Westworld Alberta
Issue link: http://westworldmagazine.ama.ab.ca/i/402160
E E E 38 W e s t W o r l d a l b e r t a | w i n t e r 2 0 1 4 bon voyage Blissfully Bill-Free: Ellie Gabert SAVED: $30,000 leanor Gabert has no idea how much medical treatments in American hospitals cost. And thanks to her AMA travel medical insurance policy, she'll never have to. Ellie, 72, and her husband Len live in Camrose, but escape each winter to their second home in Sun City West, Arizona. ey'd just settled in last December when, one morning, Ellie started to get a headache and feel dizzy. She checked her blood pressure, and it was high – and rising fast. Len took her to a pharmacy to double-check, and the pharma- cist sent them straight to the nearest emergency room. Turns out that in addition to a blood pressure of 205 over 100, she had an electrolyte imbalance. "My blood chemistry was out of whack," says Ellie. She spent a night in the hospital, where she received blood-pressure medication, a chest X-ray, a CT scan and IV therapy. Pricey procedures in an American hospital – but she didn't pay a penny, thanks to her insurance policy. With the crisis averted, the couple was able to stay south and bask in the desert sunshine for three more months. "e insurance looked after everything. We never saw a bill. I don't even know what the claim was," she says. And that's exactly how it should be. Ellie's Travel Health Tips: Get insurance, even for short trips. "All it would take is a horrific car accident or even a minor medical issue and you could be out thousands of dollars." If you travel frequently, consider an annual plan. "It's nice just to know that we've got the annual cov- erage, and tomorrow if we want to jump on a plane and go to Las Vegas, we're covered." If you're travelling with a spouse or partner, keep a copy of each other's plans. "My husband and I always have our insurance information avail- able and accessible. Phone number, insurance policy number. We have each other's in our wallets." Know the location of the closest medical facility to where you're staying. "We always scout out where the local hospital is, just to be sure." W T here's plenty of misinformation out there about travel medical claims. For instance: the percep- tion that insurance companies are always looking for ways to deny your claim, scouring your paperwork for omissions. But that couldn't be further from the truth, says John Thain, presi- dent of the Travel Health Insurance Association of Canada. "Insurance companies would be happiest if all claims were paid," he says. "But they have a responsibility to all their insured policyholders not to be paying claims that are not valid under the terms of the policy." In other words, claims affect premiums. So insurers have to look out for the best interests of their customers. And in fact, according to a Travel Medical Insurance Association of Can- ada survey, fewer than five per cent of claims are denied across the industry each year. For some insurers, the num- bers are even lower. Take AMA travel insurance: of the roughly 1,900 claims received since September 2013, there have only been 10 denied claims; or 0.5 per cent of the total. And none due to errors on the medical questionnaire. Here are the top three reasons for claim denial, and how to protect yourself: 1. PlannEd ProcEdurEs and rouTinE chEckuPs. Travel medical insurance is for emergencies and unforeseen health issues. So you can't claim the cost of a general checkup south of the border. Nor can you fly to Montana to have an elective hip replacement (a common scenario in this age of medical tourism) and then expect a travel medical policy to cover the cost of follow-up antibiot- ics. "Some people have a perception that travel insurance replaces your Members First! In 2012, AMA joined forces with CAA South Central Ontario to form its own travel medical insurance company: Orion. The goals? Trans- parency, simpler medical questionnaires, faster payments and greater flexibility in evaluating claims. "Now that we're part owner of Orion, the focus remains on where it has always been – on our member," says Pam Murray of AMA. "Members can simply come in, tell us about their health so that we can provide them the right coverage for the right price and then they can travel without the worry – because AMA will be there to help wherever and whenever they are in a medical emergency." Crisis averted: Camrose retiree Ellie Gabert recommends an annual travel medical insurance plan for Canadians who travel south frequently. The Top Three Reasons for Denied Claims The real reasons some travel medical insurance claims don't go through – and how to prevent it from happening to you