Policy Maximum (Travel)
The policy maximum is the highest amount your travel medical insurance plan will pay for all eligible emergency medical expenses during a covered trip. This limit represents the maximum liability the insurer assumes and typically ranges from $1 million to $5 million per person, depending on the plan.
How It Works
The policy maximum is the highest amount a travel medical insurance plan will pay for all eligible emergency medical expenses during a covered trip, representing the maximum liability the insurer assumes. Once the policy maximum is reached, any additional emergency medical expenses become the traveller's own responsibility. Travel health insurance maximums can vary from a few thousand dollars to unlimited coverage for hospital and medical expenses, and some policies cover only a certain percentage of costs. There may also be maximums related to age, meaning the policy maximum or sub-limits can differ depending on the traveller's age.
Travel health insurance plans cover emergency care only. Routine or elective treatment that could have been received in Canada or deferred until your return is usually not covered, so it does not draw against the policy maximum. Within a Canadian travel plan, the overall emergency medical maximum is stated per person and applies on top of smaller sub-limits for specific services such as private nursing, emergency dental due to an accidental blow to the mouth, and emergency relief of dental pain. Canadian travel policies express the emergency medical maximum on a per-person, per-claim basis and may also cap it at a lifetime maximum per person.
Example:
A Manitoba resident on a winter trip buys an emergency travel health plan with a per-person, per-claim emergency medical maximum. If they are hospitalized abroad, the plan pays eligible hospital, physician, and ambulance costs up to that maximum, while smaller sub-limits apply to items like emergency dental from an accidental blow to the mouth and emergency relief of dental pain. Because the plan covers only sudden emergencies, any routine care they could have deferred until returning to Canada is not paid and does not count against the maximum.
What to Watch For:
Failing to contact the insurer's assistance service before treatment can reduce the maximum benefit payable. Under one Canadian plan, the benefit is cut to 80% of covered medical expenses up to a capped maximum, with the traveller responsible for the rest. Because maximums and sub-limits can differ by age, confirm which limits apply to your situation before you travel. If you are covered through a government plan, note that Government of Canada out-of-province emergency travel medical coverage supplements the provincial or territorial plan in the traveller's province of residence, with eligible expenses outside Canada based on the member's province or territory of residence.
