In the Spotlight May 06, 2000 Travel Insurance and Emergency Medical Care: What You Need To Know By Lee Phillips, MD PersonalMD.com Medical Contributor

Whether you have waited a lifetime to take the perfect trip or are an experienced world traveler, international travel can be a rich and rewarding adventure.

When you travel abroad, the odds are in your favor that you will have a safe and incident-free trip. However, unexpected illnesses and accidents do befall U.S. citizens in all parts of the world, so it is wise to review your health insurance policy before you travel.

Travel insurance

Obtaining medical treatment and hospital care can be costly for travelers who are injured or who become seriously ill overseas. In some places, particularly at resorts, medical costs can be as high or higher than in the United States. The Social Security Medicare/Medicaid program does not provide coverage for hospital or medical services outside the United States.

However, some Medicare supplement plans offer foreign medical care coverage at no extra cost for treatments considered eligible under Medicare. These are reimbursement plans. You must pay the bills first and obtain receipts for submission to them later for compensation. Many of these plans have a dollar ceiling per trip. Senior citizens may want to contact the American Association of Retired Persons (AARP) for information about foreign medical care coverage with Medicare supplement plans.

Before you leave the U.S., you should be informed about which medical services your health insurance will cover abroad. If your insurance policy does not cover you abroad, it is strongly recommended that you purchase a policy that does. There are short-term insurance policies designed specifically to cover travel. You can find the names of companies that provide such policies from your travel agent or health insurance company.

Depending on the plan, travel insurance usually promises to cover you for cancellation or interruption of your trip, emergency medical care while you are traveling, lost or stolen luggage and various other troublesome occurrences in the same package.

Trip cancellation

One sure way to ruin a vacation is to lose money because an emergency forces you to postpone or cancel your trip. Except for tickets on regularly scheduled airlines, almost any travel package you purchase will have a penalty for cancellation and some companies will give no refund at all.

Regularly scheduled airlines usually give a refund if an illness or death in the family forces you to cancel. Airlines require a note from the doctor or a death certificate. Take careful note of the cancellation penalty for any other large travel purchase you make, such as a tour package, charter flight or cruise. Unless you can afford to lose the purchase amount, protect yourself by buying trip insurance.

If you invest in trip insurance, make sure your policy covers all reasonable possibilities for having to cancel. For instance, if an emergency with a family member would force you to cancel, insure against that as well.

Some trip insurance policies will give a refund if the company goes out of business or otherwise does not make good on its offering. The best insurance against company default is to choose a reputable company that guarantees a refund if they do not provide the services offered. If, however, you are tempted to purchase a tour at a great bargain price and you can't find a guarantee of delivery in the fine print, protect yourself by purchasing trip insurance that covers company default.

Emergency medical care

The PersonalMD.com Emergency Card As a member of PersonalMD.com, you will receive an ER Card that contains instructions on how your Emergency Record can be viewed by a physician - anywhere in the world. You can also use your PersonalMD.com E-File to store your travel itinerary and other information.

As part of travel insurance coverage, companies usually offer emergency consultation by telephone. They may refer you to the nearest hospital or call directly for help. If you need an interpreter, they may translate your instructions to a health care worker on the scene.

Although some health insurance policies pay "customary and reasonable" hospital costs abroad, very few will pay for medical evacuation back to the United States. Medical evacuation can easily cost $10,000 or more, depending on your location and medical condition. One of the main advantages of health and emergency assistance policies is that they often include coverage for medical evacuation to the United States. Even if your regular health insurance covers you for emergencies abroad, you should consider purchasing supplemental insurance to cover medical evacuation.

Another benefit that is normally part of travel insurance coverageis payment for the cost of local burial or shipment of remains home to the United States. Otherwise, this cost must be borne by your next of kin and can be extremely expensive. The federal government cannot pay for transportation of remains to the United States.

If your regular health insurance already covers you for medical expenses abroad, you can buy insurance that offers all the consultative and evacuation services listed above except for health insurance. The cost of partial coverage is usually inexpensive without health insurance coverage.

Once you have adequate coverage, carry your insurance policy identity card(s) and claim forms with you when you travel. You may also wish to carry a letter from your physician explaining your desired treatment should you become ill.

Do You Need Travel Insurance?
If you are already adequately covered by other insurance policies, you may not need travel insurance. It is a good idea to check your other insurance policies. For instance, your homeowner's or tenant's insurance may cover the loss or theft of your luggage. Certain credit cards also provide additional travel insurance if you have used them to purchase the ticket.

Before you decide on a travel insurance plan, it is wise to investigate the plan carefully and read the fine print. You should closely check any agreements with your travel agent, tour operator, airline or other companies involved with your travel plans. Their agreements may include written guarantees.

If you have a fully refundable airline ticket, you may decide that you would not need trip cancellation/interruption insurance.

On the other hand, it may be worthwhile noting that travel insurance plans can protect you by covering the financial costs in case of the following situations:

• A sudden, serious injury or illness to you, a family member or a traveling companion;
• Financial default of the airline, cruise line or tour operator;
• Natural disasters or strikes that impede travel services;
• A terrorist incident in a foreign city within 10 days of your scheduled arrival in that particular city;
• The fact that you, a traveling member of your family or a traveling companion were quarantined, served with a court order or required to serve on a jury;
• A circumstance in which you were directly involved in an accident enroute to departure for your trip.