Time to Buy Travel Insurance?

Nita Haas, a travel consultant in Westmont, Ill., recently booked a trip to Russia for one of her clients. Right before the final payment was made, Haas suggested that the young woman purchase travel insurance. Although the client initially declined, she was finally persuaded and bought coverage from insurance provider Travel Guard. The purchase added about $100 to her total, but it was money well spent: After the woman arrived in Russia, her appendix burst, says Haas. “She spent more than two weeks in a Russian hospital. The insurance company covered her care, acted as a liaison with the hospital and ultimately flew her and her sister home business-class so she’d have room to stretch out, because she was still quite ill.”

Simply carrying health insurance is not a guarantee of quality care when traveling. Even those with otherwise excellent insurance may not be covered when they travel overseas, or may have limited coverage and high deductibles. Medicare, for instance, does not cover medical expenses outside U.S. borders, and some insurance policies specifically exclude injuries sustained while traveling.

The need for speed—and care

If someone gets hurt or sick while overseas, she is typically required to pay for medical services before being treated, says Paul Swart, president of Natural Migrations, a Bend, Ore.–based luxury tour operator. Those services can be very expensive, and the person’s tab goes up if she needs to be flown back home for additional care. “Hospitals won’t treat you unless you have insurance or pay [in advance of treatment],” says Swart. “We’ve had people who had to be repatriated to the U.S. and had to book a nurse to travel back with them and two business-class seats. Most people end up having to provide a credit card and spending thousands of dollars.”

And that’s if they can even get care when they need it. In some countries, where socialized medicine is the norm, it’s not uncommon for a patient to wait up to 12 hours to be seen. Private physicians and hospitals are available—for a significant premium.

But there is a solution: travel medical insurance, which will, after you pay a deductible, cover all your medical bills in the case of a travel emergency. Companies such as Travel Guard, USA Assist and Travelex Insurance Services provide such coverage.

Just because you purchased travel insurance doesn’t mean you’re going to get the best care possible, though. For that level of care, experts say, you may need to fly to a hospital in your hometown or to a top hospital elsewhere in the U.S. This is where medical evacuation insurance comes in. There are more than 30 companies listed on the U.S. Department of State’s Web site, such as Medjet Assist, Travel Guard, On Call International and Global Rescue, that will transport travelers to any hospital or facility they request, often with a doctor or nurse in tow.

Both types of services are available for domestic and international travel, and they can be purchased on a per-trip or an annual basis. You can buy the policies directly from your travel provider—airlines, hotels and tour operators make such insurance available—as well from your insurance broker, or you can buy online directly from the provider. Pricing varies based on where you’re traveling, how old you are and how long you plan to be away. Typically, per-trip policies run between 4 and 8 percent of your total trip cost.

Protection and pampering

Medical travel insurance goes beyond footing the bills. It provides services that are crucial to many travelers, especially when you’re traveling to a country that doesn’t use English as its main language, explains Matt Tassey, the former chairman of the Life and Health Insurance Foundation for Education (LIFE), a nonprofit insurance industry group.

“Oftentimes, insurance companies can provide an interpreter and someone who can help you make medical decisions based on what they discuss with your medical personnel,” Tassey says. This is why it’s important, when buying coverage, to make sure the company you choose has more than one office and provides 24/7 support. “If you’re sick, and it is afternoon in Rangoon [Yangon], you don’t want to call San Diego and get a recording asking you to call back in the morning,” says Tassey. Haas adds that you may also want to check in advance of your trip to find out if the company will contact your family or friends if you are incapacitated.

In addition, find out before traveling if the insurance company outsources services to one specific medical assistance firm or if it uses several (often depending on the day, time or location). “You want to get the best care possible, and that only comes if you’ve got a company working for you that knows the customs and language,” says Dr. Myles Druckman, vice president of medical services for International SOS, a medical assistance and healthcare provider with doctors in 70 countries. “The company your insurer uses should be able to send you to the hospital with an English-language department and help you avoid the hospital it knows closed its ER doors for renovations,” he says. “It should be a known entity wherever you’re going.”

Once you’ve narrowed down your provider to a couple of similar choices, you may want to make your final selection based on additional amenities. Some insurance offerings include nonmedical perks, such as concierge services or business assistance. If you need to entertain a client, the service might help you with event ticketing, restaurant reservations and tee times. Some can also handle requests, such as printing and conference calling, and may include traditional travel insurance that will enable you to be reimbursed if you lose your luggage or have to cancel your trip, which saves your having to purchase that type of coverage separately.

Reading the fine print

Keep in mind that insurance can be voided, depending on the individual situation. As with traditional insurance policies, there are limitations that may render your purchase worthless. For example, unlike traditional insurance, travel insurance is usually purchased for a specific time frame for use in a specific locale. This means that if you buy insurance for a trip to Morocco but take a side trip to Egypt, you may not necessarily be covered if you get sick near the pyramids—especially if you’re doing any sort of adventuring. “If you’re skydiving or mountaineering or doing some sort of extreme sport, those activities are often listed as policy exclusions,” says Druckman. Then there are the preexisting condition exclusions: If you are on heart medication and you change your prescription within a certain period of time before you fly, you may not be covered if you have a stroke, says Haas.

You can also fall out of coverage should your trip be unexpectedly extended, Says Tassey. “If you’re not buying an annual policy, make sure you extend your trip [coverage]. Always add two or three days on both sides.”

Finally, says Tassey, be aware that what you do while traveling can impact your coverage. If you’re breaking the law when you break a bone, you’ll be the one who pays for it to be set, he says.

“It’s not necessarily something that you’d be arrested for,” he says. “But even if you’re picking a mango in a restricted area and get hurt, the company may invoke a waiver, leaving you with the costs.”

KAREN J. BANNAN is a writer who, while traveling on personal business, once needed a CAT scan and wished she opted for the insurance coverage.