Alison Griffiths

Have you ever been on vacation and experienced a sick feeling in your stomach? I'm not talking about Montezuma's Revenge striking after over-indulging at the buffet or bar. I'm referring to that nasty feeling you get when you're sitting in a foreign ER with a broken wrist and realize you have no medical insurance.

According to a survey done by TD, the average out-of-country medical bill runs upwards of $10,000 a day for a hospital stay, while an emergency room visit averages $1,000, not including extras like X-rays.

Costs can really mount up, especially in the U.S. Last year I had a painful ear infection while in Florida. I ended up in an emergency room late one night. I wasn't actually seen by a doctor but the tab was $1,200 plus $300 for a follow up visit and another $100 for prescriptions. That's $1,600; not a killer but it sure could put a damper on a vacation. Fortunately, I had insurance.

Two readers recently told me about their $100,000-plus bills after out-of-country medical emergencies. One didn't have travel insurance and the other's claim was disallowed because he didn't disclose a pre-existing condition.

Wait a minute, you say, what about our own medical coverage? "Provincial health plans provide minimal coverage when travelling outside Canada and there are several benefit restrictions even when travelling within Canada," notes the Canadian Snowbird Association (CSA).

Here are eight tips to ensure you get the most benefit from your travel medical coverage.

1. Save receipts. I didn't file my claim until I was back in Canada and by that time I'd misplaced my prescription receipts, which would have been covered under my policy — $100 lost.

2. Check your credit cards. Some cards give you travel coverage, but read the small print to understand the limitations and time restrictions.

3. Compare policies. Some travel insurance will appear cheaper but may provide considerably less coverage. Among the things you should be concerned with are deductibles (the range is from 0 to $10,000) and maximum benefits. The CSA recommends a $1 million minimum with a maximum available of $5 million.

4. Travel before your birthday. Coverage in a higher age bracket can cost 20 to 60 percent more.

5. Don't bluff. Insurance companies hold all the cards. As you age, the number and type of medications you take increasingly becomes an issue. You may be charged more for insurance or be refused coverage outright. Some people try to get around this by not disclosing medications or changes in medication before they travel. But after you file a claim it's a simple matter for the insurer to review your medical files — you've already given permission — and refuse your claim.

Nor can you avoid this by not taking a medication prescribed by a physician. "This does not work," Medipac Travel Insurance emphasizes. "If a doctor recommends a change in drugs and you do not accept the change, the insurance company will treat this as an unstable pre-existing condition. A claim will not be paid." Better to disclose your condition and the recommended treatment. There is quite a bit of variation among insurers with respect to how they treat medications.

6. Adjust the policy. If you leave earlier than stated in the application or come back later, your coverage won't help you. I have often forgotten about this, particularly in reference to return date. Fortunately, the travel gods have smiled on me because, statistically, the highest proportion of claims comes at the beginning and end of a trip.

7. The young aren't immune. Young people often think they're invulnerable. I never even considered insurance when I travelled throughout Europe in my twenties but I should have. It could be a nice gift from a parent or grandparent before their offspring sets off on that great adventure. And the best part is that travel insurance is quite cheap for the younger folks.

8. Insurance keeps you on your toes. Travel insurance is a guarantee that you'll seek medical help promptly if you need it. It seems to be human nature to avoid going to a doctor or the hospital if you're sick while travelling. But if you've already paid for insurance, chances are you'll go more promptly and avoid getting sicker.

Regardless of the price, travel insurance is one thing you don't want to leave home without.

Alison Griffiths' latest book isCount on Yourself: Take Charge of Your Money. You can reach her at www.alisongriffiths.ca, and on Twitter at @alisononmoney.