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TravelInsuranceFile: The definitive, online consumer’s guide to out-of-country health insurance for the traveler -in plain language, without the fine print, what you need to know before you buy.

Who Needs Travel Insurance? Everyone who leaves the country for even a day.
Having none can ruin you. So can having the wrong kind.

Milan Korcok, veteran medical journalist and lecturer is a recognized authority on international healthcare and travel insurance. Chief North American correspondent for the International Travel Insurance Journal (ITIJ), a long-time contributor to the Canadian Medical Association Journal, and author and publisher of consumer travel guides, Milan is a dual Canadian/U.S. citizen who has been covering the evolution of health insurance systems.

Air Ambulance Plans: Good Supplements to Insurance: Not Substitutes

As essential as comprehensive travel health insurance is in planning any trip—short or long–don’t overlook air ambulance assistance plans as possible supplements to basic coverage.

Most Canadian out-of-country travel insurance will provide air repatriation to a hospital at home, if necessary, as part of their benefit package. Many American plans, unless they specify repatriation (not just evacuation), will only transport you to the closest available hospital, whether it’s close to your home or not. Dedicated air ambulance assistance plans—which you can buy for short single trips, long-term or even expatriate travel–at rates starting from $200 to $400 annually for a family, can bring you home, not just drop you at a foreign hospital and leave you there. And that’s a benefit you need to have to consider yourself properly insured.


Will Klein, president of Scottsdale, Arizona-based SkyMed, which offers single trip or annual air ambulance repatriation plans, says that even among Canadians, who have  comprehensive out-of-country travel health insurance, there are people whose claims for emergency treatment and repatriation  are denied because of pre-existing conditions or other “nuances” in their policy coverages.  This leaves them facing the problem of getting themselves home on their own, or remaining in a U.S. hospital at several thousand dollars a day.

“For as little as $1 a day (on an annual membership) they can gain SkyMed services”, says Klein. “Why would anybody in their right mind not consider that a worthwhile investment?”

The fact is that if you encounter a medical emergency you first need to be treated and stabilized in a hospital and for that you either need insurance or you will have to pay. That’s why an air ambulance plan by itself is not total protection. But if you have an air ambulance plan you can be repatriated to a hospital at home as soon as you are stable and your attending doctor clears you for travel. That can usually be done quickly and safely as the modern air ambulance is a highly sophisticated unit—capable of carrying very ill patients very long distances.

Making arrangements for air ambulance transport, getting a hospital bed at home, and making sure you can be safely transported, is a job for professionals.  You can’t do that alone. Air ambulances are also very expensive: from $15,000 for a flight from a sunbelt location in the U.S. to a city in Canada, or $75,000 from central Europe back to North America.

With an air ambulance assistance plan, you will be guaranteed a flight back to a hospital in your home community or wherever else you choose to go, so long as your emergency warrants this level of transport. But don’t consider this a free flight home. If all you have is a sprained wrist or you don’t require continuing inpatient hospital care, you’re not going to be flown home in an air ambulance costing several thousand dollars an hour to operate. But even if you have lesser needs, most air ambulance services will assist you if you need a medical assistant or paramedic to accompany you, or if other arrangements are necessary to get you home safely.  This is especially important now that most airlines no longer provide medical stretcher services. In any case, you need to read the fine print and clearly understand what the guarantee of repatriation means and what its limitations are.

Many large corporations too are signing on with air ambulance assistance firms to cover their far flung employees in these dangerous times. But don’t make the mistake of thinking of air ambulances as substitutes for full-service travel insurance.   They are supplements to travel health insurance, not substitutes for it. Consider them. Weigh their merits. And above all, read the fine print.

Credit Cards Are No Substitute for Travel Medical Insurance

Don’t count on credit cards to cover your medical expenses while traveling abroad: not unless you have supplemental health insurance specifically written into your policy.

The days of automatic travel health coverage by even the most basic credit cards are long over. Now, only the higher end cards, mostly those with annual fees offer medical benefits as part of their travel insurance, although most will offer optional medical and evacuation or repatriation benefits from established travel insurers for an additional fee.

The bottom line is that you cannot take for granted that your credit card will pay your medical expenses in case of accident or illness abroad. You must have such assurance in writing and you must know what you have and what you need to have.  And don’t accept “emergency or medical assistance” as a substitute. Such services only help you get emergency services. They don’t pay the bills.

Following are some tips and guidelines we suggest you follow.

Know the benefits and limits of any travel insurance you buy. Don’t count on the word of a travel agent or tour operator who says “You’re fully covered, don’t worry about it.”

Make sure you qualify? Many credit card companies limit their coverage to younger and middle age groups.  If you’re over 55, or a snowbird, make sure your age group is covered.

Be aware of pre-existing conditions exclusions. Many basic credit card plans do not cover pre-existing conditions. So if you have any kind of medical history, or if have been treated, or taken any medications, or been investigated for any symptoms or conditions in the past year or less (some policies will even go back farther than year) tell your insurer and make sure you know what is covered and what is not.  Fortunately, most full service travel insurers can offer you underwritten coverage based on your health status. But you’ll have to answer health questions candidly, accurately and fully. What About Those In Less Than Perfect Health?

Plan your time of travel. As a rule, credit card travel plans only cover you for a limited time, say 15 or 30 days, though some may go a little longer. And many will not extend that time, especially if you have some pre-existing conditions.
 

Here it gets tricky, as some will not allow you to “top up” or extend your coverage beyond their stated limits with any other insurer. So if you are in the Bahamas, and you decide to stay beyond your allotted 15 days and you call your credit card company to get an extension, you may be denied.

Combining your short-term credit coverage days with longer term stand-alone travel insurance can be tricky. I know of many frequent travelers such as snowbirds leaving the country for up to six months who try to save money by using their credit cards to cover their first 15 or 30 days. It doesn’t always work, and you better know that ahead of time. For example, if you come down with an illness on the 28th day of your first 30 day plan, you not only run out of benefits after that, but your illness becomes a pre-existing condition for your add-on plan and you can be disqualified from coverage. That happens more than you think. The best way to go?  Leave your credit card for purchases, and take a stand-alone, dedicated travel health insurance plan from one of the established travel insurance companies to cover you from day one of your trip. It’s easier, safer, and you’ll probably end up with far more comprehensive coverage.

What is adequate medical coverage for international travel? Whether it’s a guided tour, independent travel, a cruise trip, or a weekend jaunt across the border, you need the following:

  • At least $1 million in medical emergency coverage. And be sure you understand what is covered, what is left for you to cover, and what your responsibilities are in case of emergency.  Many insurers require you to call your assistance service within 24 hours of an emergency. Remember also this is not a blank check for you to spend as you wish.  Your insurer’s representative will determine what is medically necessary and will very likely fly you home by air ambulance rather than let you soak up $1 million in hospital services. But you need it anyway. Nowhere in the world is top quality medical care cheap, and that is the only kind of care you want.
  • Repatriation to a hospital close to your home if medically-necessary. Evacuation to the most appropriate hospital chosen by your insurer is not good enough. You need to get home an air ambulances are not cheap.
  • Direct payment of hospital and medical bills by your insurer. You don’t want to be stuck with a $50,000 hospital charge on your credit card—if you’re lucky enough to have one that goes that high.
  • 24/7 access to an emergency assistance service that can help you get the services you need and will monitor and consult with the medical professionals caring for you.
  • Where do you find these plans?
    In the United States visit the Full Members section on www.USTIA.com (the website for the U.S. Travel Insurance Association). In Canada visit the Members Section of www.thiaonline.com, home of the Travel Health Insurance Association. And in the U.K. and Europe, where travel insurance is a fact of life, media ads for travel insurance are everywhere.