Travel insurance: what RAMQ does not cover
Plenty of Quebecers travel assuming their health card follows them abroad. It does, but not very far: RAMQ reimburses care received outside Quebec at Quebec rates, which is a fraction of what a hospital stay actually costs in the United States or elsewhere.
The gap is not theoretical. A night in a US hospital routinely bills in the thousands, and the RAMQ reimbursement is counted in tens. Here is how to cover the rest.
What RAMQ actually pays
Outside Canada, RAMQ reimburses hospitalization at a fixed daily amount and medical services at the Quebec rate for the same procedure. Ambulance costs, repatriation, medication bought locally and emergency dental care are not covered.
RAMQ is not travel insurance and has never claimed to be. It reduces the bill, it does not absorb it.
Your credit card coverage, and its blind spots
Many Canadian credit cards include travel medical insurance, and it is often enough. The trap is in the conditions, which vary enormously from card to card. Check four things before relying on it:
- The covered duration : often 15 or 21 days per trip, sometimes less past a certain age. A month-long stay may be covered only for its first half.
- Age : coverage frequently drops at 65, and sometimes earlier. This is the clause that surprises the most people.
- Pre-existing conditions : almost every policy requires your condition to have been stable for a set number of months. A recent medication change can be enough to void a claim.
- Paying with that card : some cards require the trip to have been paid for with them, in whole or in part. Paying with a different card cancels the protection.
Medical and cancellation are two different products
Medical insurance pays for care received during the trip. Cancellation insurance reimburses the trip you do not take, or have to cut short. They are separate coverages, and a card offering the first does not necessarily offer the second.
Cancellation earns its keep mainly when the trip is expensive and non-refundable, or when a family member is unwell at booking time. On a $400 ticket bought three weeks out, it often costs more than the risk it covers.
When to buy, and for how much
Medical coverage can be bought up to the day before departure, but cancellation has to be taken out early, usually within days of booking, or anything already known is excluded. That is the only real calendar constraint.
On the medical coverage amount, go high. The premium difference between $1 million and $5 million of coverage is small, and a ceiling is exactly the thing you do not want to discover is too low from a hospital bed.
What to do before you go
Call your card's insurer and get confirmation, for this specific trip, of the covered duration, your age and your health conditions. Note the emergency number and keep it off your phone, on paper in your wallet. Most policies require the insurer to be called before treatment except in a life-threatening emergency, and one forgotten call can be enough to get a claim refused.