# Travel insurance is it really worth it?



## carverman

Recent news: A Saskatchewan pregnant mom was given clearance by her doctor to travel on vacation to the US (Hawaii).
Baby came 9 weeks premature.. The baby had to be incubated for a few weeks The couple had purchased Blue Cross insurance but the insurance refused to pay, explaining that there was a " medical pre-condition" with the mother prior to travel. 



> Saskatchewan Blue Cross did not return a request for comment. However, CTV News cited a letter the insurance agency sent to <mother> noting that she “was diagnosed and treated for a high-risk pregnancy in the six months prior to departure.”
> *Blue Cross called this a pre-existing condition that nullified her insurance*,


Mother denied that it was a high risk pregnancy and just some normal medical issue that she had a simple infection that was
treated and cleared up before travel. The couple got a 1 million dollar bill from the US hospital. 

Now that is going to take some doing to pay it off..what's that in CDN dollars?...1,200,000? with exchange right now. 
They better hope for a readjustment of the bill or the Saskatchewan Provincial Hospital Insurance to pay for some of it
and not travel to the US ever again or buying some lottery tickets and hoping to win the jackpot.


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## Nemo2

http://www.torontosun.com/2014/11/18/saskatchewan-family-billed-1m-for-baby-born-in-us



> Staff told her if the baby survived it would need to stay in the neonatal intensive care unit (NICU) costing $10,000 to $15,000 per day.
> 
> Huculak-Kimmel looked at various options to return home, but the doctors said it wasn't safe.
> 
> Her daughter, Reece, was delivered by emergency C-section on Dec. 10, 2013, and *spent two months in the NICU *before the family returned Feb. 13.
> 
> *During those two months, Huculak-Kimmel rented a condo and a car to travel back and forth to the hospital, spending another $30,000 to live.*


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## marina628

Does it really cost $15,000 a month to rent a place in Hawaii?I know it is not Hawaii but you can rent a 5 bedroom house with pool etc in most of Florida for $3500 a month .I would think a 1-2 bedroom condo would have been fine here.I personally have friends with a $200,000+ unpaid insurance claim and I feel these policies have their mind set they will only pay out to a certain dollar amount then deny .My friend from Sweden went to Malta and needed to go to hospital ,overnight stay and all medications cost her only 300 Euros with no insurance not sure why USA is $10,000 -$15,000 a night.


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## Nemo2

^ I know zero about this incident other than what I've read online, but the $30k does give rise to some speculation that these, seemingly, outrageous living expenses _might_ have been attributed to a "What the hey, the insurance is paying for it" attitude.....


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## carverman

Well I guess the her doctor has to share some responsibility in that...maybe they could sue him for.."malpractice"?


> She is adamant that if she'd been told the pregnancy was high risk or if she didn't have travel insurance she wouldn't have gone on the trip.





> "Anybody in their right mind doesn't risk their life, their unborn baby's life to go on a vacation."


She has a point there. 

lets take a hypothetical case..a senior with a heart issue requiring an electrocardiogram is told by his family physician that he didn't see any real issue to prevent travelling to the US.
He fills out the travel insurance questionaire and goes ahead. 
While in the US , he plays a round of golf and suffers a serious heart attack requiring hospitalization and a huge bill. 

The travel insurance refused to pay the bill citing that he had a "pre-condition"...
Shouldn't the doctor be partly responsible?


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## Nemo2

carverman said:


> Shouldn't the doctor be partly responsible?


_"Aye, there's the rub,
For in that sleep of death, what dreams may come"_

Were that the case, I suspect doctors would advise everyone not to go anywhere, ever.


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## carverman

Nemo2 said:


> ^ I know zero about this incident other than what I've read online, but the $30k does give rise to some speculation that these, seemingly, outrageous living expenses _might_ have been attributed to a "What the hey, the insurance is paying for it" attitude.....


Ok, something doesn't quite make sense here with this story.

The baby born premature spent 2 months (60 days) in the NICU at 10K to 15K per day..assuming $10k per day that is $600K just to allow the baby to be healthy enough to travel. 
Assuming here they ripped her off by inflating the daily charges because she claimed she had Blue Cross..
at $15K per day it would come to $900K US..so that figure doesn't make any sense.
When they told her somewhere's between 10K and 15K per day...that is where the questions should have come
out..but then this couple wasn't worried about the bill at that time. 



> According to a 2010 article in "Managed Care Magazine," the average cost for infants in NICU is around $3,000 per day. This average does not include surgeries or helicopter transports.


She spent 6 weeks at say $3k per day in the same hospital (42 days) thats another $126k added to the bill...$726K
So she rented out a condo at $15K a month plus a car for her hubby to travel back and forth ..$30k

Ok now by my math that's $756K....what's the rest of the 1 million USD charge for?..bandages?


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## HaroldCrump

Something reeks in this story...it seems the woman in question was already about 30 weeks pregnant.
*This news story says the baby came 9 weeks early*.

So, my wonderment is...why would a woman that is 30 weeks pregnant travel from Saskatchewan to Hawaii for vacation?
Note that the common medical advice is that travel should not last beyond the 24th week of pregnancy.
Starting the travel on week 29 or week 30 is completely crazy...


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## Beaver101

carverman said:


> Ok, something doesn't quite make sense here with this story.
> ....
> 
> Ok now by my math that's $756K....what's the rest of the 1 million USD charge for?..bandages?


 ... I haven't read the story in full details other than saw the headlines. Now does your $756K include taxes? :biggrin:

On a serious note, so what happens if she doesn't pay? We're talking about 1 million bucks (and that's in US dollars, meaning approx. $1,120,000 (give or take a few loonies) in CAD ... what happens to most of these astronomical claims eventually?


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## lightcycle

Worries are far from over.

The baby is a US citizen now and will have future FATCA problems on top of all of this...


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## Charlie

A 30 week pregnancy is a pre existing condition, and if she did go to the hospital in the 6 months prior she should have disclosed that. She was foolish to go without double checking she was covered. The doctor just clears her for medical risk. My doc can say I'm OK to travel with a heart condition, but that doesn't mean the insurance company will cover me.

The costs are indeed crazily inflated. But at 30 weeks pregnant she really shouldn't have just assumed she would be covered.


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## Toronto.gal

For sure an infection + hemorrhaging at 4 months [or any point], would be considered a pre-existing condition that should have been disclosed [did she?]. Not very smart to have taken a holiday entering her 3rd trimester, especially with the problems experienced in her 2nd one.


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## HaroldCrump

Charlie said:


> The costs are indeed crazily inflated.


The costs are not "crazily inflated".
This is what a 2 month hospital stay (and intensive care) for a premie baby costs.
A US resident with a standard PPO health care plan would have been charged the same amount - except that insurance would have paid the hospital in that case, less deductibles.

I am not sure what the whole story is...but traveling so far on holiday at 30 weeks is what is the crazy part.


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## carverman

Charlie said:


> A 30 week pregnancy is a pre existing condition, and if she did go to the hospital in the 6 months prior she should have disclosed that. She was foolish to go without double checking she was covered. The doctor just clears her for medical risk. My doc can say I'm OK to travel with a heart condition, but that doesn't mean the insurance company will cover me.
> 
> The costs are indeed crazily inflated. But at 30 weeks pregnant she really shouldn't have just assumed she would be covered.


Ok agreed. but the Blue Cross medical questionaire should have asked that question, and refused her coverage based on the
pre-existing condition and her pregnancy. Had she known she wouldn't be covered, she probably would not have travelled
out of province. 

A lot of people assume that just because they don't seem to have a medical issue at time of travel, they are good to go with
the insurance companies.  The fact that she spent 6 weeks in the hospital indicated a more serious problem than she first 
believed. Again, as I mentioned in another post..her doctor should have advised her not to travel in her condition.

Excerpt from Blue Cross Saskatchewan:


> Most travel plans exclude pre-existing conditions. Give us a call or stop by and chat if you have any concerns about your situation. If a medical questionnaire is required fill it out accurately and disclose all known medical conditions. Review your travel plan policy before you leave to make sure you understand what is covered.


Ignorance (of the policy details), is no excuse. As always, the insurance companies just take your money...and you take your chances that you won't have to collect on the policy they issue.


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## carverman

Toronto.gal said:


> For sure an infection + hemorrhaging at 4 months [or any point], would be considered a pre-existing condition that should have been disclosed [did she?]. Not very smart to have taken a holiday entering her 3rd trimester, especially with the problems experienced in her 2nd one.


Her doctor should have been aware of this fact that she was susceptible to this medical condition also and advised her not to travel.

Whether he followed up on her first bleedng problem or not, she should have checked in any case with her doctor, and decided to play it safe in case of complications and in this case..the medical issue that led to the baby being delivered as a "premee."

This is a case where 'two wrongs don't make a right" and they are going to pay dearly for their mistake, if they don't get some financial help from somewhere.


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## uptoolate

Traveling beyond 24 weeks is risky. Traveling to the US even moreso but I didn't think being a US citizen is a worry for the baby anymore. They should have gone to Cuba!


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## HaroldCrump

carverman said:


> Ok agreed. but the Blue Cross medical questionaire should have asked that question, and refused her coverage based on the
> pre-existing condition and her pregnancy. Had she known she wouldn't be covered, she probably would not have travelled
> out of province.


You are misunderstanding _pre-existing conditions_.
She is indeed covered with health insurance...just not for pregnancy related complications.
Had she broken a leg, she would have been covered.
Had she had a sudden onset of gestational diabetes, she would not have been covered (because of the pre-existing condition).

So, if her question to BCBS was - _Am I covered?_
Their answer would have been _Yes_.

I don't know...seems to me that it would be just common sense not to travel 8 weeks from due date.


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## Charlie

From the link to the article:



> The only problem she'd had with the pregnancy was a bladder infection that caused some bleeding. She told the Blue Cross representative about this, and that she would be travelling when she was between 24 and 27 weeks pregnant.


If that's accurate, I'm back on her side. 

I can't blame the doc for letting her travel, though. Again, I go to the heart condition example. I'm no medical expert so I can't say if it's overly reckless to travel in late pregnancy -- but I'm guessing it's done. Can't imagine it's very comfortable, but not my call to make. And it appears she did tell the insurance company her med history.


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## Toronto.gal

carverman said:


> 1. A lot of people assume that just because they don't seem to have a *medical issue at time of travel*, they are good to go...
> 2. The fact that she *spent 6 weeks in the hospital indicated a more serious problem* than she first believed.
> 3. her doctor should have advised her not to travel in her condition.


*1.* You're right, people assume. But there have been enough cases going public lately for people to have become aware of the very important pre-existing exclusions in the contract that, also a lot of people do not bother to read.
*2.* She was kept hospitalized probably to prevent premature labour since her water had broken early, but after 6 weeks, she required an emergency c-section. 
*3. *Completely agree!


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## Toronto.gal

carverman said:


> Her doctor should have been aware of this fact that she was susceptible to this medical condition also and advised her not to travel.


Yes, but patient is not free of blame here, after all, she's the one that experienced the hemorrhaging, but still wanted a vacation.


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## heyjude

I am a baby doctor. Here are some relevant facts.

1. The "preexisting condition" was a urinary tract infection. The incidence of UTI in pregnancy is 0.3 - 1.3%. However, the incidence of asymptomatic bacteriuria in pregnancy is up to 11%. From the media story, it is not clear which one the mother had. Either condition is usually a minor inconvenience. The family doctor was correct in that the risk was low. However, from an insurance company's point of view, it is a good excuse to avoid paying the bill. 

http://emedicine.medscape.com/article/452604-overview#a0156

2. The mother did not travel to Hawaii at 31 weeks' gestation. *She travelled there at 25 weeks' gestation*. Two days after arrival, she had PPROM, or preterm premature rupture of membranes, a condition which occurs in 3% of pregnancies and is the leading identifiable cause of premature delivery. 

http://emedicine.medscape.com/article/452604-overview#a0156

3. PPROM leads to delivery within a week in 50% of cases. Patients with PPROM need to be carefully monitored, should not travel, and should be in a centre where tertiary NICU care is available. Remember, the patient in question was 25 weeks pregnant when this happened. A baby delivered at 25 weeks has a ~70% chance if survival even with NICU care and the chance of long term complications is extremely high. The priority is to keep the pregnancy going as long as safely possible to increase the chances for the baby. 

http://emedicine.medscape.com/article/261137-overview#aw2aab6b4

4. In this case, the mother was on Maui when PPROM occurred. The only tertiary NICU in the state of Hawaii is at Kap'iolani Medical Center in Honolulu. The mother had to be airlifted there by a medical team. I estimate the cost of that transport at $25000. She then spent the next six weeks in that hospital. Her baby was delivered at 31 weeks gestation. This was a great outcome from the baby's point of view. The chances of survival at 31 weeks are well over 90% and the probability of brain damage is much lower than at 25 weeks. However, if there was little fluid remaining in the uterus during this six weeks, the baby's lungs might not have grown as well as they should. Her lungs were also immature, so she required mechanical ventilation. Some of the photos show the baby being ventilated. Ventilation is labour intensive and costly. It is the principal driver of cost in the NICU. And in the US, every endotracheal tube, suction catheter, oxygen probe and hour of a respiratory technologist's time goes on the bill. 

So the mother spends over six weeks in the hospital, and the baby spends two months in the NICU. I can tell you from my professional experience that the stated costs are no surprise to me. I can also tell you that the care in that NICU is second to none. For example, there is a very low infection rate. 

5. When it comes to living in Honolulu for two months, be aware that housing costs in the Hawaiian capital resemble those in Vancouver. 

http://money.cnn.com/galleries/2011/real_estate/1106/gallery.highest_priced_markets/

http://www.numbeo.com/cost-of-living/city_result.jsp?country=United+States&city=Honolulu,+HI

6. American patients without health insurance usually go through some negotiations to get their costs reduced. However, healthcare expenses are the number one cause of bankruptcy in the US. In this case, I am sure that the family will end up with a bill of at least half a million. The next question is how much of this the government of Saskatchewan will cover. That will have to be negotiated with the Out of Province division of the Department of Health. They will look at what the same care would have cost in Saskatchewan. The family would be liable for the difference. They may end up with a substantial, but much smaller bill. I expect a media fundraising campaign. I hope they will not go bankrupt and lose their house, because that baby needs a good home and parents who can cope with their stress to develop at her full potential. 

Two more insights:

7. Despite all its faults, aren't you glad we have universal healthcare in Canada? 

8. Note to pregnant women: this might be a good time to stay close to home.


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## Toronto.gal

heyjude said:


> Two more insights:
> 
> 7. Despite all its faults, aren't you glad we have universal healthcare in Canada?
> 
> 8. Note to pregnant women: this might be a good time to stay close to home.


+1. 

Why take such a risk, no matter how low, when not necessary.


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## heyjude

Toronto.gal said:


> +1.
> 
> Why take such a risk, no matter how low, when not necessary.


Vacations in Hawaii, while wonderful, are never necessary. But people think they are invulnerable.


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## Toronto.gal

heyjude said:


> But people think they are invulnerable.


Indeed.

Btw, thanks for all the links.


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## carverman

Beaver101 said:


> ... I haven't read the story in full details other than saw the headlines. Now does your $756K include taxes? :biggrin:
> 
> On a serious note, so what happens if she doesn't pay? We're talking about 1 million bucks (and that's in US dollars, meaning approx. $1,120,000 (give or take a few loonies) in CAD ... what happens to most of these astronomical claims eventually?


Here's what a lawyer is saying about this case...



> What I typically counsel people to do is to not pay the bills, depending on their circumstances, because I have yet to see a big health authority come into Canada to try and enforce and collect," said Scott Stanley, a Vancouver-based lawyer who works on similar cases. "And of course, they'd have to do that."


https://ca.news.yahoo.com/lawyer-says-jennifer-huculak-kimmel-173517184.html

Now of course, this is all well and good advice from a lawyer who is not responsible for paying the bill either..Blue Cross denies any payment and gets off "scott free" (no pun intended for lawyer).

But if the hospital in Hawaii pursues the matter legally, and I'm sure that they have enough lawyers there to take on the case pro bono, and file with the US courts to sue the Canadian resident, or leave it with bill collectors, if it's a small amount...like to apply a bandage..$1000. Chances are that for a 1 million, the hospital will be pursuing this
matter vigorously. 

I guess you can always find a cost containment expert to negotiate and settle, *but then you better have the money to pay up as well.*


> British Columbia-based cost-containment expert who negotiates settlements between US hospitals and foreign insurers, is that more and more Canadian travellers are likely to be faced with demands for up-front payments upon admission to US hospitals—and they are also more likely to be billed for outstanding balances left behind by cost-containment companies that sometimes pay only 15 to 30 per cent of a hospital’s submitted bill.


Depending on how the legal procedures are done, it could mean they possibly wouldn't be allowed to visit the US again, or be allowed any kind of medical treatment at any US hospital as a foreign visitor without paying thousands up front from their CC up to the limit of their CC.


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## Beaver101

carverman said:


> Here's what a lawyer is saying about this case...
> 
> https://ca.news.yahoo.com/lawyer-says-jennifer-huculak-kimmel-173517184.html
> 
> ...
> Depending on how the legal procedures are done, *it could mean they possibly wouldn't be allowed to visit the US again, or be allowed
> any kind of medical treatment at any US hospital as a foreign visitor *wiithout paying thousands up front from their CC up to the
> limit of their CC.


 ... I don't think she/her family would want to be visiting the US any time soon. 

At the end of the day, what good would it do for the US hospital, and the insurance company if this family declares bankruptcy? Or they going to go after the baby now she is a US citizen (borned on US soil)?


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## heyjude

So I see on CTV that the SK government is willing to put up $20K. That would cover 2-3 weeks of NICU care in Canada. But of course it is a drop in the bucket in the US. Frankly, I thought SK would cover more. Perhaps they are willing to cover the equivalent cost of the mother's hospitalization, but not the baby's. 

There are new Canadian data out from 2013. Outcomes for micropremies have improved. Survival at 25 weeks is now about 80%. But this is no picnic.


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## Rusty O'Toole

Medical bills in the US are usually 10X what they are in other countries for one reason. In the US, the health care industry is the only one that is exempt from all monopoly and price fixing regulations and has the right to charge whatever they like without disclosing the cost to the customer beforehand.

The result is the steady increase of health care costs over the years.


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## james4beach

This family should get some legal help. If Blue Cross is failing to deliver on the insurance contract, then Blue Cross should be sued.

As far as owing a large US debt ... it's one of thing if it's federal liability (like IRS -- there's no escaping that, even in Canada). But a corporation? If you're willing to never enter the US again, then maybe you can just walk away from it... f' em. There may be a lawsuit and judgement in your absence, and you might get arrested if you ever enter the US again. They'll take any US assets you have.


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## carverman

Rusty O'Toole said:


> Medical bills in the US are usually 10X what they are in other countries for one reason. In the US, the health care industry is the only one that is exempt from all monopoly and price fixing regulations and has the right to charge whatever they like without disclosing the cost to the customer beforehand.
> 
> The result is the steady increase of health care costs over the years.


Well, their bill is now down to: $950,000 - $20,000 (fromSask Heath) - $12,000 that the hospital absorbed -> $918,000. 

There is more to this story that has been released to the media, me thinks, Rusty.

1. She told the network that she purchased Blue Cross insurance and *received approval from her doctor to travel.*
2. The baby came 9 weeks premature. 
3. Somewhere in all those weeks, her travel insurance policy expired..according to what she said on the TV interview
on Global last night. 




> The total bill of $950,000 included more than *$160,000 for Huculak’s hospital stay and $40,000 for a medical evacuation,* she said.
> The rest of the cost went to care for Huculak’s daughter.
> 
> So far, she said *Saskatchewan Health has paid for $20,000 of the bil*l and the *U.S. picked up the cost of Reece’s delivery, at $12,000. That leaves $918,000, she said.*


I guess because the baby is officially a US citizen, there was some provision in the US for the hospital to claim for US funding for the delivery at least. 



> “I had a bladder infection and I hemorrhaged a bit at four months,” she said.
> “My doctor saw no reason for me not to go. “We had no questionnaire [from Blue Cross].”
> The total bill of $950,000 included more than $160,000 for Huculak’s hospital stay and $40,000 for a medical evacuation, she said. The rest of the cost went to care for Huculak’s daughter.
> 
> So far, she said Saskatchewan Health has paid for $20,000 of the bill and the U.S. picked up the cost of Reece’s delivery, at $12,000. That leaves $918,000, she said.
> 
> Blue Cross denied her claim, citing a pre-existing condition.
> 
> “I had a bladder infection and I hemorrhaged a bit at four months,” she said. “My doctor saw no reason for me not to go.
> 
> *“We had no questionnaire [from Blue Cross].”*
> 
> She said her doctor sent a letter to Blue Cross confirming that Huculak’s pregnancy was stable when she went on vacation,* but the claim was still denied.*


Pre-existing yes...she was pregnant..but read this below:



> Kanetix works with nine different insurance companies and each one has its own statement and guidelines defining what will be covered. Some policies will cover a woman travelling within her first 18 weeks of pregnancy;
> others will offer coverage up to 32 weeks.*
> In almost every case, coverage will not extend into the eight weeks ahead of the child’s expected date of arrival.
> *
> Most emergency medical coverage will help alleviate the cost incurred by the expecting mother, while some others will extend that coverage to the newborn.


If this is true, then the insurance industry is shafting this couple by playing games with all these fine print exclusions, and possibly forcing them into bankruptcy, if the hospital decides to take any legal action...regardless of the the lawyer is saying. 
I'm sure if the couple couldn't pay his bill, he would sue them or send it to bill collectors..so you can't always believe what they say. 


I also found out that hospitals in the US are used to insurance companies discounting their charges down to 30%, so the hospitals bump up their rates to ensure they still get paid at least what the realistic charges would be for them
and try to sue the insurance companies for the rest. 

Sad to see that the insurance industry and US hospitals have come to this, with unfortunate travellers squeezed in between. 
I guess these days like the song goes.."I found a million dollar baby in a five and ten cent store" doesn't apply anymore. :biggrin:

Well anyway, their US hospital bill is now down to: $950,000 - $20,000 (fromSask Heath) - $12,000 that the hospital absorbed -> $918,000. 

So the GOOD NEWS is that the Saskatchewan couple don't owe nearly a million USD to the hospital that looked after them so well.
The BAD NEWS is however, that they still owe a big chunk of change $918,000 USD , so that is still over a million Canadian with exchange.:dejection:


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## PrairieGal

It is possible to buy travel insurance that covers pre-existing conditions, but it will cost you a lot more. 

The question in this case is whether a bladder infection is a pre-existing condition for her water breaking pre-maturely. What did heyjude call it? PPMO? It seems to me like Blue Cross is just trying to weasel out of paying.


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## carverman

There are other facts about this "million dollar baby" case that are not being disclosed to the media.

Regardless of whether this was a risky pregnancy (or not) after all, she did call Blue Cross to confirm that when they took out the Travel policy they would still be covered while she was pregnant and the assumption at the time would be that the mother would return to Sask for delivery before that. 

The mother also admitted on TV last night that she had let the travel policy lapse during all the commotion, 
and did not try to extend it until after she was stabilized. She was medivac airlifted from one of the islands to a hospital on Maui. 
That was a $25,000 charge for that as well...not sure if they paid that, or the insurance (Blue Cross) paid it.

With travel insurance policies, *you cannot let the policy lapse while out of the country*. If you feel that you will be staying longer than N days for which the travel policy was issued, you have to advise the insurer before it expires by phone, and add the extra days you expect to away from Canada to your existing policy as an extension...and charge the difference to your CC. 

This was not the case however, and from what I gathered from the snippets of her interview..it was done after she was hospitalized and the baby in NICU. 

The question here is..where was her husband in all this? he should have been on top of their policy and reviewing it with the insurer for an extension immediately, even if she was not in any shape herself to discuss it.


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## heyjude

The Globe and Mail website has a video this morning where a travel insurance "expert" says that pregnant women should be aware that if they give birth while abroad, the insurance will not cover the baby, who is a new, noninsured person. 

In contrast, I recall a case some years ago where an American family was visiting Canada and the mother unexpectedly gave birth at about 29 weeks. The baby was a dual Canadian and US citizen whose NICU care was covered without question by the province, which planned to bill the US insurance company after the fact. The parents were not out of pocket except for accommodation costs. As soon as the baby was stable, we organized a medical evacuation back to their hometown. (We needed the bed and the family needed to be at home!) The American insurers laughed at the bargain cost of the care the baby was receiving in Canada and wanted the baby to complete his hospital stay here. They were not enthusiastic about paying for the transport and moving the baby to the US, where they would have to pay a lot more, so we had to phone them daily to get them to agree to cover the transport. The parents were thrilled with the care they received in Canada and sent goofy family photos to the Canadian NICU every Christmas.


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## kcowan

I wonder if their travel policy was individual or family. DW and I have individual coverage. So a 3rd person would need a policy extension/rider.

Policies can be extended while out of country but the insurer reserves the right to refuse such extensions. When we purchase our snowbird insurance, it is for a fixed number of days starting upon departure. It consists of 30 days that is an annual multiple trip coverage plus a one time extension to cover the entire trip. Any prescription changes within 90 days of departure cause that coverage to not be covered, e.g. Lipitor for heart, hypertension meds, COPD meds.


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## carverman

heyjude said:


> The Globe and Mail website has a video this morning where a travel insurance "expert" says that pregnant women should be aware that if they give birth while abroad, the insurance will not cover the baby, who is a new, noninsured person.


This is all coming together now...the largest hospital bill would be for the baby that was not part of their agreement with Blue Cross at time the travel policy was taken out..it was a risky gamble, and they learned the hard way... unfortunately.

Only the mother would be covered in any case, and that is assuming that they didn't find any pre-condition with the mother that would disqualify her, and the policy was in force (did not lapse)...which apparently it did. 
I suppose they could go on a "legal fishing expedition', hire a lawyer, and try to sue the insurer for charges incurred
during the mother's hospital stay..that maybe (or maybe not) would be covered..according to her doctor
and other witnesses..but that case could take years..and who pays their legal bills if they lose?


Lets say that the NICU costs for baby was $10k a day...and the baby was in NICU for 2 months (60days) until all the baby's organs were fully developed and the baby was safe to travel..even at $10,000 USD per day, that's at least $600,000 USD that they owe the hospital in Hawaii for saving their baby's life....how much is a life worth?..now they are complaining about that?

And, what about the mother who had to spend 6 weeks in a hospital to heal ..bedrest etc; even at $3,000 USD a day (nominal charge if no specialists are involved in her care) it would amount to at least 42 days at $3,000 = $126,000 USD

Adding these amounts together $726,000 USD at least, to save the mother and baby who was strong enough to be emergency medivac transported to Saskatchewan, without a team of NICU specialists on board. Not sure about what other additional charges to round it up to $950K USD. 

I'm starting to understand why Blue Cross refused to pay the bill. A lawsuit against the insurer isn't going to help them because it was all probably specified in their policy for two adults, no mention of a baby involved.


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## Toronto.gal

carverman said:


> 1. that they *owe the hospital in Hawaii for saving their baby's life*.... how much is a life worth?..now they are complaining about that?
> 2. A lawsuit against the insurer isn't going to help them...


*1.* Exactly! But there is always the rush to blame the insurance company right away, but never take personal blame/responsibility for one's actions. 
*2.* But that's the beauty of going public, isn't it, to have others pick up the tab [though the woman claimed to have done so to just punish the insurance company].


----------



## Charlie

it seems odd there was no questionnaire. She claims to have told the insurance co. her med history and current situation -- but if it was just a verbal ask of the agent, with no written follow up then that's not so good. I don't know what to make about the expiry of the policy -- that should have been on her (or her family) to address at the time. There's no word on whether it was a family or personal policy -- but again, whomever she told that she was expecting should have keyed her into who was covered under the policy. 

maybe she just declares bankruptcy and moves on...with a healthy happy baby and a tale to tell. Not such a terrible result.

I'm not about to absolve the insurance co. Their bad reputation of trying to wiggle out of payments is well earned.

But I guess the lesson for us is to double and triple check policies on the assumption of 'can they deny coverage?' Too many unknown factors about her case to make an informed judgement on who is at fault here.

As an aside -- I recall a news story on many injuries from 'extreme' sports not being covered by insurance companies. These include the parasailing/zip line/ scuba trips many of us sign up for without a second thought. Time to recheck the policies! Never assume you're covered!


----------



## Toronto.gal

Charlie said:


> 1. But I guess the lesson for us is to *double and triple check policies..*
> 2. it seems odd there was *no questionnaire.....There's no word on whether it was a family or personal policy.*
> 3. healthy happy baby and a tale to tell.


*1.* Even reading the policy ONCE would help. I recall reading that the woman purchased the insurance a day before her travel date, which makes me wonder whether she even made time to read the contract.

*2.* I don't believe travellers under 60 are required to complete a questionnaire, but it goes without saying that pre-existing conditions are not covered for any age group.

*Exclusion from a 2012 Sask. Blue Cross brochure:*

Any expenses related to a medical condition (whether or not the condition has been diagnosed or the diagnosis has changed) for which any symptoms occurred during the six (6) 
months prior to the Effective Date for Covered Persons age fifty-nine (59) and under, or twelve (12) months prior to the Effective Date for Covered Persons age sixty (60) and over, 
and/or for which the Covered Person:

- consulted a physician
- was hospitalized
- was prescribed new medication or a change in dosage
- received medical investigation or was advised to do so
- received treatment or was advised to do so
- was on a waiting list for medical investigation or treatment
- was waiting for test results
- ignored or did not follow recommended medical advice or treatment

*Family Coverage*
Means benefits are available to the Policyholder, Spouse and Dependent Children.

*3.* Happy & healthy she seems indeed, not to mention absolutely adorable!


----------



## Charlie

I'm holding on to her claim (perhaps too strongly) that she did inform the company of her hospitalization and pregnancy. I doubt she was nearly as explicit in this as she should have been, or that she got clearance that she was covered. I suspect she was extremely reckless travelling without adequate insurance in her condition. Essentially, she was uninsured for pregnancy related treatments -- even in the smoothest of pregnancies she would have consulted a physician within 6 months of travel.

So in answer to the thread's question: YES. Travel insurance is absolutely worth it. But make sure you cover your risks. It may have cost this family $1m to have gone without.


----------



## carverman

Charlie said:


> I'm holding on to her claim (perhaps too strongly) that she did inform the company of her hospitalization and pregnancy. I doubt she was nearly as explicit in this as she should have been, or that she got clearance that she was covered. I suspect she was extremely reckless travelling without adequate insurance in her condition. Essentially, she was uninsured for pregnancy related treatments -- even in the smoothest of pregnancies she would have consulted a physician within 6 months of travel.
> 
> So in answer to the thread's question: *YES. Travel insurance is absolutely worth it. But make sure you cover your risks. It may have cost this family $1m to have gone without.*


But you can't always depend on travel insurance backing you up these days. 
They try to weasel out of paying citing "a precondition" as their excuse.

Sure the mother may have had an incident related to her pregnancy, but at the time they were travelling, 
she was cleared to go by their doctor. I think this case also had something to do with
the original travel policy taken out expiring and maybe they were not able to renew it in time due to the 
unexpected event. It would be nice to know the real facts and timetable in this case as there seems
to be some gaps in the story...

1. IF she was cleared to go by her doctor, and *he also called Blue Cross advising them of her situation*,
and *a questionaire was issued before their travel from Blue Cross to determine that she was or NOT eligible for
coverage.*.they probably would have made other arrangements and not travelled before the birth.

2. If the "unforseen events scenario" had been given to the couple by Blue Cross in a letter...such as
a) only you and your husband are covered for medical expenses, not the unborn baby and certainly
not a premature baby requiring a lengthy stay in an NICU..they also might have made other arrangements. 

If they planned on a 14 day vacation in Hawaii and took out a travel policy for 14 days ,and there was no
medical issues at the time with her and she was still 9 weeks away from the expected date, the policy
would have probably covered some of her medical issues until they returned home...
but not 2 months in the NICU at $10k or more per day. 
No insurance company is going to pay up for this kind of unforseen event. 

What the travel insurance companies are really saying is.. don't travel while your pregnant. 

In another "million dollar baby" case, the Alberta gov't and donations kicked in the 1 million to pay for full medical costs.



> Seventeen years ago, Calgarians Laurie Wolfe and her husband were travelling in the United States.
> 
> *Wolfe was 26 weeks pregnant and had clearance from her doctor to travel when she unexpectedly went into labour*.
> 
> It wasn't long before the couple realized the mounting medical costs they would be paying for their stay in a Nebraska hospital wouldn't be covered by their travel insurance.
> 
> Not surprisingly, Wolfe sympathizes with Jennifer Huculak-Kimmel, who was handed huge medical bills after she travelled to Hawaii and went into early labour.
> 
> "It brought me back immediately to the circumstances we faced when our son Grayson was born 14 weeks early," said Wolfe, recalling her experience in 1997.
> 
> She said it was horrifying to have a critically ill baby staying at a hospital that was constantly asking for money.
> The Wolfes were in the Nebraska hospital for about two months, with bills totalling close to $1 million.





> The Alberta government, with the help of some generous Calgarians, paid the bills and saved the Wolfes from financial ruin.


----------



## carverman

Charlie said:


> it seems odd there was no questionnaire. She claims to have told the insurance co. her med history and current situation -- but if it was just a verbal ask of the agent, with no written follow up then that's not so good. I don't know what to make about the expiry of the policy -- that should have been on her (or her family) to address at the time. There's no word on whether it was a family or personal policy -- but again, whomever she told that she was expecting should have keyed her into who was covered under the policy.


These are examples of why travel insurance policies are not to be taken lightly. The travel policy doesn't matter where you get it from, even if it's CAA, it is still underwritten by some insurance company that will have their rules and policies of what is covered and what is not, and under what circumstances.

You have to read the fine print and ask questions and get it in writing...what expenses are covered under the policy and what are not.
Also are there any 'preconditions" in your case that can be used as "the weasel out clause" for the insurance company. Sure they take your money up front in the hope that it will add to their profit margin, and they never have to pay out for you...but if they do...you can be sure they will investigate your medical history from your family doctor and any hospitals you may have visited in the last few years.

If you get into a car accident , break a limb or get attacked by an alligator... that is unforseen event..but if you get a stroke or heart attack while playing golf and require a lengthy hospitalization in the US..Watch out!
The travel insurance underwriter (not the agency you bought it from) will examine your medical history thoroughly to determine if you had any type of medical precondition..such treated for angina or high blood pressure or anything heart related to possibly deny coverage. 




> But I guess the lesson for us is to double and triple check policies on the assumption of 'can they deny coverage?' Too many unknown factors about her case to make an informed judgement on who is at fault here.


Yes, you must double check the travel policy and ask questions from the agency, on what's covered and what is not..get it in writing if necessary from the agency who sells you the policy. 
Keep a copy of any correspondence, take that with you along with the policy..and hope that nothing serious happens to you while
you are out of Canada. 



> Time to recheck the policies! Never assume you're covered!


----------



## carverman

Toronto.gal said:


> *1.** Even reading the policy ONCE would help*. I recall reading that the *woman purchased the insurance a day before her travel date, which makes me wonder whether she even made time to read the contract.*


*2.* *I don't believe travellers under 60 are required to complete a questionnaire, but it goes without saying that pre-existing conditions are not covered for any age group.*

You mean the standard questionnaire for those over 60? I filled out one of those on my travels to the US once..there was no mention of pregnancy.:biggrin:

Here is an example of a standard questionaire from an travel insurance underwriter:
http://www.bcaa.com/-/media/BCAA/files/brochures/TMI_MHQ_English.pdf


What was her pre-existing condition other than the fact she was pregnant? 
She was healthy and her doctor gave her the go-ahead for the US vacation. I'm sure that in her conversations with her doctor, she would have mentioned that, and it was mentioned (somewhere in the media stories)that her doctor also contacted Blue Cross...why? Probably because she needed his support when the policy issuer (Blue Cross in this case) wanted confirmation from her doctor, that there was no complications with her condition. That would be enough to assure her that she was indeed covered by the travel insurance policy for the original duration of the policy. 

With (perhaps) her doctor's intervention with Blue Cross..she would have peace of mind that she was able to travel and protected in case of a medical emergency...but was there any discussion about a possible premature birth and the length of stay for the baby in a US hospital?..that would be my question.


----------



## Toronto.gal

Charlie said:


> 1. even in the *smoothest of pregnancies she would have consulted a physician within 6 months of travel*.
> 2. I recall a news story on many injuries from *'extreme' sports not being covered by insurance companies.* These include the parasailing/zip line/ scuba trips
> 3. YES. *Travel insurance is absolutely worth it.*


*1.* True enough, but I'm not sure that consulting a doctor for a regular prenatal check-up would be the same as consulting for a specific diagnosis/symptom [that's one of the questions to certainly ask].
*2.* And also clearly stated in the contracts under the exclusion section, which is rather long, from bungee jumping, hand-gliding, mountain climbing, parachuting, rock climbing, sky diving, the ones u noted, etc., etc.
*3.* Most definitely.


----------



## Cal

I think in extreme situations like this, where there is an immediate perceived risk for health care, travel insurance is a must. Assuming you get the plan for your situation.

Otherwise, I am not sure it is worth it. I have purchased travel ins in that past, and have had to use it. but considering all of the hoop they make you jump through, and the time and effort to get refunded, I choose to simply have a travel visa and whatever the insurance that comes with that doesn't cover, I will pay out of pocket in the future.


----------



## Toronto.gal

carverman said:


> 1. But you *can't always depend on travel insurance backing you up these days. *
> 2. They try to *weasel out of paying *citing "a precondition" as their excuse.
> 3. What the travel insurance companies are really saying is.....*don't travel while your pregnant.*
> 4. You mean the standard questionnaire for those over 60? I filled out one of those on my travels to the US once..*there was no mention of pregnancy.*


*1.* And you can't always assume you're covered when you have not even read the policy [not saying the couple in this case did not do so, but it seems that they mostly relied on verbal conversations].

What should be emphasized over and over as u have also mentioned, is that policyholders need to read their respective [short] legal contracts in full, and ask all the questions they don't understand pertaining to those policies. Insured travellers have a big responsibility as well, that of understanding the coverage and exclusions [granted is not always easy & insurers can be unfair]. Such policies typically lists about 20 exclusions, but do you think most travellers read them, especially the young & indestructible ones? Some people believe that insurers are responsible for paying every claim under the sun so long as they have paid their premiums.

*2.* Any idea how many claims the weasels pay as opposed to decline? 

*3.* Coverage is excluded after a # of weeks' gestation [32 I believe in the case of Blue Cross, and others even earlier]. In this case, the woman was 26 weeks pregnant at time of travel, so she was cutting it rather close for that last bit of fun sans baby [as she put it], though surely she's in good company. I vacationed while pregnant as well, except I travelled earlier, had zero problems up to that point, and read my policy in full. 

*4.* Did u read the exclusion section of ur policy?


----------



## carverman

Toronto.gal said:


> *1.* And you can't always assume you're covered when you have not even read the policy [not saying the couple in this case did not do so, but it seems that they mostly relied on verbal conversations].


The assumption is that if you pay your premium you are covered, no matter what. That is a fallacy. How many people read their fire insurance policy to see what the exclusions are? Not meaning to go off topic here, but in the news recently, a NFLD couple (now living in Markham) had a fire and all of their "irreplaceable mementos of their archaeological travels" were lost in the fire...the contents were insured for over $396K.

After making the claim, the insurer only paid a 25% of that coverage, because the value of the 'irreplaceable art objects" could not be determined accurately even though the couple thought they were fully insured They wee assured by their agent that they were covered for the full value of their contents. 
I have the same insurance company, and sure enough if you read the policy in full, you will see the exclusions and what they will pay after 'depreciation" is factored in. 



> Some people believe that insurers are responsible for paying every claim under the sun so long as they have paid their premiums.


Insurance companies in in business to make a profit..if they start paying out millions in claims as opposed to the small premiums they collect on short duration travel policies, they would be out of business. The risk and exclusions are determined at time of applying for the policy.
If you are young and healthy, then the only unforseen problems would be accidental injuries..and depending where you travel and what activity you are engaged in while on vacation (high risk of injury) and there are exclusions for that. I'm sure that if you were to travel to an African country where there are serious diseases such as ebola..you would probably denied coverage as well.



> I vacationed while pregnant as well, except I travelled earlier, had zero problems up to that point, and read my policy in full.


Well you were prepared. However she wasn't, and she took a chance travelling being so close. 



> *4.[/B Did u read the exclusion section of ur policy? *


*
ABSOLUTELY.. I was on medication at the time 2007 and later, prednisone and some other drug, and I wanted it clarified before I drove or flew across the border, and of course after turning 60, they automatically sent me the questionnaire to fill out each time. They wanted to know what kind of medical problem I had, and why the drugs were prescribed in the questionnaire. 

I was not denied the policy after they replied back, but then again..I was fortunate that I never had to make a claim on my travel insurance policies and I took the letter and policy with me. I did extend my policy while
in the US when I was delayed by a couple of days or so. 

We were driving to/from from Memphis then, so I was concerned about any accidental injury on the highways getting back.*


----------



## Toronto.gal

carverman said:


> ABSOLUTELY...


I had no doubt that u had read ur policy, but since u mentioned 'pregnancy', that's the exclusion I was referring to. 

Another million-dollar baby, delivered in Canada.

'Evans says she and her husband were able to work out an agreement with the hospital that will see them paying $300 a month for the rest of their lives. Still, Evans says she doesn’t begrudge the hospital for the bill and says *she and her husband take full responsibility for not reading the fine print of their insurance policy.'*
http://www.thestar.com/news/canada/...ouple_gives_birth_to_milliondollar_baby.html#

Little Piper's weight was just 862 grams; some survival stories are just incredible. I have heard many such survivals from a paediatric cardiac surgeon friend of mine [from less weight even], that are nothing short of miracles, and which I would not have believed had I not visited his NICU unit. Imagine heart surgery being performed on a baby just over 1 lb.?

As heyjude told us, survival at 25 weeks is now about 80%.


----------



## Beaver101

carverman said:


> *2.* *I don't believe travellers under 60 are required to complete a questionnaire, but it goes without saying that pre-existing conditions are not covered for any age group.*
> 
> You mean the standard questionnaire for those over 60? I filled out one of those on my travels to the US once..there was no mention of pregnancy.:biggrin:
> 
> Here is an example of a standard questionaire from an travel insurance underwriter:
> http://www.bcaa.com/-/media/BCAA/files/brochures/TMI_MHQ_English.pdf


 ... that is a trick questionnaire .. these days which 60+ year old does not have hypertension?


----------



## realist

On our guys trips to Buffalo the (somewhat tongue in cheek) standing policy is that anything not life threatening means we haul *** back to the border and go to a hospital in Canada.


----------



## 6811

Beaver101 said:


> ... that is a trick questionnaire .. these days which 60+ year old does not have hypertension?


Me. My Blood Pressure is under the normal 120/80. Why is it a trick questionnaire?


----------



## Toronto.gal

^ Because: a) the insurer asked the question, and b) because too many complain of distress/stress? But it's the under 60 who does that with more frequency.


----------



## Beaver101

Toronto.gal said:


> ^ Because: a) the insurer asked the question, and b) because *too many complain of distress/stress? But **it's the under 60 who does that with more frequency*.


 ... +1 :biggrin:


----------



## carverman

Beaver101 said:


> ... that is a trick questionnaire .. these days which 60+ year old does not have hypertension?


 High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg *or above *most of the time.

Mine is less than that...120 over 80 something last time it was done a year ago. 
Age	60-64 years
Blood Pressure Type.....	Range (mmHg)
-------------------Minimum----Average--aximum
Systolic Blood Pressure	121	134	147
Diastolic Blood Pressure	83	87	91


Hmmm..should I worry about hypertension "doctor"? :biggrin:


----------



## Beaver101

carverman said:


> High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg *or above *most of the time.
> 
> ...
> Hmmm..should I worry about hypertension "doctor"? :biggrin:


 ... no you're not travelling ... and have to worry about going through those body scanners. :biggrin: 

Seriously, I'm no doc but I can presume you have no heart condition, hence, no hypertension.


----------



## Toronto.gal

Toronto.gal said:


> *2.* Any idea how many claims the weasels pay as opposed to decline?


I don't think anyone responded, but here's the answer I just read 2day:

*More than 95% of the 108,000 Canadian claims were paid out last year for a total of $138-million*, the travel health insurance association says. The top two reasons claims were denied related to medical misrepresentation and pre-existing conditions.' 
http://business.financialpost.com/2...ant-moms-need-to-know-about-travel-insurance/


----------



## heyjude

This article in the Financial Post clarifies the pregnancy issue:

http://business.financialpost.com/2...ant-moms-need-to-know-about-travel-insurance/


----------



## carverman

heyjude said:


> This article in the Financial Post clarifies the pregnancy issue:


Good article...good to know.

The examples 1, 2, 3 shown in the financial post link should be attached to all travel policies, where there is a pregnancy apparent
before travel. It would clear up a lot of confusion on what is covered and what is not. 

The other issue raised is to travel out of province, that you should also have additional medical insurance?..most people do not know this and assume that government medicare is universal medicare for every province/territory, and that everything is covered at the rate charged by the hospital that handled the medical condition.



> First, people need to understand that even if you’re simply traveling within Canada, it’s worth considering travel insurance. Your provincial health care system will *only cover between 7% and 9% of out-of-province medical costs*.


Hmmm?..Where is the statistics to support this statement?

Most interprovincal travellers take chances anyway thinking that any medical expenses they incur while 
away from their home province will be covered by their provincial health insurance,
but then, other than Quebec, most provincial health insurances have reciprocal agreements, so maybe it is not that necessary to take out a travel insurance policy within Canada, if you are flying within Canada, or on the road to visit someone? 


Also, the "90 day rule: is a good reminder.. that your medical condition needs to be stable 90 days before travel,
otherwise you may not be covered.


----------



## Beaver101

^ ^ ^ ... agree great article for clarification. 

Based on the numbers in that NP article - the "averaged-out" claim amount was $1,300 ($138 millions divided by 108 thousand claims)...what out of country medical / health service would be that cheap?


----------



## uptoolate

So we should ask the travel insurance industry if we should buy travel insurance. This is what passes muster for investigative/informative reporting in one of our 'national' newspapers. As carverman points out (and as is pointed out in comments on the FP article in the comments section) the assertion that your provincial health coverage will only cover 7-9% of your out-of-province expenses in Canada is ridiculous. Reciprocal agreements are in place between the province and although there may be some differences the amounts involved shouldn't be huge. Certainly, check the specifics as they might apply to you but come on. On the other hand, the American medical system is fraught with peril and even the well insured can run into nasty surprises if they have medical issues there.


----------



## heyjude

Beaver101 said:


> ^ ^ ^ ... agree great article for clarification.
> 
> Based on the numbers in that NP article - the "averaged-out" claim amount was $1,300 ($138 millions divided by 108 thousand claims)...what out of country medical / health service would be that cheap?


Most visits to the ER while on vacation are for minor cuts and sprains, perhaps requiring bandages, tetanus shots and antibiotics.


----------



## heyjude

uptoolate said:


> So we should ask the travel insurance industry if we should buy travel insurance. This is what passes muster for investigative/informative reporting in one of our 'national' newspapers. As carverman points out (and as is pointed out in comments on the FP article in the comments section) *the assertion that your provincial health coverage will only cover 7-9% of your out-of-province expenses in Canada is ridiculous. *Reciprocal agreements are in place between the province and although there may be some differences the amounts involved shouldn't be huge. Certainly, check the specifics as they might apply to you but come on. On the other hand, the American medical system is fraught with peril and even the well insured can run into nasty surprises if they have medical issues there.


This does sound ridiculous. My guess us that it's 70-90% and that the missing zero was missed in what passes for proof reading these days.


----------



## uptoolate

Perhaps it was proof-reading but that was two zeros that they would have missed. One of my mentors was very fond of say, 'Never attribute to malice what can be easily explained by incompetence'. Experience has taught me that if an insurance company is involved, it is more likely malice good business.


----------



## carverman

heyjude said:


> This does sound ridiculous. My guess us that it's 70-90% and that the *missing zero was missed in what passes for proof reading these days*.


From FP article:http://business.financialpost.com/2...ant-moms-need-to-know-about-travel-insurance/



> First, people need to understand that even if you’re simply traveling within Canada, it’s worth considering travel insurance. Your provincial health care system* will only cover between 7% and 9% of out-of-province medical costs.*


+1 ; Besides lack of proof reading, maybe the insurance spokesperson that the FP article writer/reporter contacted, passed on what they thought were facts off the top of their head?

But if you read the OHIP link below...you will note that they specify "if they meet the OHIP eligibilty requirements"
That means that if the person in the family travelling with you does NOT MEET the eligibility requirements of
being a resident in Ontario, and don't have an OHIP card, (ie: a visitor from out of country) , 
and they haven't bought travel insurance coverage while visiting you from their home country,
then they probably should... if they want to want to stay with you or travel in or out of province with you
and be covered for all medical emergencies..except for premature births. 

A medical emergency can happen any time, so can a car accident on the highway or in town. 






> Insured residents of Ontario who travel or work outside Ontario but within Canada are eligible for continuous OHIP coverage for up to 12-months if they meet the OHIP eligibility requirements.


http://www.health.gov.on.ca/en/public/programs/ohip/outofprovince/travellers.aspx


----------



## Toronto.gal

carverman said:


> Besides lack of proof reading, maybe the insurance spokesperson that the FP article writer/reporter contacted, *passed on what they thought were facts off the top of their head?*


Facts off the top of their heads? Come on.

Given the low %s noted, I interpreted to mean out-of-country, not province; a simple enough error to make, but a mistake nonetheless. The former is in fact very limited. For example, as per the [?] 2012 rates noted below, Ontario would only cover $200/$400/ per day for inpatient services, so that would pay $6K/$12K for a month; in the US, a drop in the bucket for sure.

http://www.health.gov.on.ca/en/public/publications/ohip/travel.aspx

Wonder what Cuba would have charged.


----------



## carverman

Toronto.gal said:


> Facts off the top of their heads? Come on.
> 
> Given the low %s noted, I interpreted to mean out-of-country, not province; a simple enough error to make, but a mistake nonetheless. The former is in fact very limited. For example, as per the [?] 2012 rates noted below, Ontario would only cover $200/$400/ per day for inpatient services, so that would pay $6K/$12K for a month; in the US, a drop in the bucket for sure.






> First, people need to understand that *even if you’re simply traveling within Canada, it’s worth considering travel insurance. *Your provincial health care system will only cover between 7% and 9% of out-of-province medical costs.


Ok, T.G., it looks like there are two thoughts in these two statements in the quote and some clarification is required by the FP writer of the article. 
The first one suggests, it's worth getting travel insurance travelling WITHIN Canada...why? if you are registed as a resident and have a genuine OHIP card. You pay for OHIP coverage from your income tax filings.

The second part is saying that the provincial health care system will only *cover between 7 to 9% out of province medical costs.* 
It is conceivable that the writer was referring that "out of province" is actually "out of Canada"? 
In that case it does make sense, since there is no way that OHIP or any other provincial health plan will cover hundreds of thousands charged by the US hospitals for a lengthy stay. 




> Wonder what Cuba would have charged.


Far less I'm sure than what maybe the US hospital charge..but its probably not cheap either. 

But the reality is that your provincial plan probably will not cover the Cuban hospital/doctor charges in any case, since you are a visitor there.



> Canadians visitors *carrying only provincial government health insurance cards will have to pay Cuban hospitals, doctors or other providers in full at the time of treatment* and then seek reimbursement from their provincial plans, which normally cover only a fraction of the charges.


*



Travellers should note that Cuban authorities will not allow anyone with outstanding medical bills to leave the country.

Click to expand...

*


> All health insurance policies are recognized, *except those issued by U.S. insurance companies, as they cannot provide coverage in Cuba."*


Better make sure you have a valid travel insurance policy and a couple "Platinum MC" with the highest limits possible if you have to pay up front...ouch! even at the lowest CC interest rates...otherwise, if your insurance won't
pay because of some weasel out clause "pre-existing condition"..you could be in serious trouble.
http://www.cbc.ca/news/technology/cuba-visitors-face-new-medical-insurance-rule-1.910444


----------



## Toronto.gal

carverman said:


> The second part is saying that the provincial health care system will only *cover between 7 to 9% out of province medical costs. It is conceivable that the writer was referring that "out of province" is actually "out of Canada"?*
> In that case it does make sense, *since there is no way that OHIP or any other provincial health plan will cover hundreds of thousands charged by the US hospitals for a lengthy stay.*


Exactly what I thought when I read it. Sask. paid the woman $20K I believe, and that was probably more even than what had been considered 'eligible'.

If someone would write that, 2+2=5, are you going to ask for clarification? :biggrin: But no question that the article made an error, but overall, it was more useful than not.


----------



## carverman

Toronto.gal said:


> Exactly what I thought when I read it. Sask. paid the woman $20K I believe, and that was probably more even than what had been considered 'eligible'.
> 
> 
> 
> If someone would write that, 2+2=5, are you going to ask for clarification? :biggrin: But no question that the article made an error, but overall, it was more useful than not.
Click to expand...

Mathematically it could be clarified..but it still won't make sense to anyone...it would be a false proof.
I think that Mr. Chretien said something to that extent.

However, in certain instances 1+1 = 3, as in the original story for this thread.:biggrin: 

I think there is a song that goes something like.."you and me and baby makes three" .


----------



## Toronto.gal

^ How much of the $1 million claim in the story was covered by the gov.? I rest my case.


----------



## heyjude

One of the principles of the Canada Health Act is *portability*, meaning that if you are out of province but somewhere in Canada, your health insurance covers you for hospital care. What happens is that the province where you had health care bills your home province after the fact. The same goes for your out of province doctor(s). Because different provinces have different fee schedules, your home province may or may not pay the entire bill, but the province where you had the healthcare and the doctors who delivered the care are obliged to accept what your province pays, and cannot bill you for a copayment. If you are visiting a province whose billing schedule is a bargain compared to your own, your provincial treasury will benefit.

You will be out of pocket for meals, transportation, outpatient services such as physiotherapy, prescription drugs outside of a hospital and accommodation, and this could easily account for 10-30% of your hospital costs. That's why I think that 70-90% is plausible.


----------



## carverman

Toronto.gal said:


> ^ How much of the $1 million claim in the story was covered by the gov.? I rest my case.


I think the story mentioned $950k USD? minus what Sask Health care paid ..somewhere around $20K USD.



> Saskatchewan Health has paid for $20,000 of the bill


 I would also expect it would be USD
so at the current exchange 
7% of 950,00 = 66,500 6% of 950,000 is 57,000 5% is 47,000 4% is 38,000 3% 28,500 

2.1% 19,950 USD = $22,586 cad)..... which would be about 2.5% of the total bill. 
Not even close to 7% to 9% as the writer mentioned in the FP article. 

Apparently the insurance also expired during her stay and she was no longer eligible to get it.
Now a Toronto lawyer has agreed to help them with their case pro bono.




> During the couple's hospital stay, Blue Cross had contacted the two, saying the insurance had run out after the baby was born. Kimmel said it didn't make much sense to extend the insurance when the pair had already been refused by the company.


http://www.cbc.ca/news/canada/saska...l-denied-by-saskatchewan-blue-cross-1.2847097


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## carverman

> Did you know that if you need to see a doctor in Florida, you could be handed a bill for $1,200? OHIP would pay $50.12 of it — *the price of the visit if it had happened in Ontario*. An overnight stay in hospital could cost $10,000 in the U.S. OHIP would pay $400 if you were in a cardiac ward or ICU. A good reason to buy travel insurance. But even extra coverage won't help if it's decided what ails you is a 'pre-existing' condition.


10k for overnight stay in a US Hospital and OHIP covers $400 of that bill. That's about 4% of the hospital bill that OHIP covers.
For a 1200 doctors bill, OHIP pays $50.12..that's about 4.25% of the total bill.


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## Toronto.gal

carverman said:


> *$950k *USD? minus what Sask Health care paid ..somewhere around $20K USD. 7% of 950,00 = 66,500.....Not even close to 7% to 9% as the writer mentioned in the FP article.


Ah, you're taking the entire amount into account, but as you don't know what charges were not eligible for ANY reimbursement, you can't calculate the % paid. 

If you had a plan that covered X at 50% to a max. of $50K, but you had submitted a $100K claim for X, would you call the company asking for another $25K when u had noticed a payment of only $25K? :biggrin: 

I forgot to mention that I brought the error to the journalist's attention; those %s have now been removed, so you can now take a break from any calculation. each:


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## Beaver101

Toronto.gal said:


> ...
> 
> I forgot to mention that I brought the error to the journalist's attention; *those %s have now been removed*, so you can now take a break from any calculation. each:


 ... any idea if he/she is going to provide the correct #s then? :fatigue: Accurate and responsible reporting you know. :wink:


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## carverman

Beaver101 said:


> ... any idea if he/she is going to provide the correct #s then? :fatigue: Accurate and responsible reporting you know. :wink:


Whew!...thank goodness for the "retraction"...my Dollarama calculator was getting burned up from all the calculations.:biggrin:


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## carverman

Toronto.gal said:


> Ah, you're taking the entire amount into account, but as you don't know what charges were not eligible for ANY reimbursement, you can't calculate the % paid.
> 
> If you had a plan that covered X at 50% to a max. of $50K, but you had submitted a $100K claim for X, would you call the company asking for another $25K when u had noticed a payment of only $25K? :biggrin:


So true..but not knowing what wasn't covered I made the assumption that the Sask health plan only paid for her stay in hospital..what was that? around 6 weeks I believe, and if we were to use the $400 a day that OHIP pays out here in Ont..that's.......wait a minute..gotta calculate that..:barbershop_quartet_
hmm...that's $16,800 only...and that's CAD..so if we add about 22% exchange to convert to US dollars...calculating..calculating ..
ok thats another $3520 ...there now that adds up to $20,320.:biggrin:


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## heyjude

carverman said:


> So true..but not knowing what wasn't covered I made the assumption that the Sask health plan only paid for her stay in hospital..what was that? around 6 weeks I believe, and if we were to use the $400 a day that OHIP pays out here in Ont..that's.......wait a minute..gotta calculate that..:barbershop_quartet_
> hmm...that's $16,800 only...and that's CAD..so if we add about 22% exchange to convert to US dollars...calculating..calculating ..
> ok thats another $3520 ...there now that adds up to $20,320.:biggrin:


Surely $16,800 Canadian would be worth* less than $16,800 US* at the current exchange rate?


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## carverman

carverman said:


> So true..but not knowing what wasn't covered I made the assumption that the Sask health plan only paid for her stay in hospital..what was that? around 6 weeks I believe, and if we were to use the $400 a day that OHIP pays out here in Ont..that's.......wait a minute..gotta calculate that..:barbershop_quartet_
> 
> hmm...that's $16,800 only...and that's CAD..so if we add about 13% exchange to convert to US dollars...calculating..calculating .. that's only * $14,873 USD at the current exchange rate, so the SASK gov't health plan would have to kick in another $5,127 CDN to pay the US hospital the $20,000 USD payment..ouch! *.


.

It would be good to get the straight facts on how much has been paid out so far. 
If the couple still owe $900K USD, that is 
still $1,016,541.00 CAD they owe, so it doesn't make much difference with that small payment...its' still a "million dollar baby". I can see now why Blue Cross is standing their ground on not paying anything. 

Not sure how successful their pro bono lawyer will be in this case, since the couple's travel policy expired while
she was in hospital and she was not able to renew at that point...no travel policy in force...no payment even
if it ends up in court. 
They may be stuck with that huge bill , unless "Crowdfunding" (presently a little over $9K so far), 
collects over a million dollars CAD for them, they don't have any options..but file for personal bankruptcy. 

With the Canadian dollar so low..you don't want to end up in a US hospital any more


----------



## Beaver101

heyjude said:


> *One of the principles of the Canada Health Act is portability*, meaning that if you are out of province but somewhere in Canada, your health insurance covers you for hospital care. What happens is that the province where you had health care bills your home province after the fact. The same goes for your out of province doctor(s). Because different provinces have different fee schedules, your home province may or may not pay the entire bill, but the province where you had the healthcare and the doctors who delivered the care are obliged to accept what your province pays, and cannot bill you for a copayment. If you are visiting a province whose billing schedule is a bargain compared to your own, your provincial treasury will benefit.
> 
> ...


... interesting ... didn't know this principle but then I have never read the Canada Health Act. So basically under this principle, does it really make sense to purchase inter-provincial emergency medical travel insurance if the traveller is covered under their provincial health care plan anways?


----------



## Beaver101

carverman said:


> Whew!...thank goodness for the "retraction"...my Dollarama calculator was getting burned up from all the calculations.:biggrin:


 ... your Dollarama calculator is still functioning? :biggrin: With a brain as sharp as yours, why do you need a calculator anyways?


----------



## Beaver101

carverman said:


> .
> 
> It would be good to get the straight facts on how much has been paid out so far.
> If the couple still owe $900K USD, that is
> still $1,016,541.00 CAD they owe, so it doesn't make much difference with that small payment...*its' still a "million dollar baby". *I can see now why Blue Cross is standing their ground on not paying anything.
> 
> Not sure how successful their pro bono lawyer will be in this case, since the couple's travel policy expired while
> she was in hospital and she was not able to renew at that point...no travel policy in force...no payment even
> if it ends up in court.
> They may be stuck with that huge bill , unless "Crowdfunding" (presently a little over $9K so far),
> collects over a million dollars CAD for them, they don't have any options..but *file for personal bankruptcy. *
> 
> With the Canadian dollar so low..you don't want to end up in a US hospital any more


 ... short of filing for personal bankruptcy ... my question is does a $1M health bill-charge makes sense?


----------



## carverman

Beaver101 said:


> ... short of filing for personal bankruptcy ... my question is does a $1M health bill-charge makes sense?


Apparently there is a lawyer who will look into their case pro bono..with Blue Cross...good luck with that one, since their travel policy expired when she went into hospital..and the preemie baby was never covered, so at some point in her 6 week stay in hospital, they HAD NO INSURANCE, and they could not extended it either.

Besides the pro bono lawyer's "fishing expedition"....they have "one last kick at the can" with the Ombudservice for Life and Health Insurance, but their recommendations are not binding on the insurance companies. 

My prediction is that they don't have too much of a chance of success in any legal proceedings,
and more than likely will be stuck with what's left of the hospital bill..unless an anonymous donor steps up to help them..or the crowdfunding grows over a few months. it's a little over 9K Canadian..a far cry from the 1 million CDN they need to pay the US bill. 

As far as paying it monthly for the rest of their lives, they would have to reach a legal agreement for a reduction in the bill to make it feasible.

The other thing is whether the hospital would charge interest on the unpaid bill for that length of time. Even a small percentage would effectively cancel any principal paid against their debt..not to mention exchange...very ugly!

If they accept to pay the hospital..at say $100 a month USD, it will take them 750 months (62.5 years) to pay it off even without the exchange or any interest factored in. She would be well into her 80's by then.

https://ca.news.yahoo.com/cp-newsalert-blue-cross-reaffirms-decision-not-cover-172450646.html


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## Toronto.gal

Beaver101 said:


> I have never read the *Canada Health Act.*


I was reading up on it last night after heyjude's post. 

The key principles are:

*- Public Administration* [non-profit basis].
*- Comprehensiveness* [must insure all services that are medically necessary].
*- Universality* [access to public health care insurance].
*- Portability *[requires provinces to cover insured health services provided to their citizens]. 
*- Accessibility* [insured persons must have reasonable and uniform access to insured health services].

*See 1. Criteria*
http://www.parl.gc.ca/Content/LOP/researchpublications/944-e.htm#dtherequirementstxt


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## Toronto.gal

After this interesting discussion, time to test your knowledge. 

*Scenario:* new landed immigrants have to wait 3 months to be eligible for OHIP [in Ontario]- what if, new immigrant is 6 months pregnant at time of arrival, and 2 days later has a PPROM, and delivers 6 weeks later, like Sask. mom did. 

Answers will depend on province in question.

a) are baby charges covered?
b) are mom's charges covered?


----------



## heyjude

Beaver101 said:


> ... short of filing for personal bankruptcy ... my question is does a $1M health bill-charge makes sense?


As a former worker in this field, I can confirm that $1M is quite plausible for the type of care that this baby received, at US prices. NICU is expensive.


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## carverman

Toronto.gal said:


> I was reading up on it last night after heyjude's post.
> 
> The key principles are:
> 
> *- Public Administration* [non-profit basis].
> *- Comprehensiveness* [must insure all services that are medically necessary].
> *- Universality* [access to public health care insurance].
> *- Portability *[requires provinces to cover insured health services provided to their citizens].
> *- Accessibility* [insured persons must have reasonable and uniform access to insured health services].
> 
> *See 1. Criteria*
> http://www.parl.gc.ca/Content/LOP/researchpublications/944-e.htm#dtherequirementstxt


Read it...Portability only means that the province will pay for whatever it would have cost for her hospital stay in her home province.
Not sure about the NICU care, but it would be covered in her home province as well.




> As stipulated in section 11, the criterion of portability* requires provinces to cover insured health services provided to their citizens while they are temporarily absent from their province of residence or from Canada.*
> 
> For insured health services provided in another province, payment is made at the rate negotiated by the governments of the two provinces.
> 
> *For out-of-Canada services, the Act states that the amount paid will be at least equivalent to the amount the province of residence would have paid for similar services rendered in that province.*


^ there you go. Sask Health did pay the portion ($20K CAD or USD) to the US hospital for services that she would have received in her home province at the rate paid by the provincial health care.


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## Toronto.gal

^^ Even at CAD prices. In 2012, an Australian woman, who gave birth in Vancouver at 6 months [posted a link upthread] was charged $8K+/day [but worked out an arrangement without including lawyers].


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## heyjude

Toronto.gal said:


> After this interesting discussion, time to test your knowledge.
> 
> *Scenario:* new landed immigrants have to wait 3 months to be eligible for OHIP [in Ontario]- what if, new immigrant is 6 months pregnant at time of arrival, and 2 days later has a PPROM, and delivers 6 weeks later, like Sask. mom did.
> 
> Answers will depend on province in question.
> 
> a) are baby charges covered?
> b) are mom's charges covered?


a) yes (Baby is a Canadian citizen)

http://www.cic.gc.ca/english/newcomers/after-health.asp

b) no, not until she has applied for and received her provincial health insurance card. Refugees are a special case (recent controversy regarding Federal decision to limit their health care). 

So called "birth tourism" occurs when a pregnant woman enters a country specifically for the purpose of giving birth to a citizen who will benefit from its social programs. Some countries have voted to deny citizenship to such babies. So far, that hasn't happened here, but the Conservative government is considering changes:

http://www.vancouversun.com/Birth+tourism+crackdown+gets+frosty+reception+from/10206193/story.html

A completely different situation can arise within Canada, as follows:

The Hutterites are have opted out of paying taxes and therefore are not entitled to social programs. I'm not sure how they are allowed to do this when the rest of us cannot, but it does happen. They are responsible for paying their own bills. When a Hutterite patient is hospitalized, the community is watching the cash outflow very carefully and will advocate (in the nicest way) for early discharge. I have seen this many times in the NICU. The good thing is that Hutterite moms have a very high rate of success with breastfeeding and supplying breast milk for tiny premies to receive by tube. That makes a huge difference to their baby's health, even in reducing the chances of complications in the NICU.


----------



## carverman

Toronto.gal said:


> After this interesting discussion, time to test your knowledge.
> 
> *Scenario:* new landed immigrants have to wait 3 months to be eligible for OHIP [in Ontario]- what if, new immigrant is 6 months pregnant at time of arrival, and 2 days later has a PPROM, and delivers 6 weeks later, like Sask. mom did.
> 
> Answers will depend on province in question.
> 
> a) *are baby charges covered?*
> b) *are mom's charges covered*?





> *If you are a refugee*
> 
> Before your OHIP coverage begins, you can get emergency and
> essential health services through the Interim Federal Health
> Program (www.servicecanada.gc.ca/eng/goc/interim_health.shtml),
> or call 1-888-242-2100.
> 
> More details about health costs
> 1) I*t is possible to receive some health care services without
> OHIP coverage at community health centres *(www.aohc.org)
> and through midwives (www.aom.on.ca).* Many services
> such as Healthy Babies Healthy Children and Infant Hearing
> are also free.*
> 
> 2) If you need to take an ambulance to a hospital,* your Ontario
> Health Card will pay for most of the cost but you will need to
> pay part of the fee*.
> If the doctor who sees you at the hospital
> d*oes not think that you truly needed to take an ambulance or
> if you do not have health coverage, you will have to pay the
> full cost. This can be very expensive. *
> 
> 3) If you have to pay for health care, find out if your health care
> provider or *hospital will agree to a payment plan, such as
> paying some of the total each month, instead of all at once.*
> Discuss these plans with your health care provider while you


http://www.beststart.org/resources/rep_health/newcomer/newcomer_guide_english.pdf


----------



## Toronto.gal

^^ Right, but b= yes for provinces that have no waiting period for health coverage [don't know what provinces those are].
http://www.health.gov.on.ca/en/public/publications/ohip/ohip_waiting_pd.aspx

Why wasn't baby born in Vancouver considered a Canadian?


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## heyjude

Toronto.gal said:


> Why wasn't baby born in Vancouver considered a Canadian?


Which baby was that, TG? Can you provide a link?


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## Toronto.gal

http://www.thestar.com/news/canada/...ouple_gives_birth_to_milliondollar_baby.html#

And what if baby had been born in-flight? Emergency landing for sure given it was a premature delivery.

Btw, I know the answer regarding the baby's citizenship, but just threw it out there for discussion.


----------



## heyjude

Toronto.gal said:


> http://www.thestar.com/news/canada/...ouple_gives_birth_to_milliondollar_baby.html#
> 
> And what if baby had been born in-flight? Emergency landing for sure given it was a premature delivery.
> 
> Btw, I know the answer regarding the baby's citizenship, but just threw it out there for discussion.


Thank you. I do not have personal knowledge of this case, but I do know that the baby would be an Australian citizen. *Australia does not allow dual citizenship*. So while the baby would be entitled to be a Canadian citizen, I guess the parents could not forgo Australian citizenship on her behalf. When she comes of age, she can decide for herself.

Regarding births in flight, it does happen. If a pregnant woman goes into labour during a flight, there will be an emergency landing. Imagine having your preterm baby in a country you gave never visited before.


----------



## Toronto.gal

heyjude said:


> *1.* So called *"birth tourism"* occurs when a pregnant woman enters a country specifically for the purpose of giving birth to a citizen who will benefit from its social programs. *Some countries have voted to deny citizenship to such babies.* So far, that hasn't happened here, but the Conservative government is considering changes....
> 
> *2.* *Hutterites have opted out of paying taxes* and therefore are not entitled to social programs. I'm not sure how they are allowed to do this when the rest of us cannot, but it does happen.
> 
> *3.* Hutterite moms have a very *high rate of success with breastfeeding* and supplying breast milk for tiny premies to receive by tube.
> 
> 4. Imagine having your *preterm baby in a country you have never visited before.*


*1.* Actually, per the article you posted, mostly Canada and the US have birth on soil provisions; Australia/NZ & most EU countries restrict citizenship to babies born to at least 1 parent with citizenship/residency. 

*2.* That is very interesting, the part that Hutterites can opt out of paying taxes I mean. 

*3.* So if a mom does not produce milk or enough of it, babies would get it from another new mom, is that what u mean by breastfeeding success? Breastmilk is beneficial for full-term babies, so I can imagine how much more for premies.

*4.* Or if baby were born in flight, not even knowing the country's name until after the birth. 

*'Cuius est solum, eius est usque ad coelum et ad inferos.'* I bet Nemo knows the meaning. :biggrin:


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## carverman

heyjude said:


> a) yes (Baby is a Canadian citizen)


I can understand the case of a baby born in Canada to a refugee even if the refugee doesn't have citizenship yet.
The baby, as you mention would be automatically considered a citizen...but in the case of the Sask couple, the
birth was in the US and the baby would be considered a US citizen, even if born to two Canadians, until such time as the baby can be naturalized.

This was the reason (from what I read) that the US hospital found some Medicaid funds to pay for the actual birth ($12K?)...
but not the NICU stay.



> Medicaid will cover your emergency situation - which is the birth of your child. Regardless, the hospital HAS to treat you and deliver your baby - it is an emergency situation. Worst case scenario, the hospital will try to get the expense of your birth covered (via emergency/presumptive eligibility Medicaid coverage) or if you are denied for Medicaid, then they will try to get charity care to cover the cost of your hospital bill


So far the crowdfunding website has raised $14,900 for paying the bill. 



> Pre-existing condition provisions vary from broker to broker, he said, but generally there is a “stability period” dating backwards 30 days to six months from the first day of the trip. If an emergency arises, insurers will assess medical situations that occurred within that period to determine whether or not to disqualify a claim.
> *Though Hucalak’s policy expired by the time she left hospital*, McAleer said normally, a policy would extend in that situation.
> “Generally that’s not an issue … *Policies will extend while you’re hospitalized, because you’re still in that emergent situation.”*


*

Legalities seem to play a big role in this case. *


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## heyjude

Toronto.gal said:


> *3.* So if a mom does not produce milk or enough of it, babies would get it from another new mom, is that what u mean by breastfeeding success? Breastmilk is beneficial for full-term babies, so I can imagine how much more for premies.


Hutterite mothers don't give up easily on breastfeeding. They see breastfeeding as a priority and will work hard to express milk for their babies if the baby can't feed directly. They also have a very supportive community which will step in to care for older children, housework, etc. 

When a mother's own milk is not available, options include formula or someone else's breast milk. Way back in the 1980s, many hospitals had donor human milk banks. However, when (Canadian) scientists proved in the early 1990s that HIV could be transmitted through breast milk, almost all of those milk banks closed down. In recent years, the evidence that breast milk really is best for all babies, and that formula fed premie babies have a substantially higher risk of several nasty illnesses, has resulted in an upsurge in (very carefully regulated) milk banks again. In rare cases, a family member or close friend can donate breast milk, subject to rigorous testing for hepatitis, HIV, etc. Most hospitals will not permit the use of breast milk bought off the internet, because it cannot be guaranteed safe.


----------



## carverman

Toronto.gal said:


> http://www.thestar.com/news/canada/...ouple_gives_birth_to_milliondollar_baby.html#
> 
> And what if baby had been born in-flight? Emergency landing for sure given it was a premature delivery.


You seem to be raising more and more worse case scenarios here T.G.:biggrin:

I would think that if such an event occurred, and the plane was NOT flying over international waters, the country 
it would be flying over would be considered for the nationality of the birth, and when landing the hospital that continues handling the birth care.


You could go one step further..what if the baby is born on a passenger or cruise ship...where is the birth recorded and citizenship attributed?


> Under the 1961 Convention on the Reduction of Statelessness, for the purposes of determining the obligations under the Convention, a* birth on a ship or aircraft in international waters or airspace shall be treated as a birth in the country of the ship or aircraft's registration.* However, the Convention only applies to births where the child would otherwise be stateless. Since in most cases a child would be covered by one or more countries' jus sanguinis at birth (getting the same citizenship as its parents), this Convention rarely comes into play. In addition, there are still very few Member States that are party to the 1961 Convention.


----------



## Toronto.gal

heyjude said:


> Hutterite mothers don't give up easily on breastfeeding/express milk/have a very supportive community which will step in to care for older children, housework, etc.


You have piqued my interest. Sounds like they have a nice old-fashioned community going. 

*carverman:* The scenarios seem pretty endless. What if a baby is born in a legendary land, like El Dorado, or Fantasy Island? Have u been to any of those? :biggrin:

http://www.youtube.com/watch?v=1x_QbVDlLbI 
http://science.nationalgeographic.com/science/archaeology/el-dorado/


----------



## Nemo2

Toronto.gal said:


> *1.*Australia/NZ & most EU countries restrict citizenship to babies born to at least 1 parent with *Canadian* citizenship/residency.


 Typo methinks?




Toronto.gal said:


> *'Cuius est solum, eius est usque ad coelum et ad inferos.'*


Some people with beachfront property have found this not to be the case I believe. :wink:


----------



## carverman

Toronto.gal said:


> You have piqued my interest. Sounds like they have a nice old-fashioned community going.
> 
> *carverman:* The scenarios seem pretty endless. What if a baby is born in a legendary land, like El Dorado, or Fantasy Island? *Have u been to any of those?* :biggrin:


Only in my mind....but I would rather be somewhere where the legendary Amazonian women are if I had my choice...:biggrin:
Fantasy Island does not exist..."the plane senor..the plane!"


----------



## glenna

As for me, travel insurance is a must! Even if you're still lucky enough not to use the one, think about your possible expenses, just in case... A few $$ a month spent on the travel insurance won't ever cover any possible financial losses.


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## carverman

glenna said:


> As for me, travel insurance is a must! Even if you're still lucky enough not to use the one, think about your possible expenses, just in case... A few $$ a month spent on the travel insurance won't ever cover any possible financial losses.


You might want to read the entire thread. It is about a case which could happen to anyone when purchasing travel insurance, and the agent telling you ' your pregnant but still good to go", and then having the insurer deny any claim citing "sorry but you had a precondition exclusion" within 3 months of travelling. Your claim ((950,000 USD is denied.


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## Toronto.gal

carverman said:


> It is about a case which could happen to anyone *when purchasing travel insurance*....


And most definitely when *not* bothering to read their respective policies.


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## Charlie

I do think insurance companies should have a greater responsibility to explicitly spell out exclusions in a prominent manner.

I'm sure most of the Canadians signing up for zip line, and atv tours during their 'orientation' at a Mexican resort had no idea they were probably not covered for injuries in these activities. 

Imma be checking my policy twice. It's hard to tell a teenager he cannot go parasailing on the beach.

I'm curious what percentage of claims over a certain level are seriously challenged/denied?


----------



## Toronto.gal

Charlie said:


> *1.* I'm sure most of the Canadians signing up for zip line, and atv tours during their 'orientation' at a Mexican resort *had no idea* they were probably not covered for injuries in these activities.
> *2.* I do think insurance companies *should have a greater responsibility to explicitly spell out exclusions* in a prominent manner.


*1.* You're probably right, but you can't blame unawareness on the insurer. 

Blue Cross policy exclusion:

Expenses incurred due to training, practicing or participating in professional sports (receiving remuneration) or any speed contest, rodeo or extreme sports (including but not limited to parachuting, bungee jumping, mountain climbing, rock climbing, spelunking, hang gliding, parasailing, sky diving]. 

Could the wording be any clearer? Perhaps, but I'm not sure that there is much room for confusion/misinterpretation there. It doesn't mean that one can't do X-treme sports, just to be aware that the risk in all respects is ours.

*2.* Indeed, especially when it comes to pre-existing exclusions.

Some clarifications by insurers in the last year or so, have included items such as:

MFC policy - What does medically stable mean?

Medically stable means that in the 90 days before departure, the insured person (you or your dependant) has not been treated or tested for:

- any new symptoms or conditions,
- had an increase or worsening of any existing symptoms, 
- changed treatments or medications (other than normal adjustments for ongoing care), 
- been admitted to the hospital for treatment of the condition. 

Coverage is not available if you (or your dependant) have scheduled non-routine appointments, tests or treatments for the condition or an undiagnosed condition.


----------



## My Own Advisor

I'm with you T.Gal.

People need to read the fine print, there is always a risk of a claim being denied because the underwriting process happens AFTER the fact.


----------



## carverman

Toronto.gal said:


> *1.[/B
> Blue Cross policy exclusion:
> 
> Expenses incurred due to training, practicing or participating in professional sports (receiving remuneration) or any speed contest, rodeo or extreme sports (including but not limited to parachuting, bungee jumping, mountain climbing, rock climbing, spelunking, hang gliding, parasailing, sky diving]. *


*

That sounds like a weasel out clause if I ever read one. 
"not limited to" what?
underwater diving probably, horseback riding, lion, elephant and rhinoceros safaris too..getting injured from a riot, drinking too much?

From an Australian travel insurance web page. 



]Indulging in reckless activities, such as excessive drinking or taking recreational drugs], can lead to a rejection of any insurance claim, whether related to medical, baggage, liability or anything else.

Click to expand...





Could the wording be any clearer? Perhaps, but I'm not sure that there is much room for confusion/misinterpretation there. It doesn't mean that one can't do X-treme sports, just to be aware that the risk in all respects is ours.
Sure you can do any extreme sport while travelling or on vacation, just don't spend any time in the hospitals, and you may be ok.

Click to expand...





Coverage is not available if you (or your dependant) have scheduled non-routine appointments, tests or treatments for the condition or an undiagnosed condition.

Click to expand...

Ok, so let me paraphrase the above statement.

1.Check all your medical appointments for the date you have been treated for something in the last 6 months. 
2. Count the days from these to the actual date of travel (has to be 90 days or more). 
3. Have your lawyer determine if any of the conditions you were treated for could be interpreted as "pre-conditions" to a worsening situation while travelling. 
4. Send a detailed list, and explain what the treatment was, before buying the policy and if there is any chance while travelling, that the pre-condition will surface again or get worse. 
5. Pay us the premiums, have a good trip, but remember if you get sick or injured...we will be looking into your medical history, so we don't have to pay..if we don't have to. :biggrin:*


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## My Own Advisor

People need to understand the underwriting process happens after you've already paid your premiums for travel insurance. This is like mortgage insurance, i.e., not a good product. 

Life insurance on the other hand, the underwriting process happens up-front, before you pay your premiums.

To answer the question, travel insurance IS worth it but there are no guarantees with the coverage, especially for pre-existing 'conditions'.


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## Daniel A.

It's amazing how many people travel on the strength of random visa/mastercard insurance or other products and make assumptions that they will be covered.

I have an annual blue cross policy and have looked it over very closely with my doctor giving input. 

Folks should know when it comes to the USA 50% of bankruptcies are medical related in older people. 
Even Mexico where procedures are cheap show up at a hospital due to medical distress and the cost goes up to the extreme. 

Maybe its because I carry an annual policy that I pay attention and travel to other countries more than once a year.

But even those that cross the boarder for a day of shopping could easily have an accident and not be covered.


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## My Own Advisor

Excellent points Daniel....


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## Charlie

Toronto.gal said:


> [... but you can't blame unawareness on the insurer. .


I do though. I know it's in there -- even explicitly -- but not prominently and people are not directed to it. Again...if most people don't know, that's not entirely their negligence -- some of it rests with the insurance Co. If people are regularly, unknowingly breaching their insurance by doing things that they would not consider reckless, there is something missing in the disclosure.

Same rational that requires you to initial certain clauses in contracts.

I go back to the Mexico resort example. You're at the resort on day one and the WestJet/Canadian Holidays rep pitches an excursion through your resort. It's not unreasonable to think these are activities you might ordinarily do on vacation and should be covered by your insurance. They are activities directed at tourists and done by tourists without any special expertise or training. I just know the line up of people signing up do not each have special riders on their travel insurance. 

It's easy for me to sit back now, and say 'buyer beware' 'read the print', but I know I've gone on these activities thinking I was covered. 

Being pregnant, or having a particular ailment are different. A climbing expedition, professional sports or races, or those types of events I would not simply expect to be covered. They are not 'ordinary' travel conditions, undertaken by your everyday tourist, so I would double check coverage. And I do...now...check for so-called 'extreme' activities. 

But I know I haven't done this in the past. So it's hard to sit in judgement now. (Parasailing? -- they strap you to a parashoot, tow you behind a boat and then bring you back down. It takes the skill and training of a sack of potatoes. Same with zip lining. Same with skydiving using a static line. Riding the bus in certain towns is probably less safe).


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## Toronto.gal

carverman said:


> 1. *"not limited to" what?* horseback riding, lion, elephant and rhinoceros safaris too.....
> 2. Pay us the premiums/have a good trip/but *remember if you get sick or injured...we will be looking into your medical history, so we don't have to pay*..if we don't have to


*1.* Hey, why did u leave the toros out? :biggrin:

It means that, if your hobby such as the one below, is not specifically listed, to CALL your insurer and find out.

*Locos[as]* :stupid: :stupid:
http://www.theguardian.com/world/video/2014/jul/07/pamplona-bull-run-spain-injuries-video

I have to admit that I didn't check the first time I went camel riding.

*2.* Wrong order.


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## Toronto.gal

Charlie said:


> *1.* I do though. I know it's in there -- even explicitly -- but not prominently and *people are not directed to it.*
> *2.* Again...if *most people don't know, that's not entirely their negligence *--
> *3.* I've gone on these activities *thinking I was covered.*
> *4.* *(Parasailing? * -- they strap you to a parashoot, tow you behind a boat and then bring you back down. *It takes the skill and training of a sack of potatoes*.


*1.* Not directed to it? I thought you read your policy now 7x.

*Blue Cross policy:*

Table of Contents

Coverage Available 1
Extended Coverage 1
When You Have a Medical Emergency 1
Emergency Medical Care Benefits 2
Accidental Death and Dismemberment 5
Definitions 7
*Exclusions and Limitations* 10 *[note there are just 3 pages worth of exclusions to read, not 30].*
General Terms 13
Travel Plan Extensions 15
Cancellation

*And right after the above in caps/bold letters:*

IMPORTANT NOTICE - PLEASE READ YOUR POLICY CAREFULLY BEFORE YOU TRAVEL

Travel insurance is designed to cover losses arising from sudden
and unforeseeable circumstances. *It is important that you read and
understand your Policy before you travel as your coverage may be
subject to certain limitations or exclusions.*
A pre-existing exclusion may apply to medical conditions and/
or symptoms that existed prior to your trip. In the event of an
accident, injury or illness, your prior medical history may be
reviewed and your pre-existing symptoms or conditions may result
in your Policy being voided or your claims being declined. Check
to see how this information applies to your Policy and how it
relates to your date of purchase, departure date or Effective Date.

*2.* Are you saying then, that 'most people' read their policies? You should not be making excuses for this group, that's no way to help them.

*3.* And now you know better, why is that? The fact of the matter is that, some travellers require more than standard coverage; riders are not exactly unaffordable, but some people treat their travel insurance as group insurance. Why should non-adventurous travellers subsidize x-treme sport junkies? 

*4.* Parasailing isn't exactly soft sailing, even when all goes well. The sport is excluded for good reason, but those who don't understand the sport itself, such as yourself it seems, wouldn't understand. 
http://www.youtube.com/watch?v=4LZqeyHeerE


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## carverman

Toronto.gal said:


> *1.* Hey, why did u leave the toros out? :biggrin:


I thought it was a lot of "bull" (double entendre)..that anyone in their right mind would be doing this sort of thing.
If your're bent on being a receipient of the "Darwin award" by being gored to death by a bull..why would you even bother with travel insurance?



> The Darwin Awards are a tongue-in-cheek honor, originating in Usenet newsgroup discussions circa 1985. They recognize individuals who have supposedly contributed to human evolution by self-selecting themselves out of the gene pool via death or sterilization by their own actions.





> It means that, if your hobby such as the one below, is not specifically listed, t*o CALL your insurer and find out*.
> 
> *Locos[as]* :stupid: :stupid:


Hello "Blue Cross"..I want to travel to Pampalona Spain and participate in the local festivities there..will I be covered?

*"travel insurance provider*: Of course sir...but first we must warn you that engaging in any dangerous sports will result in you being excluded from complete coverage..unless of course you can prove to us that you can outrun a charging bull. 

Would that make me a winner or loser?

"*Travel insurance provider*":it depends on how fast the bull is. If you outrun it, you have no claims for injury to submit to us.

And if I lose?

"*travel insurance provide*r" Then sir..your travel policy is null and void.




> I have to admit that I didn't check the first time I went camel riding.


 One hump or two? :biggrin:

The reason I asked was that you can fall off a one hump camel easier than a two hump. 



> the Arabian camel, also called dromedary, which has one hump, and (2) the Bactrian camel, which has two humps.


Besides, if the camel decides to kick you, that could result in a serious injury too.


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## Nemo2

carverman said:


> One hump or two? :biggrin:


I would presume one.


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## Beaver101

carverman said:


> that sounds like a weasel out clause if i ever read one.
> "not limited to" what?
> Underwater diving probably, horseback riding, lion, elephant and rhinoceros safaris too..getting injured from a riot, drinking too much? ...
> 
> Ok, so let me paraphrase the above statement.
> 
> 1.check all your medical appointments for the date you have been treated for something in the last 6 months.
> 2. Count the days from these to the actual date of travel (has to be 90 days or more).
> *3. Have your lawyer determine if any of the conditions you were treated for could be interpreted as "pre-conditions" to a worsening situation while travelling. *
> 4. Send a detailed list, and explain what the treatment was, before buying the policy and if there is any chance while travelling, that the pre-condition will surface again or get worse.
> 5. Pay us the premiums, have a good trip, but remember if you get sick or injured...we will be looking into your medical history, so we don't have to pay..if we don't have to. :biggrin:


 ... Lol!!


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## Toronto.gal

carverman said:


> *1.* a lot of "bull" that *anyone in their right mind would be doing this sort of thing.*
> *2.* if your're bent on being a recipient of the "Darwin award" by being gored to death by a bull..*why would you even bother with travel insurance?*
> *3.* if the camel decides to kick you, that could result in a *serious injury* too.


*1.* Actually, not just anyone, but thousands of 'mozos' are attracted to such an event [exclude the Spaniards from the count since it's in their blood]. Just ask Rick Steeves. 

How many of the injured do you believe were shocked when their claims were denied, or even what % of these adventurers had purchased/read their travel insurance policies even? Elsewhere I read: 'injuries resulting from a pre-existing mental condition [thinking you can outrun a terrified bull] would not be covered'. LOL. OTOH, if you get injured as a matador, you might just be covered, as that's not considered a sport [in some countries], but 'fine art'. 

https://www.ricksteves.com/watch-read-listen/read/articles/pamplonas-running-of-the-bulls 

*2.* heyjude answered that one: *'people think they are invulnerable.' *

*3.* Death even. Done it twice, and that was enough for me.


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## kcowan

My GP decided it was time to treat my COPD the week before we embarked on our 6 month trip to Mexico. So any lung-related illness is not covered for this trip. OK so with reduced coverage, did they insist on reducing my premium? Not a chance. The whole process needs to be taken on to improve fairness.


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