Travel insurance through medical aid: Is it enough?

Having travel insurance as an added benefit with your medical aid is common practise, but what does it cover and is it enough?

This week Justmoney explores the travel benefit that medical insurance offers to ensure that you are sufficiently informed and covered the next time you travel.

Breaking down the benefit

“It is fairly standard practice to offer travel insurance as part of medical aid cover in the case of medical emergencies while traveling outside of South Africa,” says Gerhard van Emmenis from Bonitas medical fund.

The larger open medical schemes will likely offer some travel-related insurance. This will typically apply to the more comprehensive options within those schemes.  Smaller schemes and restricted schemes are unlikely to cover travel insurance, says Heidi Kruger, independent medical insurance expert.

But while it is standard, there are certain requirements – such as having to pay an extra fee to register with the International Travel Benefit (ITB).  

ITB covers members for medical emergency treatment outside the borders of South Africa for typically 90 days from the date of departure.

The reason you need to register is that this benefit is often underwritten by an independent authorised financial service provider that is outside the spectrum of your medical insurance provider.

However, this is not the case with every medical aid product and it best for you to check with your medical aid provider at inception of your policy.

But apart from the registration fee, it is generally considered a “free” benefit as it is catered for in the base cover or monthly premium fee.

While ITB is comprehensive in allowing for emergency medical and related expenses, what specifically are you covered for?

Exploring the spectrum of cover

“Cover varies from one insurance company to another. The ITB offered by Bonitas has certain exclusions and pre-existing conditions – especially in the case of dangerous activities,” says van Emmenis.

So if you plan to sky dive or climb Mount Kilimanjaro, always confirm the extent of your cover with your provider who will walk you through the ITB first. If not, you could be liable for all medical expenses.

According to van Emmenis the basic benefits include:

• Mandatory vaccine expenses (when a country you’re travelling to requires certain vaccinations)
• Emergency medical expenses
• Medical evacuation and transport
• Hospitalisation
• Out-patient and in-patient treatment
• Optical and dental expenses
• Travel assist services

However, travel insurance is not a one-size-fits-all and having that approach could be financially detrimental.

“Travel insurance is probably one of the most overlooked elements when booking a trip,” says Otto de Vries, chief executive officer of the Association of South African Travel Agents (Asata).

Some banks offer travel insurance when you use your credit card to pay for your flight. However, never assume that this provides complete cover, warns De Vries.

“This type of cover is usually quite basic and may not be enough as is the case with the travel insurance included in your medical cover.”

De Vries says you put yourself at risk if you do not find out if your cover will be adequate. This is especially true for those with pre-existing illnesses who may need additional cover.

According to Michelle Kapilevech, an independent travel consultant, you should check with your medical aid exactly what the benefit covers you for. Be aware of any excess fees that might be applicable in case of a claim.

Is this cover enough?

Another consideration should be the value of the currency in the country you are travelling to, says Kapilevech.

“Bearing in mind that we usually travel to countries where the rand is not strong, you need to consider their currency. A travel benefit of R5 million may sound like more than enough, but it does not go far if your bills are in euros or dollars, or if you need complicated surgery or hospitalisation.”

Be realistic in your expectations of a travel benefit and the cost of medical care in the country you are travelling to, especially in the light of the fluctuating exchange rate.

“Therefore, check what is being offered, balance this with the destination you are visiting, and the activities planned – and if necessary, top it up with additional travel insurance,” van Emmenis explains.

When asked if they found the travel benefits built into medical aid sufficient, Kapilevech believed it not adequate enough, while van Emmenis said it was trip-dependent.  

Kapilevech always advises clients to take out comprehensive travel insurance on top of any free insurance you might get from the bank or medical aid.

“This way you are covered for more scenarios than only medical expenses, for instance cancellation and repatriation. Taking out comprehensive travel insurance and activating any free insurances you might qualify for is the best solution for peace of mind,” says Kapilevech.

Van Emmenis recommends that you first consider the type of holiday you are going on and the country you are visiting. 

“Check whether there are any travel warnings or restrictions around the city or country you’re visiting and plan accordingly. Remember all travel insurance has limits so check those before you go,” van Emmenis adds.

Planning a holiday or going on a work trip is exciting, but the notion of being underinsured is not. When planning your next trip, contact your medical aid and enquire about the cover you are eligible for. This way you can make a sound financial decision.

Travel insurance is your safety net. It gives you the confidence that you will be prepared should anything happen.