Your travel itinerary is set, and your overseas vacation will begin soon. You have thought of everything — passport, flight arrangements, hotel bookings. All that is left is to pack your bags. There is one step you may not have considered. Are you prepared for a medical emergency while you are out of the country? What if you are in an accident and can’t speak for yourself?
Even those who are in good health can encounter a medical issue that was previously undiagnosed. Most of us have a regular doctor who is only a phone call away when we are at home. We know who to call in an emergency. Who do you call when you are out of the country? What if you don’t speak the language?
The first step is to create a medical bio to include with your travel itinerary. The bio should include a contact sheet of family and friends to contact in the case of emergency as well as a copy of health insurance information and contact phone numbers. Your bio would list current medical conditions and prescriptions you take regularly. Your health information should include any allergies, blood type, medical devices and a brief medical history. Listing all your immunizations and the dates they were received would complete the bio.
Obtaining medical care overseas generally requires cash or credit card payment at the time of service. You cannot count on providers accepting insurance coverage from your home country. If you are traveling in a country that has nationalized health care services, don’t assume nonresidents will be covered. You may be faced with a large expenditure up front, then get reimbursed by your stateside insurer later. When paying out-of-pocket for care overseas, you should obtain copies of all bills and receipts. If necessary, contact a U.S. consular officer, who can assist U.S. citizens with transferring funds from the United States.
Contact your current medical insurer to determine what coverage is already available to you when you travel overseas. Many U.S. insurers cover overseas medical treatment, but Medicare is not one of them. Pay close attention to any policy exclusions or preauthorization requirements. Here is a partial list of exclusions to watch for:
- The insurer’s policy for “out-of-network” services
- Exclusions for high-risk activities such as skydiving, scuba diving, and mountain climbing
- Exclusions regarding psychiatric emergencies
- Exclusions for injuries related to terrorist attacks, acts of war, or natural disasters
Some people believe their credit card provides travel health insurance. They should review this benefit closely. Most offer travel accident insurance that pays only in the event of accidental death and/or dismemberment while traveling.
The U.S. State Department periodically issues warnings about traveling to at-risk countries. If you’re visiting one of these countries, your medical insurance will likely not be honored, unless you buy supplemental coverage.
Supplemental Travel Health Insurance
You may want to consider buying a special medical travel policy even if your health plan does cover you overseas. Travel health insurance and medical evacuation insurance are both short-term supplemental policies that cover health care costs on a trip and are relatively inexpensive. Overseas hospitals will often work directly with your travel-insurance carrier on billing but not with your regular health insurance company. This is particularly true in emergency situations involving costly procedures or overnight stays. Non-emergency doctor visits will likely be an out-of-pocket expense.
Another advantage of travel health insurance is that they cover many pre-existing conditions depending on when you buy the coverage and how recently you’ve been treated for the condition. In addition to covering costs of treatment or medical evacuation, the travel health insurer can also assist in organizing and coordinating care and keeping relatives informed. This is especially important when the traveler is severely ill or injured and requires medical evacuation.
Even if you have covered the cost of getting medical care, the quality of care may be inadequate. Medical evacuation from a resource-poor area to a hospital where definitive care can be obtained may be necessary. The cost of evacuation can start at $25,000 and exceed $250,0001. Be sure to check the emergency medical transportation benefit on the travel health policy you are considering. The benefit limit can be as high as $500,000 or $1 million, depending on which plan you choose. The Centers for Disease Control & Prevention advises2 all travelers to scrutinize all policies before purchase, looking for those that provide:
- Arrangements with hospitals to guarantee payments directly
- Assistance via a 24-hour physician-backed support center (critical for medical evacuation insurance)
- Emergency medical transport to facilities that are equivalent to those in the home country or to the home country itself (repatriation)
- Any specific medical services that may apply to their circumstances, such as coverage of high-risk activities
A discussion of insurance options is an important part of any pretravel consultation. Particularly for those who plan extended travel outside the United States, have underlying health conditions, participate in high-risk activities, or if the destination is remote and lacks high-quality medical facilities.
Severe illness or injury abroad may result in a financial burden when traveling. Although planning for every possible contingency is impossible, travelers can reduce the cost of a medical emergency by planning ahead. Take the time to create a medical bio to take with you and review your insurance coverages. Buy supplemental coverage if needed.
- Medical insurance may not be honored when traveling in a country identified as at-risk by the U.S. State Department.
- Overseas hospitals often work directly with travel-insurance carriers on billing but not with regular health insurance companies.
- Travel health insurers can also assist in organizing and coordinating care and keeping relatives informed.
1 Five myths about medical evacuations. USA Today. July 6, 2015
2 Centers for Disease Control & Prevention, Chapter 2 – Obtaining Health Care Abroad. By Rhett J. Stoney.