Jane Dotson
Travel insurance is a must-have for many, offering peace of mind and financial protection in the event of unforeseen circumstances. When it comes to medical expenses, travel insurance policies vary in their coverage, and it's important to understand what's included and what might be excluded. In Australia, travellers should be aware that medical expenses incurred within the country are typically not covered by travel insurance, as these are the responsibility of the individual's health insurance provider. However, when travelling overseas, medical cover is usually included in travel insurance policies, providing valuable assistance in the event of accidents or illnesses during your trip.
| Characteristics | Values |
|---|---|
| What does travel insurance cover? | Medical expenses, trip cancellation, trip interruption, baggage loss, trip delays, etc. |
| What does medical cover within travel insurance include? | Cost of medication, doctors' appointments, hospital expenses, emergency medical costs, surgical and ambulance transportation costs, air ambulance, additional travel and accommodation costs. |
| What does medical cover not include? | Treatment for deliberate self-harm and attempted suicide, private hospital room (unless deemed necessary by medical professionals), pre-existing medical conditions, costs covered under RCHA, costs incurred from not following advice, illegal or reckless behaviour, not taking reasonable precautions. |
| What is RCHA? | Reciprocal Health Care Agreement. RCHA agreements are only available for a limited number of countries and only cover emergency medical expenses. |
| What if I have existing health insurance? | Check the coverage limit and consider buying an additional policy. |
| What if I have pre-existing medical conditions? | Declare your condition to your insurer. Some providers are open to assessing all conditions or offering competitive premiums for cover. |
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What You'll Learn
Pre-existing medical conditions
If you have a pre-existing medical condition, it is important to disclose it when purchasing travel insurance. Failure to do so may result in your claim being rejected or your policy becoming void. Most insurance policies do not cover pre-existing conditions, and even if they do, there may be restrictions. For example, insurers may cover allergies but not anaphylaxis.
When declaring your pre-existing condition, you may be required to fill out a medical assessment form, which can be time-consuming and frustrating. It is worth trying at least three different insurers, as premiums and cover vary widely. Some insurers use a 'black box' risk rating system, where each health condition is assigned a risk factor. Depending on the risk factor, the insurer may rule out cover or offer cover for an additional premium.
If your condition is approved for cover, you will need to pay an extra premium, and the medical condition will be listed as covered on your certificate of insurance. You may also have the option to not pay extra if there are certain conditions you don't want to be covered. If your condition is not approved for cover, you may still be able to get travel insurance for things unrelated to your medical condition.
Some insurers provide unlimited coverage for overseas travellers diagnosed with COVID-19 by a qualified medical practitioner during the period of insurance. However, this usually does not include destinations subject to "Do Not Travel" advice on Smartraveller.gov.au due to COVID-19.
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Overseas medical expenses
When travelling overseas, it is always a good idea to consider taking out travel insurance with medical cover to help mitigate the costs of overseas medical expenses. Medical-only travel insurance policies are designed to almost exclusively provide medical assistance overseas. They can cover the costs of medication, doctors' appointments, hospital expenses, emergency medical care, surgical and ambulance transportation costs, and air ambulance costs if it is deemed medically necessary to repatriate you back to Australia. Some policies may also cover the additional travel and accommodation costs for you and a travel companion if you need to extend your stay due to illness or injury.
However, it is important to note that travel insurance policies have limitations and restrictions on what you can claim. For example, you may not be covered for private hospital rooms unless deemed necessary by medical professionals, or for treatment for deliberate self-harm and attempted suicide. Other exclusions may include failure to notify your insurer of hospitalisation immediately, not following the advice of medical professionals, illegal or reckless behaviour, and not taking reasonable precautions, such as wearing a helmet when riding a scooter or moped.
Additionally, Australian travel insurers are not permitted by law to pay medical expenses to Australians travelling within Australia. Therefore, it is essential to check the terms and conditions of your policy carefully to understand what is and is not covered.
When choosing a travel insurance policy, it is worth considering the activities you plan to undertake and the level of risk involved. For example, if you intend to participate in adventurous activities or winter sports, you may require additional cover. It is also important to declare any pre-existing medical conditions and ensure you are covered for these.
Furthermore, travel insurance can provide coverage for other travel-related incidents such as trip cancellations, interruptions, and baggage loss, but these may require a standard or comprehensive travel insurance policy rather than a medical-only policy. Credit cards may also offer complimentary travel insurance, but it is important to review the coverage limits as they may be relatively low, and you may need to purchase additional insurance.
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Medical-only travel insurance policies
Medical-only travel insurance covers you for 24/7 emergency medical assistance, including organising emergency medical transport, arranging payments to hospitals, and helping to reorganise your trip if a disaster impacts your plans. It also includes emergency medical evacuation or repatriation, which means that if you become seriously injured or ill, you can be evacuated to a medical facility with better resources or back to Australia. If you pass away overseas, your policy may help cover the cost of repatriating your body back home.
Additionally, medical-only travel insurance can help with unexpected non-life-threatening medical issues, such as emergency dental treatment. It covers medical treatment, doctors' visits, prescribed medication, specialist treatment, and medical transport costs. It also often includes support from qualified medical advisers and guarantees for medical expenses. It's important to note that medical-only travel insurance doesn't cover domestic medical expenses incurred in Australia, as these may be covered by Medicare or private health insurance. Pre-existing medical conditions are typically excluded from coverage unless they have been declared and accepted by the insurer, which may involve paying an additional premium.
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Medical evacuations
When facing a medical emergency, the priority is always to seek immediate assistance. Contact local emergency services or seek treatment at a nearby medical facility. If you are in a remote location or require specialized medical attention, a medical evacuation may be necessary. This could involve transportation by ambulance, helicopter, or even a specialized medical aircraft, depending on the severity of the situation and your location.
Travel insurance policies typically cover medical evacuations when they are deemed medically necessary by a qualified physician or medical professional. This means that transportation is required to ensure your health and safety, and the treatment you need cannot be adequately provided at your current location. For example, if you are in a remote area with limited medical resources and require specialized care, a medical evacuation would be warranted.
It is important to understand the specific coverage provided by your travel insurance policy regarding medical evacuations. Some policies may have limitations or exclusions, such as pre-existing medical conditions or hazardous activities that increase the risk of injury. Additionally, there may be requirements for prior authorization or preferences for specific transportation providers. Familiarize yourself with the terms and conditions of your policy before your trip, so you are aware of the coverage extent in case of a medical emergency. Keep your insurance information easily accessible during your travels, and don't hesitate to contact your insurance provider for assistance or clarification on your coverage.
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Medical costs for injuries
Country of Treatment
Medical expenses incurred within Australia are generally not covered by travel insurance. Australian law prohibits Australian travel insurers from paying medical expenses to Australians travelling within Australia. Therefore, travel insurance policies will only cover medical costs for injuries incurred overseas. However, if you are in a country with a Reciprocal Health Care Agreement (RCHA) with Australia, your travel insurance may not reimburse expenses already covered under the agreement.
Pre-existing Medical Conditions
Pre-existing medical conditions can affect your coverage for medical costs related to injuries. Some pre-existing conditions may preclude you from obtaining reimbursement for injury-related costs. However, minor pre-existing conditions, such as asthma, hypertension, diabetes, and epilepsy, are usually covered if they have been stable for a certain period, typically more than 12 months. If you have a pre-existing condition, consider declaring it to your insurer and searching for providers who are open to assessing all conditions or offering competitive premiums for cover.
Type of Treatment
Travel insurance typically covers general medical treatments, surgical treatments, and emergency medical services. It may also include ambulance transportation costs and repatriation to Australia if medically necessary. However, there are limitations and restrictions. For example, a private hospital room may not be covered unless deemed necessary by medical professionals. Additionally, expenses related to deliberate self-harm, attempted suicide, or reckless behaviour, such as not wearing a helmet, are usually excluded from coverage.
Additional Costs
Travel insurance can provide valuable assistance with additional costs associated with injuries. It may cover travel and accommodation expenses for you and a companion if you need to extend your stay due to medical reasons or require someone to travel with you. It can also help with the costs of reorganising your trip in case of disasters or emergencies.
Exclusions and Limitations
It is essential to understand the exclusions and limitations of your travel insurance policy. For example, some policies may not cover cancellation expenses due to terrorism, pandemics, military action, or travel provider insolvency. Additionally, there may be specific activity restrictions, such as engine size limits for mopeds, which, if exceeded, could void your coverage. Always read the Product Disclosure Statement for detailed information about your policy's exclusions and limitations.
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Frequently asked questions
Travel insurance with medical cover typically covers medical expenses incurred overseas due to accidents or illnesses. However, it's important to note that Australian travel insurers are not permitted by law to pay medical expenses to Australians travelling within Australia. Therefore, it is essential to understand the terms and conditions of your travel insurance policy and any exclusions that may apply.
There are several circumstances under which medical expenses may not be covered by travel insurance. These include:
- Treatment for deliberate self-harm or attempted suicide.
- Private hospital room expenses, unless deemed necessary by medical professionals.
- Failure to notify your insurer immediately after hospitalisation.
- Not following the advice of medical professionals or travelling against medical advice.
- Illegal or reckless behaviour resulting in injury or illness.
- Not taking reasonable precautions, such as not wearing a helmet when riding a motorcycle.
Some credit cards offer complimentary travel insurance coverage for incidents such as trip delays or cancellations. However, the health insurance benefits provided by these cards may have low coverage limits, which may not be sufficient in the event of a medical emergency. It is important to carefully review the terms and conditions of your credit card's travel insurance coverage to understand the extent of their medical expense coverage.
When purchasing travel insurance with medical cover, it is important to consider the following:
- The type of holiday you are planning and the level of medical care you may require.
- Any pre-existing medical conditions you have, as these may impact your ability to obtain reimbursement for related costs.
- The cost of additional travel and accommodation expenses that may be incurred if you require medical treatment while travelling.
- The reputation and reliability of the insurer, including their claims handling process and customer service.
