Do you need travel insurance to visit another province?

Your provincial health card works in the rest of Canada, but it pays for only part of what a medical emergency costs. It covers medically necessary doctor and hospital care. It doesn't cover an ambulance, it doesn't cover prescription drugs, and in some cases you pay the doctor on the spot and claim the money back later. It also never covers a cancelled trip or the ride home. So yes, you want some travel insurance for a ski weekend in Alberta or a family visit in Nova Scotia, and you may already have it.

What your health card pays for in another province

Each province runs its own health plan, and the plans have agreements with each other so you don't need a new card when you cross a border. Ontario's health ministry says that when you show your Ontario health card elsewhere in Canada, you're covered for physician services, such as a visit to a walk-in clinic, and for services in a public hospital, such as emergency, diagnostic or lab care. The care has to be medically necessary.

Alberta works the same way. It has reciprocal agreements with every other province and territory for hospital services, and in most cases the hospital's bill goes straight to the Alberta Health Care Insurance Plan. If you turn up at a public hospital with a broken wrist, you generally won't see an invoice for the hospital's part.

Where the bills are

Ontario, BC, Alberta and Québec leave the same gaps, and their own health plans point you toward extra cover.

Ambulance. Ontario lists ambulance services, including transport and paramedic care, as not covered in other provinces. British Columbia says it doesn't subsidize ambulance services outside BC. Québec's health insurer, the RAMQ, lists emergency transportation by ground or air as not covered outside Québec. Alberta puts it plainly: emergency medical care and transportation can be expensive.

Prescription drugs. Ontario doesn't cover prescription drugs given outside a hospital. BC's PharmaCare doesn't cover prescriptions or medical supplies bought outside BC. The RAMQ says drugs bought outside Québec aren't covered even when a doctor prescribed them. Pack your medication before you go, with a few extra days' worth in case you're delayed.

Doctors who want to be paid first. In most provinces the doctor bills your own plan if you show your card. Québec is the one to watch. BC's page says that in Québec you may be asked to pay for physician services and claim the money back from BC's Medical Services Plan, and Alberta says the same: see a doctor in Québec and you may have to pay up front. Ontario goes further and warns that a doctor can charge you even when you show your card, and that you can send a claim to the Ontario Health Insurance Plan within 12 months of the visit. You're paid back at your own province's rates, not the doctor's, so any difference stays with you. That works the other way too: the RAMQ reimburses Québec residents at Québec rates even if they paid more.

At a private clinic, Alberta says you pay any physician cost above what its plan covers, plus facility fees.

Getting home and everything around the medical bill. Alberta's plan doesn't cover food, travel, accommodation or other costs of getting health care outside Alberta. The RAMQ lists the cost of bringing a person back to Québec as not covered, along with a private hospital room. A health card pays for health care, not trips, so a flight or hotel you cancel because you or a relative got sick isn't covered.

Check what you already have

Before you buy anything, check your credit card and your job, which often include travel medical cover. The Government of Canada's travel insurance page, written for trips abroad, lists where Canadians usually get a policy: straight from an insurer, through a travel agent or broker, from an employer's insurance provider, or through a credit card company or a bank.

• Your credit card. Find the benefits guide for your card, or call the number on the back, and ask four things. Does the emergency medical cover apply to a trip inside Canada, and not only outside it? Do you have to pay for the trip with that card? How long can the trip be? And does it cover cancellation and delay as well as medical care? If you're shopping for a new card, Canooq's credit card roundup is a place to start.
• Your employer plan. Open the benefits booklet, or ask your HR contact whether the plan includes out-of-province emergency medical cover, and whether your spouse and children are on it.

Write down the policy number and the claims phone line before you leave, and keep your health card in your wallet, not in the hotel safe.

If you have neither

Buy a travel medical plan. If you take several trips a year, price an annual plan against single-trip policies: one purchase covers every trip up to a set length for twelve months. The OmbudService for Life & Health Insurance, an independent body the RAMQ points people to for information on private insurance, can explain what a policy should include. When you compare quotes, look for emergency ground and air ambulance, prescription drugs, return home, and trip cancellation if you're paying for flights and a hotel you can't get refunded.

Whatever you buy, read the pre-existing conditions section. The federal government's travel advice is to get a written agreement on how your existing conditions are treated, because a claim can be voided under a pre-existing condition clause.

Booking the trip

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An airline delay or cancellation is a separate protection from insurance, and Canooq's guide to flight delay compensation shows when the airline owes you money whatever policy you hold. For a ski trip, the list of the best ski resorts in Canada is where to pick the mountain, and if you're driving, the scenic drives guide has route ideas. Tell the family who stays home which policy you hold and where its number is.