 Quickly...   • Your age, health status, destination, and trip
length may determine the level of coverage and
cost of your premium.
 
• Know how exclusions and limitations can affect
your coverage.

Making sense of
your medical coverage

Medical coverage is hands down the most confusing
part of any insurance policy. Even our staff with advanced
degrees has had trouble figuring out all the limitations
and exclusions.
We can’t stress this enough: Read your policy
from A to Z, and understand what you’re covered for and
for how much. You may discover that your existing travel
health coverage or the one you’re thinking of buying is
not the right one for you.

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Making sense of your medical coverage

 Here’s what you need to know:
• Each policy has different levels of medical protection,
allowances, exclusions, and limitations. Carefully read
all the terms and conditions so you will not be caught off
guard thinking you’re covered when in fact you’re not.
• The language pertaining to medical coverage can be
ambiguous and confusing. Sometimes it’s intended to
give insurers an ‘out’ to reduce their financial risk of
paying out medical claims. Be alert to legal and medical
jargon that may suggest one thing, but that could be
grounds for disqualifying you from coverage.
• When purchasing a travel insurance package or travel
health plan, you agree to provide your medical files to
the insurer’s doctors if you need emergency treatment.
Similarly, the insurer may want to see your medical
records if you make a medical claim.
• Depending on the insurer, if you’re 50 or older,
you’ll likely be asked to fill out a medical questionnaire
which may determine your premium and the type of
coverage you’ll get. See: The medical questionnaire.
• Despite every traveller’s diverse health status,
insurers will place you in predetermined risk
categories. Your premium will be different based on your
age, health status, length of your trip, and destination.
See: Pre-existing medical conditions.

  You’ve paid your premium and you’re set to go, but did you
know that you’re actually not completely underwritten or
financially covered by the insurer until after your medical
claim has been accepted? Before you’re in the clear,
insurers may look at your medical file and compare it to
the answers on your application to determine if you have a
valid claim.

 Note

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IAMAT   Guide to Travel Health Insurance

 Medical coverage
Generally travel health insurance covers you for the
following medical care. Make sure you know what the
maximum amount payable is for each service provided:
• Outpatient services for treating ailments that
do not require a hospital stay.
• Cost of emergency treatment or surgery by
a licensed physician or a licensed physical therapist.
• Diagnostic services such as X-rays, laboratory tests,
and scans such as ultrasounds or sonograms.
• Prescription medications.
• Medical equipment such as a wheelchair, cast, crutches,
cane, brace, or walker.
• Hospital accommodation and allowance associated with
your stay, like access to a telephone or television.
• Emergency transportation by taxi or ambulance,
where available.
• Emergency dental care and prescription glasses
replacement.
 Important  

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If you are hospitalized, the insurer’s doctor or
representatives will determine the amount of time you
can stay in their care, whether you can be evacuated
to another facility, or when you can be brought back home
to continue your treatment.

Making sense of your medical coverage

 Limitation of medical coverage
You may not be covered if you require emergency medical
care for being pregnant or if you’ve injured yourself as a
result of consuming alcohol. Other common exemptions
and exclusions are:
• Pre-existing medical conditions.
See: Pre-existing medical conditions.
• Injuries resulting from alcohol use and illegal or
prescription drug overdose.
• Routine pre-natal care, childbirth, or pregnancy
complications. Tipbox: Pregnancy and travel.
• Sexually transmitted infections acquired during your trip.
• Injuries resulting from risky outdoor activities,
professional sports, or motorized racing.
• Illness resulting from epidemics or pandemics.
• Psychological disorders such as anxiety, panic attacks,
depression, bipolar disorder, psychosis, or suicide
­a ttempts.
• Injuries resulting from exposure to pollution or
radioactive contamination.
• Elective procedures, non-emergency dental treatments,
or cosmetic surgery.
• Injuries resulting from partaking in a criminal activity.
• Injuries resulting from a riot, armed conflict, or war.

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IAMAT   Guide to Travel Health Insurance