Travel Health
Travel Insurance for Canadians in the USA — 2026
Why your provincial health card pays almost nothing in America — what to buy instead, how much it costs, and the critical pre-existing conditions stability clause you must understand.
Your Provincial Health Card Is Virtually Useless in the USA: Ontario OHIP, BC MSP, Alberta AHCIP and other provincial plans pay little to nothing for US medical costs. Ontario OHIP will pay a maximum of about $400 per day for a US hospital stay — the actual cost can be $5,000–$20,000 per day. This leaves you responsible for thousands of dollars in unpaid bills. Emergency travel medical insurance is essential.
What Does Your Provincial Plan Actually Pay in the USA?
Many Canadians are shocked to discover that their provincial health cards provide only token coverage — if any — in the United States. Here is the reality province by province:
| Province | Out-of-Country Coverage | Effective US Coverage |
|---|---|---|
| Ontario (OHIP) | $400/day for emergency inpatient hospital; $50/day for emergency outpatient; limited ER coverage | Essentially zero — a US hospital day costs $5,000–$20,000. The $400/day OHIP rate leaves you with massive out-of-pocket costs. |
| BC (MSP) | No out-of-country coverage since 2020. BC eliminated out-of-province emergency coverage entirely. | Zero coverage in the USA. BC residents must have private travel insurance. |
| Alberta (AHCIP) | Emergency services coverage at rates Alberta would pay in Alberta, not US prices | Minimal — AHCIP pays what Alberta doctors/hospitals would charge, which is tiny compared to US rates. |
| Quebec (RAMQ) | Limited emergency medical costs abroad — pays at Quebec tariff rates, which are far below US costs | Minimal coverage in the USA. Private insurance strongly recommended. |
Types of Travel Insurance Coverage Explained
- Emergency Medical Insurance (Most Critical): Covers emergency room visits, hospitalization, surgery, diagnostic imaging, ambulance, and prescription drugs needed due to an unexpected illness or injury during your trip. This is the most important coverage for US trips. Look for at least $1,000,000 USD in emergency medical coverage — most serious medical events in the US can exhaust $500,000 coverage limits.
- Medical Evacuation / Repatriation: Covers the cost of air ambulance transport back to Canada for continuing care, or repatriation of remains if you die abroad. An air ambulance from Miami to Toronto can cost $30,000–$80,000 — this benefit is critical. Most emergency medical plans include evacuation coverage, but verify the limit explicitly.
- Trip Cancellation Insurance: Refunds your prepaid, non-refundable trip costs (flights, hotels, tours) if you must cancel your trip before departure for a covered reason. Covered reasons typically include: your own serious illness or injury, death of a close family member, government travel advisories, job loss, or visa refusal. NOT covered: changing your mind, minor illness, work conflicts.
- Trip Interruption Insurance: Covers additional costs (one-way airfare, hotel, meals) to return home early due to a medical emergency, family death, or other covered event occurring after your trip began. Usually bundled with trip cancellation insurance.
- Accidental Death & Dismemberment (AD&D): Pays a lump sum benefit if you die or suffer permanent disability (e.g., loss of a limb, eyesight) as a direct result of an accident during your trip. This is separate from life insurance.
- Baggage and Personal Effects: Reimburses you for lost, stolen, or damaged baggage and personal items. Most comprehensive plans include $1,000–$3,000 in baggage coverage. Note: many Canadian credit cards (especially Platinum and Visa Infinite cards) already include some baggage protection if you purchased the trip with that card.
Pre-Existing Conditions — The Stability Clause Explained
The most common reason travel insurance claims are denied is a pre-existing condition exclusion. Almost all standard travel medical plans exclude coverage for conditions that were "not stable" before your departure. You must understand what "stable" means:
Standard Stability Definition: A condition is "stable" if, in the period before your departure (typically 90 or 180 days depending on your plan), there has been: no new diagnosis, no change in medication (dosage or type), no new or worsening symptoms, no hospitalization, no referral to a specialist, and no pending test results for that condition.
- Example of an Unstable Condition: You have Type 2 diabetes and your doctor increased your metformin dose 2 months ago. Even though you feel fine and your diabetes is "managed," the dosage change means your condition was NOT stable under most insurance definitions. If you have a diabetes-related complication in the US, your claim could be denied.
- Stability Periods Vary: Standard plans: 90–180 days stability required before departure. Plans for travellers over 60 or 65: often 90 days. Senior-focused plans with pre-existing condition coverage: may accept 30-day stability. "Top cover" or "all-inclusive" plans: may include pre-existing conditions without a stability requirement for an additional premium.
- How to Protect Yourself: (1) Always disclose all medical conditions when buying travel insurance — never conceal anything. (2) Compare plans specifically looking at the stability clause duration. (3) For complex medical histories, buy a plan with a longer stability period or one that explicitly covers your conditions. (4) Call the insurer and ask whether your specific conditions and medications qualify under their stability definition.
2026 Approximate Travel Insurance Premiums for US Trips
| Profile | 7-Day US Trip | 14-Day US Trip | 30-Day US Trip | Annual Plan (Multi-Trip) |
|---|---|---|---|---|
| Age 30, no pre-existing conditions | $25–$60 | $45–$100 | $80–$150 | $200–$350/year |
| Age 45, no pre-existing conditions | $35–$80 | $60–$130 | $110–$220 | $280–$450/year |
| Age 55, stable pre-existing conditions | $60–$150 | $100–$250 | $200–$400 | $450–$750/year |
| Age 65, stable pre-existing conditions | $120–$300 | $200–$500 | $400–$900 | $900–$1,500/year |
| Age 75, stable pre-existing conditions | $250–$600 | $450–$1,000 | $800–$2,000 | Often unavailable or very expensive |
Premiums are estimates based on $1 million USD emergency medical coverage, $500–$1,000 deductible, and standard stability clause. Prices vary significantly between insurers — always compare at least 3 quotes. Annual multi-trip plans are usually the best value if you travel to the US more than 2–3 times per year.
Key Checklist When Buying US Travel Insurance
- ✅ Coverage limit: At least $1,000,000 USD in emergency medical coverage (not CAD)
- ✅ Evacuation: Confirm medical evacuation/repatriation is included
- ✅ Stability clause: Match the stability period to your medical history
- ✅ 24/7 emergency assistance: Insurer must have a 24/7 phone line to coordinate care in the US
- ✅ Direct billing: Can the insurer pay the US hospital directly? (Avoids you paying upfront and claiming reimbursement later)
- ✅ Duration: Policy must cover your entire trip, including return travel
- ✅ Activity coverage: If you're skiing, hiking, or doing adventure sports, confirm these are covered (many plans exclude extreme sports)
Official Government References & Sources
• Government of Canada — Travel and Health Insurance Guidance: travel.gc.ca/health-insurance-guidance
• Ontario OHIP — Out-of-Country Coverage (official): ontario.ca/ohip-outside-canada
• BC — MSP Out-of-Country Benefits (eliminated 2020): gov.bc.ca/msp-out-of-country
• FSRA (Ontario) — Travel Insurance Guide for Consumers: fsrao.ca/travel-insurance-guide
Travel Insurance Must-Knows
Ontario OHIP US Coverage~$400/day only
BC MSP US Coverage$0 (Zero)
Min Recommended Coverage$1M USD
US Hospital/Day (average)$5,000–$20,000
US Air Ambulance (to Canada)$30K–$80K
Stability Clause (typical)90–180 Days
Annual Multi-Trip (Age 45)$280–$450/year