The Dullest Document.

Travel medical insurance may be the dullest travel document in your briefcase, but don't be caught dead without knowing its details

Steve Robbins was playing golf with a client on a business trip in Florida when he suffered a heart attack. Fortunately, the 44-year-old executive was rushed to hospital, had an emergency double bypass and survived the horrendous ordeal. The hospital bill, received sooner than he could say, "It's great to be home," was enough to give him a second heart attack: $80,000 U.S. Luckily his insurance plans covered what could have been a financially crippling cost.

The World Health Organization Publication International Travel and Health recently reported that about 50% of travellers who spend up to a month away from home are likely to suffer from illness or accident. The circumstances range from as minor as the common cold, to as tragic as a car crash. About 8% of travelers will be sick enough to see a doctor, and about 5% will be confined to bed at some point.

According to David Ross, a spokesperson for the Ontario Ministry of Health, excess medical insurance is absolutely necessary for all trips outside the country, even if you're only away on a day-trip.

"You never know what's going to happen. You could get across the border and someone sideswipes you in his or her car. Before you know it, you're in hospital," says Ross. "You should never take the chance, not even for an hour."

The cost of hospital care can be more painful than the accident or illness. A night in a Toronto intensive care ward can cost as much as $3,600 per day and it's doubtful that it would be less expensive elsewhere in the world. Medical bills in the U.S. costing $20,000 to $30,000 are not uncommon.

When planning a trip outside Canada, get all the facts about your health coverage first and get extra health insurance before you leave. If you are injured or become ill while travelling outside Canada, government health insurance providers, such as Ontario's plan (OHIP) will pay for emergency health services such as:

* If you receive emergency care from a physician or other eligible health care provider, OHIP will pay only as much as that service would have cost in Ontario;

* Emergency in-patient hospital services eligible for OHIP coverage will be paid up to a maximum of $400 (Canadian) per day or the amount billed -- whichever is less:

* Up to $400 for complex hospital care, such as surgery or coronary, Neonatal, pediatric or intensive care;

* Up to $200 for less intensive medical care;

* Emergency outpatient services will be paid to a maximum of $50 (Canadian) for all outpatient services provided on any one day. OHIP will only cover services in hospitals or other health care facilities that are licensed by local governments.

Extra medical insurance, therefore, is most important because in some extreme circumstances, an ambulance may not even pick you up unless you can prove you will be able to cover the cost of the ride.

Depending on the plan, excess medical insurance can also cover emergency air transportation back to Canada, a private nurse, the cost of bringing a vehicle home, and flight and living expenses of family who come and visit while you are hospitalized. If you don't survive an accident, the insurance may also cover the cost of burial or returning your body to Canada.

As with most insurance, there is no set price for travel insurance coverage. Medical insurance costs can vary quite dramatically and are based primarily on the type of plan, age and the length of the coverage. Student, couple, family and group plans can be bought and deductibles can be raised to lower rates.

The cost of medical insurance for travellers generally ranges from about $18 per week for a healthy 20-year-old to $22 for a 50-year-old and $57 or so for someone around 70.

Check whether your insurance has restrictions such as pre-existing conditions. This includes any conditions for which you have seen a doctor. For example, check whether you would be covered if you are on anti-hypertension medication and suffer a heart attack, or whether you are in the final stage of pregnancy.

Participation in high-risk activities may be excluded from coverage such as scuba diving. Some plans will not provide coverage for you in certain countries they deem as a risk. And many plans specify a time limit. Be sure to read the fine print, and call the insurance company with questions. Your travel agent may not know the full details and you want to avoid discovering that, "what the big print giveth, the fine print taketh away."

Diane McDougall is a freelance writer.

Are You Covered?

The Canadian Life and Health Insurance Association (CLUIA) represents more than 80 Life and health insurance companies in Canada. Here are questions they suggest you ask:

1. Will your policy cover you for the entire Length of your absence from Canada? If you decide to extend the Length of your stay, can your policy be renewed? How?

2. What restrictions does your policy have (preexisting health conditions, sports, time limits, certain destinations)? Does your policy pay for services provided in outpatient clinics or doctor's offices? Is your age a factor for exclusion?

3. Is there a toll-free or collect telephone number for emergency assistance? Does your policy require that you use the toll-free number at the time of the accident or illness?

4. What maximums, deductibles and/or coinsurance would apply in the event of a claim?

5. What documentation is needed to submit a claim?

6. Does your policy pay for emergency return home?

7. If you are travelling with others, does each individual need a separate policy?

8. Does your policy provide for trip cancellation, baggage loss and other damages?

9. If you have out-of-country coverage through your group plan, are there any restrictions? Does it cover you for business travel only?

Did You Know?

Bank or trust company gold-type and other credit cards may offer some protection. Check the details and be aware of any specific restrictions. For example, many credit cards only provide coverage if the trip was charged to the credit card.