken leg continued only so long as the first policy did. In respect to the new policy, the broken leg was a pre-existing condition, excluded from any further coverage.

Had the son purchased a full six-month term of insurance for his mother, which was her anticipated length of stay, she would have had seamless coverage. She would have been secure the whole time.

Though short-term purchases may have been easier on the son’s cash flow, they involved a loss of security he may not have been willing to give up had he known the potential consequences.

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Article provided compliments of Trent Health. Author Milan Korcok is a freelance medical writer specializing in travel health issues. May not be reproduced or transmitted without permission.