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RIBO Training > Travel Health Insurance (Word Problems) > Flashcards

Travel Health Insurance (Word Problems) Flashcards

Understanding Travel Health Insurance via word problems.

1
Q

What does OHIP stand for?

A

Ontario Health Insurance Plan

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2
Q

Who is eligible to be covered by OHIP?

A

Ontario residents

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3
Q

When is someone eligible to be covered by OHIP?

A

After establishing a three month residency

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4
Q

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

A

212 days

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5
Q

How much will OHIP pay out of country?

A

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

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6
Q

What are the three ways to obtain Travel Health Insurance?

A
  1. Government Health Insurance Plans (GHIP)
  2. Group Insurance Plans
  3. Private Travel Plans
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7
Q

Who are the most common buyers of Group Insurance Plans?

A

Employers

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8
Q

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

A

Reasonable and customary costs

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9
Q

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

A
  1. Single Trip Daily Plan
  2. Multi-Trip Annual Plan
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10
Q

Who needs Expatriate Insurance?

A

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

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11
Q

What is a Top-Up?

A

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

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12
Q

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

A

All other coverage is primary

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13
Q

When does coverage begin for a Single Trip Daily Plan?

A

When the insured leaves home

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14
Q

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

A

Every time the insured leaves home

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15
Q

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

A

Before the policy is bound

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16
Q

When does coverage end for Single Trip Daily Plan?

A

Insured returns home or number of days purchased has expired

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17
Q

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

A

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

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18
Q

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

A

72 hours

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19
Q

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

A

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

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20
Q

What is the maximum time a policy can be extended?

A

212 days total

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21
Q

Under what circumstances can a trip be extended?

A

If no new medical condition has developed

22
Q

Who is Visitors to Canada Insurance for?

A

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

23
Q

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

A

Pre-existing conditions and sickness within 48 hours

24
Q

What is the requirement following a Travel Health Insurance claim?

A

Call Emergency Assistance Hot Line first

25
Q

Who is a snowbird?

A

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

26
Q

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

A

Up to a stated maximum

27
Q

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

A

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

28
Q

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

A

Yes

29
Q

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

A

Yes

30
Q

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

A

Yes

31
Q

When does the policy provide Emergency Medical coverage?

A

When not covered in full by GHIP

32
Q

What is covered under Excess Hospital & Medical?

A

Hospital accommodation and physician services

33
Q

What is covered under Extended Health Care?

A
  • Private duty nursing
  • Prescribed medication
  • Diagnostic tests
  • Medical appliances
  • Local and air ambulance
  • The services of other medical professionals
34
Q

What is covered under Emergency Dental?

A

Costs associated with a direct accidental blow to the mouth

35
Q

What is covered under Coming Home?

A

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

36
Q

What does Out of Pocket Expenses pay for?

A

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

37
Q

Is scuba diving covered?

A

No

38
Q

What is a pre-existing medical condition?

A

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

39
Q

What makes a pre-existing medical condition unstable?

A

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

40
Q

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

A

Insured’s age

41
Q

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

A

No

42
Q

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

A

No

43
Q

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

A

May require a deductible or charge additional premium

44
Q

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?

A

Trip cancellation

45
Q

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?

A

Trip interruption

46
Q

What does Flight Accident cover?

A

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

47
Q

What is covered under the Emergency Medical coverage?

A
  • 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.
48
Q

What is a covered event for Trip Cancellation & Interruption

A
  • 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.
49
Q

What does Baggage coverage cover?

A

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

50
Q

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

A
  • 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)

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