By , April 8, 2011 5:30 pm
It's taken a lot of research to find a provider of long term medical insurance that fits our needs.  I guess I've been reading forums, blogs, and emailing companies on and off since I wrote my first stab at a Travel Insurance Article way back in December. Before I get too far into my own analysis, I want to stress this:
Read the fine print - Don't blindly expect my analysis will be the same for you.  Companies offer different underwrites and benefits based on your citizenship and country (sometime province) of residence.  Unfortunately, you'll have to do your own research.

My process for narrowing down insurance companies vaguely followed these steps:

Step 1: Figure out how long you need to be covered for.  In our case, it's likely to be anywhere from 1 to 3 years, and perhaps longer.  This immediately ruled out annual plans that have maximum single trip lengths of 30 days.  It also ruled out single trip plans with a maximum coverage period of 6 months or 1 year. Step 2: Decide what you want your medical insurance to cover.  For me, I really only need insurance to cover the very expensive.  I can handle paying for simple doctor visits and drugs out of pocket, especially in developing countries.  What I can't afford is long term treatment in intensive care units, expensive drugs that I may need to take for the rest of my life, and medical extraction where I need to take an air ambulance to another facility for treatment. Step 3: Get a copy of the actual policy wording for various insurance plans.  Read them and make sure they fit your needs as determined in Steps 1 and 2 above. Step 4: Send some emails to your shortlisted companies and ask for clarification on their policy.  I had a few questions, and was quite surprised by some of the responses I got.

Here are the results of this process on several popular long term plans.

World Nomads - This is a popular insurance program amongst travelers.  There are lots of travel blogs sporting large advertisements for this company, a few paid reviews, and endorsements from Lonely Planet, National Geographic, Rough Guides, and more.  Going into it, this was my front runner.  Unfortunately they were ruled out in step 3 above.  The policy had this to say about renewals past 6 months for Saskatchewan residents.
An extension of coverage is not provided for Pre-Existing Medical Conditions and/or for conditions You suffered during the term of Your original policy, or if You are 60 years of age or over at the time of the extension, or where We have not been advised of any circumstances that have or may give rise to a claim under Your original policy. Your coverage under this policy may be extended up to a maximum Trip length of 365 days provided You have obtained an extension of Your provincial health insurance plan
There we have it.  A maximum coverage period of 6 months.  Not going to work. Expat Network - I ruled Expat Network out with a simple email.  I explained that I was going on a RTW trip and asked for some clarification on a few items in the policy wording.  The response I got ruled them out:
Thanks for your email regarding the Expat Health Plan and your round the world adventure. Based on what you have said in your email and the nature of your trip I’m not certain this will be the best plan for you. I think it would be better to consider a very comprehensive (100% medical) single trip travel plan which will suit your requirements more closely.
Seven Corners - There are two programs offered that I thought would fit our requirements.  Reside, and Reside Prime.  Again, it came down to the full policy wording.  In this case, the cheaper Reside option capped payment on all of the items I was worried about insuring against.  For example, hospital beds were limited to $600 per day, ambulance rides $1,500, extraction $25,000 etc.  So, Reside was out. Reside Prime, on the other hand eliminated these restrictions, so it is an option.  The cost of Reside Prime to cover both Ashley and I with a $500 deductible is $1,744 USD annually.  I chose IMG's plan below over Seven Corners based purely on price. International Medical Group (IMG) - IMG offers several levels to their Global Medical Insurance Plan.  Like the Seven Corners Reside plan above, their lowest level plan caps all of the things I'm worried about paying for.  Again, hospital beds are limited to a maximum of $600 per day, ambulances $1,500, extraction $50,000.  The Gold Plan eliminates these caps. We've chosen to go with their Global Medical Insurance Gold Plan with a $500 deductible for an annual cost of $1,646 USD.

Email Questions:

I thought I'd include some of the questions I asked the various insurance providers by email.  Depending on your trip, you may want to ask some or all of the same questions before settling into a plan. 1. Do you pay fees directly to hospitals, or are we expected to pay and be reimbursed? 2. Do you cover medications in your plan? 3. If I required ongoing treatment for something that came up while under my first or second year of coverage, would I be allowed to renew the plan and continue receiving benefits, or would I be barred from extending the plan? 4. Are non-organized sporting events covered, for example we join in a pickup game of soccer? 5. Would we be covered on multi day trips traveling by hiking, pedal biking, and equestrian (horse riding)? 6. Is mountain climbing covered, specifically mnt. Kilimanjaro? 7. Is there a list of countries where there is no coverage (most other plans exclude Iraq, and Libya for example)? 8. Is there coverage for motor vehicle accidents? Does it matter if we are in the vehicle or struck by it? 9. Is there coverage for motorcycle and/or scooter accidents if we are driving? 10. Would there be any chance that I would be evacuated to either Canada or the USA for treatment where I may not be covered under the policy? There you go, IMG's Gold Global Medical Insurance Plan (excluding the USA and Canada) looks like the best option for us.  Who do you use for your travel medical insurance?

10 Responses to “Long Term Medical Insurance – Read the Fine Print”

  1. Excellent post Mike! I found deciding on medical insurance very tedious. I felt like they were the experts and I really was just playing the slots and hoping for the best. Your advice about setting the parameters and then looking is good – you can read policies forever but until you know what your needs are you can’t choose. Cheers!

  2. Skott and Shawna says:

    Hot damm – nice research!!! You are making our trip planning a helluva lot easier! What do we owe you? 🙂

  3. Bryan says:

    Great info and research guys! We ended up going with IMG for our year long trip in ’09 and we’ve used them on long term trips in the past, too.

    Looking forward to following your adventures!

  4. Clay says:

    Good stuff Mike. I’m involved in the same research right now and it’s a headache. IMG seems like the clear winner and I found myself looking at the Gold Plus plan too, but I’ve come across a few bad reviews on the Thorntree forum (example: http://www.lonelyplanet.com/thorntree/thread.jspa?threadID=1318470).

    Have you seen anything else on this, or have you filed any claims or know anyone who has?

    • Mike Lenzen says:

      I haven’t had to make any claims yet. Good thing, as we’re just over a week into our trip, but accidents can happen at any time I suppose. I know of other people using the plan, but none that have had to file a claim. I will say that I had no trouble finding bad reviews of insurance plans while I was looking at them. All the companies seem to have a disproportionate amount of negative reviews to positive ones. I’m not sure if that’s because people who are not satisfied are more vocal, or if the insurance companies are “evil”. Probably a bit of both.

  5. annette says:

    Hey so a late comment, I am a Canadian looking into medical insurance for my 26 month trip to Kenya, would you go with IMG again?

    • Mike Lenzen says:

      Over the last year, we have not had to contact IMG once, so it’s really hard to tell if they were any good or not. However, we did receive our renewal notification, and decided not to renew because they changed the regions of coverage.

      This sort of policy change didn’t leave us with enough confidence to stick with them long-term and we did not renew. We are currently self-insuring.

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