If you’re a frequent traveler, you’ve probably heard some variation of the following horror story: an American is traveling in a remote landscape when he breaks his leg and needs to be airlifted to a hospital for treatment.
The bone heals without incident. The traveler, however, is stuck with an evacuation bill in the six figures. If only he had purchased the right insurance.
But you don’t need to be heading deep into the wild to benefit from travel health insurance; there are far less dramatic ways that medical bills can stack up while you’re on the road. (Yes, even in countries with nationalized health care.) As with any kind of insurance, what you buy ultimately comes down to how risk-averse you are. But it also depends on what kind of coverage you already have, where you are traveling, and how you are traveling. Here’s what to keep in mind.
Find out if you’re covered.
Your domestic health insurance may automatically offer you some international coverage. Many of the standard plans from big insurance providers, including Aetna, Cigna, and Blue Cross and Blue Shield companies, include provisions for emergency and urgent care abroad. One notable exception is Medicare, which does not cover any medical costs incurred outside the United States. For that you’ll need to buy some sort of MediGap plan (see medicare.gov for options).
Even if your plan does cover emergency care overseas, be aware that your definition of an emergency may differ from that of your insurer. A bothersome rash or a toothache might put a crimp in your travels, but may not qualify as a medical condition that necessitates treatment, according to your insurer. Some managed-care plans also require you to get authorization prior to treatment. Read your policy carefully.
Get additional support.
If you have any concerns about the quality of the medical system in your destination, you may want to buy a travel health policy, for both the additional coverage and the roadside assistance most of these plans provide. “The level of care you receive from specialized travel insurance is completely different from what you’d get with your regular provider,” says Jim Grace, president and CEO of the insurance comparison website InsureMyTrip. Travel health plans usually offer 24-hour nurse-staffed help lines; referrals for prescreened doctors around the world; prescription medication assistance; and even translation services. (Note: some premium credit cards, such as the American Express Platinum, offer similar services, but don’t include health insurance.) You can buy a stand-alone policy for as little as $10 from companies such as Frontier Medex or bundle it with coverage for trip cancellation and interruption from insurers such as Allianz or Travel Guard. (See InsureMyTrip for options.)
These plans can also be more generous with their coverage than primary health insurers, offering reimbursements for emergency dental care, prescription refills, and treatment for ailments that are not potentially life-threatening. Be mindful of exclusions for preexisting conditions, though. You can often get them waived if you purchase insurance within a few weeks of putting down a deposit on your trip.
Develop an exit strategy.
One of the major gaps in coverage from employersponsored plans is medical evacuations—the dreaded “airlift” scenario that can leave you deep in debt. None of the big managed-care companies cover such transportation costs; many travel policies do, though the benefit levels vary widely. The most basic coverage (also offered by some premium credit cards) will evacuate you to the nearest “suitable” or “appropriate” hospital, according to the discretion of the attending physician or insurer. At the highest level are services from special medevac companies such as MedjetAssist and On Call International that let you determine which hospital is best—even if it means chartering a medically equipped plane back to the States. These membership-based companies also provide medical referrals and other travel assistance, though they don’t offer insurance and are not responsible for any medical bills. For almost all plans, you’ll need prior approval for any transportation arrangements.
Assess the risks.
Most policies have exclusions for injuries sustained while scuba diving, parasailing, or bungee-jumping. If you’re planning an adventurous trip, look for a plan with an adventure-sports rider. And by all means, don’t hurt yourself while under the influence of alcohol. If that happens, you’re on your own.