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What YOU should know about Travel Insurance

Know your limits when checking out travel policy coverage

Which makes sense to you - spending $300 for special health insurance before a trip or $30,000 in medical expenses afterward?

For some, it seems like a no-brainer. But for gamblers . . .
Travel insurance is an area many neglect when planning vacations because they don't know their health insurance has limitations.

Travelers should not assume that their regular health-insurance policies will cover illnesses or medical emergencies anywhere they go - be it in the United States or in foreign countries.
Knowing whether your health-insurance policy offers any kind of travel benefits could be critical.

Some health-maintenance organizations' plans work principally in your immediate area; others have reciprocal rights with medical institutions in other states.
Medicare, the national health-insurance program for those 65 and older, and younger people with disabilities, has a complex set of rules about when it will pay outside the U.S.
Generally, if you plan to travel outside the U.S., don't count on Medicare to pay for hospital and/or medical services, advises the Health Care Financing Administration (HCFA), the federal agency that supervises Medicare.
For Medicare purposes, the U.S. is defined as the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands and American Samoa.
Medicare may pay for services in qualified Canadian or Mexican hospitals if:

  • You are in the United States when an emergency occurs and are treated in a Canadian or Mexican hospital, which is closer or more accessible than the nearest U.S. hospital. An example would be you become seriously ill near the Canadian border, and you're taken to the nearest hospital in Canada.

  • You live in the United States, but a Canadian or Mexican hospital is closer to or can be more easily reached from your home than the nearest American hospital.

Medicare pays for medical problems that develop aboard a cruise only if:

  • The vessel is of American registry. (Most large liners are not.)

  • The physician is registered with the U.S. Coast Guard.

  • Medical services are given while the ship is within the territorial waters of the United States. That means in a U.S. port, or within six hours of departure or arrival at a U.S. port.

  • Medicare will pay for medically necessary doctor and ambulance services in connection with a period of covered hospitalization. However, Medicare often does not pay for air-ambulance evacuations.

Extra insurance for retirees

If you plan to do a lot of traveling after you retire, consider supplemental Medigap plans designated as C through J, which have foreign travel benefits, advises Caroline Donnola, special projects coordinator with the Statewide Health Insurance Benefits Advisors (SHIBA) in the Washington state Office of the Insurance Commissioner.
These plans will cover medically necessary emergency care at 80 percent of the bill charged for Medicare-eligible emergency hospital and doctor costs for an illness that begins during the first 60 days of your trip. There is a $250 deductible and a lifetime maximum of $50,000 coverage.
The Medigap plans, or supplemental insurance policies for retirees available through former employers, generally are better bets than health-maintenance organization policies, Donnola said.
If you don't have access to an employer-based plan and you didn't buy a Medigap C through J supplemental plan, you'll need to consider an HMO Medicare choice plan.

As one example, Group Health Cooperative's Medicare plans provide travel benefits, according to Greg Scully, sales director. If Sears had chosen either the standard or "plus" plan, he would have had coverage for emergencies, such as his stroke, and urgent care, such as a broken ankle, for up to six months of travel.
Additionally Sears could have had $2,000 worth of non-emergency and non-urgent care while traveling, but not routine care such as an annual physical.

And the air ambulance trip? Group Health pays for evacuation if it is medically necessary, if deemed appropriate by the HMO, and authorized in advance, Scully said.

Air evacuation is a complex topic in itself. There are times when a regular air carrier cannot transport an ill passenger. In that situation it's wise to check with the insurance carrier to learn if an air-ambulance trip would be paid for, then research available services.

For example, Alaska Airlines, which flies to Puerto Vallarta, can take seriously ill passengers, said Jack Evans, a spokesman. But if the patient needs to be on a stretcher, it requires 11 seats - nine for the stretcher, one each for a family member and medical person. And space might not always be available on a particular flight. Alaska does require a patient be accompanied by a family member and a nurse or doctor, unless a physician is willing to sign a release.

"A commercial aircraft is not an ambulance. While we do have the ability to deal with emergencies, we're not equipped to provide medical care on board," Evans said.

Other airlines have similar policies.

Insurance for younger travelers

What other insurance policies might help a traveler if critical illness strikes while away from home?

Ask your travel agent about a special short-term medical policy. Often you can purchase one along with trip-cancellation insurance. The price of such policies is geared to your age, the cost and length of your trip.

Also check with your health-insurance carrier. If your policy doesn't cover travel, ask about adding a short-term plan.

Travel Insurance Services of Walnut Creek, Calif., sells policies for $3.25 a day or about $100 a month for travelers through age 69. These policies can provide up to $25,000 for treatment and hospitalization; up to $50,000 for emergency medical evacuation, with a deductible of $50 per illness or incident.

Another plan through Travel Insurance Services costs $5 a day and covers up to $100,000 for medical treatment, and up to $75,000 for emergency evacuation, with the same deductible. Travelers age 70 and older would pay $7.50 and $10 a day, respectively, for the same plans.

These policies can be purchased for periods from one day to a year, said Kathy Barlow, of Travel Insurance Services, and include translation services and repatriation of remains if a death occurs.

While a majority of Europeans buy special health insurance policies for travel, only a small percentage of Americans do, according to Barlow and others in the industry.

Access America, a division of World Access Service Corp. in New York, also sells travel protection policies. Travelers can have the pre-existing conditions exclusion waived in Access America products, if they purchase coverage within 14 days of their initial trip deposit. Under the company's Travel with Ease for Cruises and Tours policy, the under-55 traveler would pay $76 for a trip that costs $2,001 to $2,500. Travelers from 56 to 70 years would pay $109; age 71 to 80, $145, and 81 and older, $250.

Cruise Secure, a new business in Dedham, Maine, focuses on arranging cruises for travelers with health concerns. The service obtains specific details about cruise lines' medical facilities; prepares a "medical passport," or a detailed medical history, which might include information on a traveler's recent EKG, medications and dosage; and helps travelers find appropriate extra health insurance.

Special health insurance for travelers should cover emergency medical care and evacuation, with no exclusions for prior illnesses, advises Dr. William Mason, an otolaryngologist, who founded Cruise Secure with his wife, Shelley.

Cruise Secure uses Travel Guard insurance products for its clients. For example, if a seven-day cruise with land tours costs $3,000, the traveler could buy a special insurance policy for $199. It would cover medical problems, emergency evacuation and trip cancellation. The policy would cover up to $10,000 in medical expenses, and air evacuation up to $20,000. Comparable insurance for a cruise in the $1,000 to $1,500 price range would cost about $90, according to the Masons.

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