A few years back, the national media shared a story of a Saskatchewan couple who incurred a near million dollar medical bill when their baby girl arrived pre-maturely, crashing their Hawaiian vacation. Turns out, this little one’s arrival was not covered by the family’s travel insurance and they are now responsible for raising both the child and the money to pay for her delivery.

If you want to avoid spending a million dollars yourself, baby, read on.

Slow down.

With the proliferation of online and telephone insurance sales, I think speed kills…claims that is. Clients will often call me days or even hours before a trip to get their travel coverage. It’s true that with a credit card and few clicks, I can easily have them on their way. But what if they are unsure of how to answer a medical question? What if – in their haste to get their bags packed – they “gloss over” an answer? It’s too late to find out you answered a question incorrectly when a claim gets denied. Worse again, even if the incorrect answer has nothing to do with the claim, it could leave your policy null and void…two words no one wants to hear while lying in a hospital bed in Mexico.

Always give yourself ample time to apply, guaranteeing that any uncertainty can be clarified with a questionnaire and your doctor’s signature. These disclosures are typically mandatory for those over age 55, but I recommend them for anyone who is unclear about any aspect of their health. Assume nothing and get everything in writing.

Stable or stay home.

Travel insurance is designed to cover “sudden and unforeseeable” medical “emergencies” only. As such, all policies have a minimum period of time prior to your bon voyage when your health – including issues related to any pre-existing conditions – must be “stable.” Even annual or multi-trip plans, carry this stability requirement prior to each and every departure (not just prior to purchasing the policy). Normally, to be covered, insurers look for the following 3 to 6 months prior to your excursion:

• Having no new symptoms;
• Having no increase in the frequency or severity of existing symptoms;
• Having no test results outstanding and no tests or referrals pending;
• Having no new medications or treatments prescribed;
• Having no change (including a decrease) in dosage of medications already prescribed;
• Having no admission to hospital; and
• Having no advice not to travel due to a medical issue.

Bottom line is that if it would be reasonable to assume that complications could happen while you were away, it would also be correct to assume your claim would be denied. As a wise advisor once said, “A yellow light always turns red.”

Exclude me.

I’ve read more than one travel insurance policy in my day (what can I say, I don’t get out much), and they all contain exclusions beyond this pre-existing stability clause. Some of the more common exclusions are listed here:

• Emergencies resulting from hang-gliding, rock climbing, parachuting, skydiving or other  extreme adventure seeking activity;
• Emergencies related to pregnancy and/or childbirth within 9 weeks of the expected due date;
• Medical condition you suffer or contract while in a specific country, region or city for which the Department of Foreign Affairs and International Trade Canada has issued a formal warning advising Canadians not to travel;
• Emergencies resulting from medications, alcohol or drug abuse;
• Emergencies that were treated before getting permission from the insurance provider to do so;
• Emergencies that arise after you have failed to advise the insurer that there has been a change from non-smoker status; and
• Any treatment that is not for an emergency.

For travelers, knowing what is not covered is often more important than knowing what is.

Know before you go.

With an aging population of retirees flocking to destinations south and sunny, travel insurance claims (and stories like the one we heard this week) are likely to become more plentiful. The Travel Health Insurance Association of Canada publishes a guide for Canadian travellers entitled, “Travel Insurance – In Case of Emergency,” to hammer home the important points you should know before leaving home. Get your copy here and know before you go.

I’m going to come clean before you read another word. This month’s post falls under the category of “blatant sales pitch.”

Normally I do not promote any one specific company or its products. Instead, my main objective is always to introduce my readers to financial concepts, often wrapped around stories to which we can all relate. We’ve had a few laughs, shed a few tears and – as a result (fingers crossed) – have had more open conversations about how our lives and our money interact.

But sometimes you just have to call a thing a thing.

The subject of this post is the product, Assured Access, and the company that designed it is Medavie Blue Cross. Love ‘em or hate ‘em, they are the only supplier to develop a plan that effectively builds a bridge between times when you are covered by a group plan and times when you are not.

If you’re fortunate enough to have a plan through work that covers things like prescription drugs, trips to the dentist and trips down south, you probably take for granted that you will always have such coverage. You likely did not have to go through any medical screening to get that plan and you just assume your medical needs will always be met, at least on an 80/20 basis. I know I used to feel that way.

As a teacher, my husband is covered by the NLTA Group Benefits plan. As his wife, I and our two children have happily tagged along for the benefits ride. Furthermore, since hubby has no intentions of leaving the teaching profession before he retires and since his plan has an option that provides us with continued benefits in retirement, we really had not given our future health plan needs a second thought. Ignorance is such bliss.

But – like it or not – our kids will be kicked off his plan when they no longer meet the definition of “dependent.” What if they don’t land a job with group benefits? Will they qualify for an individual health plan?

More than one in two marriages end in divorce. Just saying. What happens if our happily ever after doesn’t pan out? Would I, as the “ex”, have any access to his group plan? Not likely.

Contrary to those who think teachers have it made in the summertime shade, it’s not easy to spend 30 years slugging it out in the hormone raging classrooms of a junior high. What if hubby can’t hack it and a career change is in the cards? Could we take our coverage with us?

If you were healthy, any of the scenarios I just described to you would not be that detrimental. In either case, as a newly uninsured person, you would simply apply for an individual health plan through any one of a number of insurance companies. You’d pick the benefits you needed and – once approved medically – simply pay your monthly premiums. Voila! A basic plan for a family of four currently starts at about $175/month.

Alternatively, if you were not healthy, any one of the scenarios I just described could wipe you out.

That is unless you had Assured Access.

What Assured Access does is take a snapshot of your health while you are covered under any group plan (it doesn’t have to be a group plan with Medavie Blue Cross…they’re not fussy). That medical image then serves as the basis for any future benefits you would qualify for under an individual health plan. Once the plan is in place, any changes that may happen to your health would still qualify for coverage under an individual plan whenever or if ever you needed one. They would not be considered pre-existing conditions and they would not be excluded from your individual plan.

Let me illustrate just how truly awesome that is.

I recall a story a colleague of mine shared a few years ago. Her clients had purchased the Assured Access product while covered under a group plan. The entire family of four was included in the application. The policy cost them $32.34 per month.

One day she received a call from the client saying she needed to see her immediately. In our industry, that can only mean one thing…bad news.

Instead of only the client showing up, the entire family appeared in her office less than an hour later. Quietly, the women started to speak. “A few years ago we purchased Assured Access from you. Did I understand you right? When our children come off our group plan, they cannot be denied an individual health plan. Correct?” My colleague nodded in agreement.

The woman continued. “And if they were healthy when we applied, any health issues that they developed since then could not be denied coverage. Correct?” Again, my colleague nodded.

With that affirmation, a visible wave of relief washed over the faces of the entire clan.

“We just left the doctor’s office. Our son was diagnosed with MS today. His medications are going to cost $3000/month. He turns 21 next month and, as such, will be kicked off our group plan. How much will an individual health plan cost him?”

My colleague quickly logged into her quote system and answered, “$62.37/month.”

Because his parents applied for Assured Access before his diagnosis, his MS drugs were fully covered. And not just at the rate of 80% as with many health plans. After all, 20% of $3000 is still a whopping $600 per month! Rather, he was able to seamlessly transition from his parents’ group plan, via Assured Access, to an individual health plan with Medavie Blue Cross that limits his prescription costs to a maximum of $100 each. A far cry from the $3000 per month he was facing!

Over and above this story, what compelled me personally to write about this product was a call I received early in my career. It was from a young woman in her early 40s. Totally disillusioned and discouraged in her current job, she was desperate for a change. She had many skills that could be transferred to any number of different occupations. But she also had diabetes and hypertension. She was diagnosed with these conditions two years after starting the job with her current employer, an employer that lacked many things but one who did provide group benefits. She felt stuck.

Her call was to ask if there was anything out there that she would qualify for on an individual basis, anything that would cover the high cost of her meds? Sadly, while some plans do cover pre-existing conditions for people leaving a group plan, they all have annual or lifetime prescription drug limits and usually carry high price tags. Truthfully, after the diagnosis, there was nothing meaningful I could do for her.

I’ve said it before and I’ll say it again: Financial planning is all about making choices in advance of your choices being taken away from you. That’s why I love Assured Access and that’s why everyone needs to have it as part of their overall financial plan. Sales pitch…complete!