PORTFOLIO DOCTOR And don't assume OHIP will cover all of your medical expenses, say columnists David Cruise and Alison Griffiths

Let's just say, as a dedicated surfer of the world, you happen to leave a leg (or some other body part) behind while hanging ten off the coast of Avatura on the Tuaomotu atoll of Rangiroa. As the shark digests, you wonder if good old OHIP will cough up the necessary dough to cover the many medical costs associated with your new condition.

You already know the answer • not hardly.

OHIP only reimburses what the same medical care would cost in Ontario. However, if you have a credit card, almost any old credit card, you're in luck. Even basic no-fee credit cards offer death and dismemberment insurance • $100,000 is the standard maximum, with up to $500,000 for most fee-based cards.

Of the 100 million odd trips (according to Health Canada) Canadians annually take across the border or abroad, relatively few result in dismemberment. Therefore, of keener concern to voyagers are more common health concerns, ranging from heart attack to contracting of exotic diseases.

There are three major ways travellers can be insured:

With group supplemental health plans at work or with a professional or trade association.

By purchasing individual travel insurance.

Or through credit card benefits.

However, it wouldn't be insurance if there wasn't a minefield of complications.

You simply can't assume, for example, that all credit cards have you, spouse and dependents covered for travel. Most gold and platinum cards do provide out of country insurance for car rental collision or damage from an accident. But if you are injured or sick, it may be a different story.

CIBC Aerogold VISA, at $120 annually, requires you to purchase travel medical insurance as an add-on. On the other hand, if you don't care about acquiring Aeroplan points, the plain Gold card, at $99, provides $500,000 of medical coverage for trips less than 31 days if you are 64 or under.

ScotiaGold Preferred VISA, costing $95 annually, offers $1 million travel medical coverage for those under 65, but the similarly priced American Express Gold ($130) offers it only as a paid, albeit low-cost, addition.

Credit card travel medical coverage also differs widely as to age restrictions, trip durations and payout limits on things like emergency dental, out-of-pocket expenses and emergency trips home.

It is worthwhile to weigh the benefits of insurance included with a credit card versus the annual fee. Generally, cards that offer travel or shopping points and rebates do not bundle in travel insurance as well.

If you only travel once or twice a year but use your credit card a lot and rack up large rewards points in the process, it may be more economical to purchase travel insurance separately.

Also, if most of your travel is using your own car to cross the border, check the credit card fine print. Some plans cover you no matter how you travel; others require the ticket or vacation package to have been charged to your card.

If you are travelling frequently, you may want multi-trip coverage which most cards and individually purchased plans provide. This saves you the bother of re-insuring every time you head off for business or pleasure.

Don't confuse travel or medical assistance with insurance. Assistance is usually an 800 number and an operator providing medical or legal referrals. This is valuable when you are in a medical or legal jam on foreign soil, but it doesn't pay the bills.

Whether you buy or have credit card travel insurance or purchase individual coverage, be aware of exclusions and limitations ready to trip the unwary.

Coverage limits can vary from $500,000 to $2 million • the latter is more common with individually purchased insurance.

This sounds like a large amount, but RBC Insurance, the largest travel insurer in the country, points out that a severe heart attack or car accident in the United States could saddle you with a bill of over half a million dollars.

If you are 60 or older, you may not be able to get coverage without answering a medical questionnaire and paying an additional premium. Most standard travel insurance, such as that which you purchase through a bank or travel agency, only covers those up to age 60 without a medical questionnaire and additional premium.

Some plans, like Canada Protection Plan, charge no deductible for those under 55 and a $200 (U.S.) deductible for older travellers. The age-limit is usually higher for credit card travel insurance benefits.

Moms-to-be are on most exclusion lists if travelling within nine weeks of the happy day. Adventurers should also take extra care. Scuba lessons in Bonaire might not be excluded but if you are injured bungee jumping off the White Cliffs of Dover you could be on your own.

One of the biggest pitfalls in travel insurance relates to pre-existing medical problems. The precise language differs from company to company, but stable is the important word.

A condition, including a mental or behaviour disorder, has to be stable (depending on the company it ranges from 90 days to over 180) in order to ensure coverage of medical costs that could be interpreted as related to that problem.

As with all insurance, the devil truly is in the details. A person suffering from epilepsy may not have had a seizure for six months, but if she or he has recently had even a slight change in medication, that change could constitute an unstable condition.

Before you set out on your trip, get your shots, check your medication supply, carefully read the policy's exclusion, limit and trip duration fine print, keep the insurer's 800 assistance number handy and, if you do need medical care, get originals of everything and complete treatment records to ensure your reimbursement is prompt.

Regardless of how or where you buy it, travel medical protection is an essential if you don't want to be left uninsured on some far off beach while a shark enjoys part of you as a snack.

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The Portfolio Doctor appears Sunday. Send your portfolio, comments or questions to The Portfolio Doctor, Business, The Toronto Star, One Yonge St., Toronto, M5E 1E6; email theportfoliodoc@yahoo.ca; Web at http://www.portfoliodoctor.ca.

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