Travel Health Insurance (Word Problems)

Question 1

What does OHIP stand for?

Answer 1

Ontario Health Insurance Plan

Question 2

Who is eligible to be covered by OHIP?

Answer 2

Ontario residents

Question 3

When is someone eligible to be covered by OHIP?

Answer 3

After establishing a three month residency

Question 4

How long will OHIP provide continuous coverage during a temporary extended absence?

Answer 4

212 days

Question 5

How much will OHIP pay out of country?

Answer 5

Maximum daily payments for emergencies are $50 outpatient services, $200 inpatient care, $400 inpatient care in an operating room or specific specialty care units

Question 6

What are the three ways to obtain Travel Health Insurance?

Answer 6

1. Government Health Insurance Plans (GHIP)
2. Group Insurance Plans
3. Private Travel Plans

Question 7

Who are the most common buyers of Group Insurance Plans?

Answer 7

Employers

Question 8

What kind of costs does Travel Health Insurance pay for outside the insured’s country of residence?

Answer 8

Reasonable and customary costs

Question 9

What are the two main types of Outbound Insurance policies that are available?

Answer 9

1. Single Trip Daily Plan
2. Multi-Trip Annual Plan

Question 10

Who needs Expatriate Insurance?

Answer 10

Canadian citizen residing outside of Canada for an extended period of time

Question 11

What is a Top-Up?

Answer 11

A Single Trip Daily Plan purchased when the duration of a Multi-Trip Annual Plan ends

Question 12

When does Travel Health Insurance pay when other policies are available to provide coverage?

Answer 12

All other coverage is primary

Question 13

When does coverage begin for a Single Trip Daily Plan?

Answer 13

When the insured leaves home

Question 14

When does coverage begin for a Multi-Trip Annual Plan?

Answer 14

Every time the insured leaves home

Question 15

When is the premium for a Travel Health Insurance policy required?

Answer 15

Before the policy is bound

Question 16

When does coverage end for Single Trip Daily Plan?

Answer 16

Insured returns home or number of days purchased has expired

Question 17

When does coverage end for annual Multi-Trip Annual Plan?

Answer 17

Every time insured returns home, number of days purchased has expired, policy term ends

Question 18

How long is the automatic extension of the Travel Health Insurance policy?

Answer 18

72 hours

Question 19

What are the three reasons an automatic extension will be granted?

Answer 19

Emergency involving the insured, common carrier delay, weather related delay

Question 20

What is the maximum time a policy can be extended?

Answer 20

212 days total

Question 21

Under what circumstances can a trip be extended?

Answer 21

If no new medical condition has developed

Question 22

Who is Visitors to Canada Insurance for?

Answer 22

Landed immigrants, refugees, international students, and workers, or those visiting the country

Question 23

What are two exclusions in a Visitors to Canada Insurance policy?

Answer 23

Pre-existing conditions and sickness within 48 hours

Question 24

What is the requirement following a Travel Health Insurance claim?

Answer 24

Call Emergency Assistance Hot Line first

Question 25

Who is a snowbird?

Answer 25

Canadian aged 55+ who spend 31+ consecutive nights outside Canada

Question 26

Is there a limit on how much will be paid for private duty nursing?

Answer 26

Up to a stated maximum

Question 27

What expenses will be paid when the insured dies on vacation?

Answer 27

Repatriation, cost to prepare body, cost to have someone identify and release body

Question 28

Will Emergency Medical pay for the cost to bring the insured home because of an insured medical condition?

Answer 28

Yes

Question 29

Will Emergency Medical pay to bring someone to the bedside of a hospitalized insured travelling alone?

Answer 29

Yes

Question 30

Will Emergency Medical pay to return a child home if they are traveling with an insured that is hospitalized?

Answer 30

Yes

Question 31

When does the policy provide Emergency Medical coverage?

Answer 31

When not covered in full by GHIP

Question 32

What is covered under Excess Hospital & Medical?

Answer 32

Hospital accommodation and physician services

Question 33

What is covered under Extended Health Care?

Answer 33

- Private duty nursing - Prescribed medication - Diagnostic tests - Medical appliances - Local and air ambulance - The services of other medical professionals

Question 34

What is covered under Emergency Dental?

Answer 34

Costs associated with a direct accidental blow to the mouth

Question 35

What is covered under Coming Home?

Answer 35

Cost of being returned to your province for immediate medical attention at the recommendation of the attending physician

Question 36

What does Out of Pocket Expenses pay for?

Answer 36

Costs of the insured and travelling companion when the insured is hospitalized such as: - Telephone charges - Meals - Hotel stays - Taxi trips

Question 37

Is scuba diving covered?

Answer 37

No

Question 38

What is a pre-existing medical condition?

Answer 38

A sickness, injury, or medical condition which existed on or prior to the effective date or any departure date

Question 39

What makes a pre-existing medical condition unstable?

Answer 39

A sickness or injury that would cause an ordinarily prudent person to expect to need medical treatment or investigation following departure

Question 40

What do the time periods used to determine stability rely upon?

Answer 40

Insured’s age

Question 41

Is coverage available for medical expenses resulting from an unstable pre-existing medical condition?

Answer 41

No

Question 42

Is diagnosis of a pre-existing medical condition necessary for the condition to be excluded as unstable?

Answer 42

No

Question 43

How do travel insurers deal with and underwrite pre-existing medical conditions?

Answer 43

May require a deductible or charge additional premium

Question 44

What coverage reimburses the traveler the non-refundable prepaid portions of a trip if it has to be cancelled due to a medical emergency prior to departure?

Answer 44

Trip cancellation

Question 45

What coverage reimburses the traveler the non-refundable prepaid portions of a trip if it has to be cancelled due to a medical emergency in the midst of the trip?

Answer 45

Trip interruption

Question 46

What does Flight Accident cover?

Answer 46

Death or loss of limb or sight due to an aircraft accident

Question 47

What is covered under the Emergency Medical coverage?

Answer 47

- Excess Hospital & Medical - Pays for hospital accommodation and physician services in excess of the limit in which GHIP allows. - Extended Health Care - Pays for private duty nursing (up to a stated maximum), prescribed medication, diagnostic tests, medical appliances, local and air ambulance, and the services of other medical professionals. - Out of Pocket Expenses - Pays for additional costs of the insured and travelling companion when the insured is hospitalized such as telephone charges, meals, hotel stays, and taxi trips. - Childcare Attendant - Pays for the cost of a child care attendant to care for the children who were accompanying the insured while travelling when the insured is hospitalized. - Coming Home - Pays for the cost of being returned to your province for immediate medical attention at the recommendation of the attending physician. - Emergency Dental - Pays for costs associated with a direct accidental blow to the mouth. - Transportation to the Bedside - Pays for round trip economy airfare and accommodation for any one spouse, parent, child, or sibling to be with the insured who is hospitalized. - Return of Deceased - Pays for repatriation of the insured’s body in a standard airline container, the cost to prepare the body, and to fly someone to legally identify and release the body.

Question 48

What is a covered event for Trip Cancellation & Interruption

Answer 48

- A personal or family situation such as death or sudden medical emergency. - Being called to service such as the military or jury duty/being subpoenaed. - Being quarantined. - Canadian government issues a travel advisory after insurance was purchased. - Severe weather delays.

Question 49

What does Baggage coverage cover?

Answer 49

Loss or damage or delay in baggage and property an insured uses on a trip

Question 50

What else besides unstable pre-existing medical conditions may be excluded from the Emergency Medical portion of the travel policy?

Answer 50

- Any sickness or injury that occurs while the policy is not in effect. - Any sickness or injury that does not relate directly to an emergency. - Expenses due to trip interruption when caused by a situation that the insured knew before leaving would make it unlikely to complete the trip as booked. - Expenses due to trip cancellation or interruption when the purpose of the visit was to visit a person who is ill. - Medical treatment when the policy is sought specifically for the purpose of obtaining treatment, whether or not it is recommended by a physician. - Pregnancy, childbirth, miscarriage, or any complications due to pregnancy occurring within eight weeks of the expected delivery date. Some policies totally exclude any costs related to pregnancy. - Suicide or self-inflicted injury. - War or terrorism. - Any air travel, unless as a passenger in a commercial aircraft licensed to carry 6+ passengers. - Continuing medical treatment if the insured is medically fit to return home. - Expenses incurred if the insured chose to travel to a region where there is a travel advisory. - Expenses incurred without promptly advising the Emergency Assistance Hot Line, unless the treatment is deemed critical, may result in reduction of benefits. - Sporting Activity Exclusions (Falling, swimming, going under)