Snowbird travel insurance and what your province really pays in a US hospital

Your provincial health plan pays only a small fixed amount toward a US hospital stay, so a Canadian snowbird needs private travel medical insurance for the whole winter. As of October 2026, Ontario pays up to C$400 a day for intensive or operating-room care and C$200 a day for other inpatient care, Alberta C$100 a day and British Columbia C$75 a day, against US bills that run into the thousands. Stay away too long and you can lose the provincial plan itself, so count your days before you count your policy.

What your province actually pays for US hospital care

A fixed daily amount in Canadian dollars, paid back to you after you have paid the hospital. The three largest English-speaking provinces publish their rates, and every one of them tells you to buy private insurance as well.

Ontario’s out-of-country page sets C$400 a day for care in an operating room, coronary or intensive care unit, or neonatal or paediatric special care unit, C$200 a day for lower levels of inpatient care, and up to C$50 a day for outpatient emergency care. Doctors are paid at the lesser of the US bill or the Ontario fee schedule. Ontario also says OHIP does not pay to move you to an Ontario hospital, which is why it tells travellers to buy insurance that includes transport home.

Alberta pays C$100 a day for inpatient care, not counting the day you are discharged, and C$50 a day for outpatient care, one visit a day. British Columbia pays C$75 a day for emergency inpatient care. Alberta and BC both reimburse doctors at no more than their own provincial rates, and you owe the difference.

How long you can stay away and keep provincial coverage

It depends on your province, and the rule you break is not the US one but your own. Overstay and you may have to reapply, or serve a waiting period when you come home, which leaves you uninsured in Canada as well.

The detail matters. Ontario’s OHIP page says that if you have been outside the province for more than 212 days in any 12-month period, you may have to reapply at a ServiceOntario centre. Its separate travel page says that if you plan to be outside Canada for more than seven months in any 12-month period, you can keep coverage for up to two years, provided Ontario is your primary home and you were in the province at least 153 days in each of the two 12-month periods before leaving.

Alberta’s rule is written as consecutive months: you keep coverage while outside Canada for less than six consecutive months, and the snowbird provision may stretch that to 212 days in a 12-month period if you contact AHCIP before leaving. British Columbia counts by calendar year, which helps a November-to-April snowbird whose winter straddles two years, and BC asks anyone away six months or more in a calendar year to contact Health Insurance BC to confirm they are still eligible. For any other province or territory, read your own plan’s rules before you book the return flight; we have not covered them here.

The US side, six months and the tax-day count

Canadian visitors can usually stay six months without a visa, but the IRS counts your days on its own formula. Travel.gc.ca says Canadians can usually stay in the United States for six months, must apply to USCIS before that runs out to stay longer, and that visitors staying more than 30 days must be registered with the US government. It suggests checking your I-94 record on the CBP website to see whether entry registered you automatically.

The IRS substantial presence test is separate from your visitor status. You meet it if you spent at least 31 days in the US this year and at least 183 days across three years, counting all of this year’s days, a third of last year’s and a sixth of the year before.

That arithmetic is ours, from the IRS formula: 122 days a year gives 122 + 40.67 + 20.33, or exactly 183. A snowbird who meets the test can still be treated as a non-resident under the closer connection exception if they were in the US fewer than 183 days this year, kept a tax home in Canada all year, had a closer connection to Canada and have not applied for a green card. The IRS says you must file Form 8840 to claim it, by the due date of the US return, and that a late filer generally cannot claim the exception. This is the IRS’s summary, not tax advice; a cross-border accountant can look at your own days.

Pre-existing conditions and the stability clause

A stability clause covers a condition only if nothing about it changed for a set period before you left, and that period is defined by your policy, not by you. The federal travel insurance page puts it plainly: you are covered only if there are no changes to your condition and no new conditions, symptoms or medications during the stability period before your trip.

In practice that catches people who do the sensible thing in September: a new prescription, a dose change, a test for a new symptom. The same page tells you to get a written agreement that your insurance covers your pre-existing condition, and to look for a compassion clause saying an inaccurate statement may not invalidate the whole policy. It also says the information you give must be accurate and complete. If you fill in a medical questionnaire, answer it from your records, not your memory.

Our explainer on declaring pre-existing conditions goes through what declaring really means, and travel insurance for seniors covers the age bands where premiums and questionnaires change.

What to check before you leave this autumn

Five checks, done in October, decide most snowbird claims.

1. Count your days away. Use your province’s rule and your actual travel dates, including any trips outside Canada earlier in the year.
2. Match the policy to the whole stay. The federal page tells you to ask whether a plan gives continuous coverage for the length of your stay and whether it is renewable from abroad for the maximum period. A credit card’s built-in cover often stops after a set number of days; see what card insurance leaves out.
3. Get the condition agreement in writing. Stability period, declared conditions, deductible.
4. Check transport home. Ontario tells you directly that OHIP will not pay to move you back; your policy should.
5. Know the claim route. You pay, then claim from both the insurer and the province. Keep itemised bills and receipts; Ontario asks for originals.

Travel.gc.ca also warns that travel insurance is not meant for people living outside Canada for an extended period or permanently. If your winters keep getting longer, confirm with the insurer that your stay is still a trip.

Our verdict

Buy a policy that covers every day you are away, with any condition agreed in writing, and treat the provincial payment as a small rebate on the bill. Then count your days twice, once against your province’s rule and once against the IRS formula. The insurance question is the expensive one if it goes wrong, but the day count is the one that quietly costs you coverage at home.

Keep reading

Sources: Government of Ontario, “OHIP coverage while outside Canada” (updated 16 January 2026) and “Apply for OHIP and get a health card” (updated 21 July 2025); Government of Alberta, “Health care coverage outside Canada” and “Leaving Alberta affects coverage”; Government of British Columbia, “Leaving B.C. temporarily” (updated 27 February 2026); Government of Canada, travel.gc.ca “Trip interruption and travel health insurance” (modified 2 September 2026) and United States travel advice (updated 8 October 2026); IRS, “Substantial presence test” (reviewed 14 March 2026) and “Closer connection exception to the substantial presence test” (reviewed 16 July 2026). All read 9 October 2026. Day-count examples are our arithmetic from the IRS formula. This is general information, not insurance or tax advice; your policy wording and your province decide.