Sick abroad? I wanna go home. Having medical evacuation insurance is a good policy.
by Judy M. Zimmerman Special to AllThingsCruise
Nobody wants to worry about getting seriously ill or having a bad accident far away from home. But it happens. My neighbor came to my door in tears following a middle-of-the-night phone call from the U.S. Embassy in Nepal. The couple’s college-age son, Namat, had been hit by a bus while riding his motorbike. The embassy needed credit card information and permission to airlift Namat to a hospital in Kathmandu. Namat’s medical treatment was fortunate; a doctor in Kathmandu set his hip and operated on one of his wrists, and soon Namat was able to travel home on a commercial flight for additional surgery.
SHABBY AND SCARY
But the next week, as I was traveling alone in China, I began looking into how a medical emergency might be handled. I visited a privately operated hospital in Shanghai where patients appeared to be receiving excellent medical care. But at another facility – considered one of the city’s best public hospitals – I followed the signs to the “Foreigners’ and Diplomats’ Floor.” The physical conditions and equipment were antiquated and in disrepair. Two women visiting a friend initiated a conversation with me. Their friend, in the diplomatic service and now a patient here, ordinarily would have been flown to superior facilities in Hong Kong or Bangkok, but the medical circumstance hadn’t allowed time for transport. This accelerated my quest to visit hospitals. I took a taxi to another and wandered through several filthy halls crowded with people waiting for attention. It was a nightmare.
I learned later that the cost of a medical evacuation from China to a hospital in the United States would have been about $50,000 and it would not have been covered by my existing medical insurance.
I’M A BELIEVER
Yes, medical evacuation–if you end up paying for it yourself–is expensive. Recently, the doctor aboard my ship in the South China Sea said it could easily cost close to $100,000 to arrange an air evacuation at sea. These days I buy medical evacuation insurance, which generally takes care of immediate expenses and brings you back home as soon as possible. Some travel insurance policies include medical evacuation, but many do not. Some policies cover only trip cancellation, loss of luggage, and other issues. Travelers seeking a medical evacuation policy can buy it with their travel insurance policy. Or, if you’re a frequent traveler, you might want to consider an annual medical evacuation policy such as MedjetAssist.
Here are some questions to consider:
- Does your existing medical policy cover injury, hospitalization and emergency evacuation when traveling abroad? Few do. Medicare does not.
- Will a travel insurance policy reimburse expenses in a medical emergency or will it provide cash up front as required by many doctors and hospitals in other nations and even places in the U.S.?
- Are there health conditions that would prevent your qualifying for medical travel coverage? If so, how can you buy a policy that waives pre-existing conditions?
- Can the insured call for emergency assistance at any time of day or night?
- What steps will be taken when assistance is called for?
- Will the insurer help locate medical facilities? Or is the patient on his own?
- Who decides if a medical evacuation is necessary? What are the terms? Who’s on the decision-making team? The team may include the insured’s doctor at home, a doctor abroad plus an employee of the medical insurance company. But because the professionals may not agree that evacuation is the right course, you may prefer a policy whose evacuation criterion is “members’ discretion”, as is the case with MedjetAssist when you require hospitalization.
- Will the patient’s transport be to the nearest appropriate facility or to a hospital of the patient’s choice?
- What are the coverage limits and exclusions?
- What happens if the policy holder dies while traveling abroad?
MY OWN MALADY
When I broke a rib and injured my knee while hiking in Switzerland several years ago the doctor required $265 in cash (he would NOT take a credit card) before providing services. This is true in many countries. My HMO reimbursed me less the deductible which another pre-trip policy reimbursed. Even when you purchase an individual trip policy that covers medical evacuation, “the criteria of what constitutes ‘adequate care’ (at the nearest hospital) is not always consistent among travel insurance providers,” said Dan McGinnity, vice president of Travel Guard, a provider of travel insurance and medical assistance. McGinnity notes that “Global companies like Travel Guard have full time medical professionals who consult with the attending physicians in a serious medical emergency, and determine whether or not the facility has the capability to provide the necessary treatment. Not all companies have this capability.”
BRING IN THE LEARJET
For example, the doctor on a cruise ship in Mexico recommended that an ill passenger be taken immediately to the nearest hospital, where a team of doctors operated and saved his life. When the patient’s attending doctor felt he should stay in the hospital another week before traveling home on a commercial flight, the passenger’s wife contacted the U.S. consulate, which helped her arrange for a second opinion. That doctor believed her husband should be evacuated as soon as possible. As it turned out, they had a travel policy with medical evacuation coverage that would ensure he travel with his own medical entourage. The next morning, a medically-equipped Learjet arrived to fly the couple back to their hometown and have the man transferred to the hospital there. Policies such as MedjetAssist or Travel Guard provide this type of emergency medical transport. “Our annual medical evacuation plan is geared to the needs of frequent travelers,” said Travel Guard’s McGinnity.
Travel Guard’s annual and per-trip plans also include medical expense coverage. Roy Berger, president of MedjetAssist, outlined his company’s annual emergency evacuation policy: “If your condition is critical and you can gain inpatient status at the hospital at both ends, we will bring you home from abroad or the U.S. in a dedicated air ambulance to the hospital of your choice.” Members of the American Automobile Association can also get emergency transport through the “Plus” plan that provides up to $25,000 of emergency medical transportation coverage and 24-hour medical emergency assistance.
If you have significant medical conditions perhaps you have had cancer or heart problems, for example take a look at how the travel insurance reads regarding “pre-existing conditions.” Most require purchasing the policy within 15 days of making the initial deposit on the trip and that your condition be stable six months prior to the travel. You may need a letter from your doctor. This way, if you have medical conditions that resurface and prevent taking the trip, or cause problems during the trip, you’ll have coverage for trip cancellation or evacuation, depending on how the policy reads.
Travel insurance is complicated. Call several insurers prior to making a decision. Ask for explanations of any unclear language. Rates for individual trip policies typically depend on the cost of the trip, length of the trip, your age and type of insurance. For a comparative analysis of travel insurance companies and plans, go to www.insuremytrip.com, call 800-487-4722 to speak to a Customer Care representative who represents all major insurers and will help you decide which plan best meets your specific needs, including
- Travel Guard International, www.TravelGuard.com; 800-826-1300
- Medjet Assist, www.medjetassist.com; 800-963-3538
- AAA “Plus” member; 800-203-7587
- International SOS, the largest worldwide emergency evacuation service, tailors memberships to the needs of business travelers, students with study programs abroad, group travelers and expatriates; www.internationalsos.com; 800-523-8661
CARRY MEDICAL INFORMATION
As noted, U.S. embassies and consulates can provide limited aid. Be sure your passport has emergency contact information on the designated page.
In addition, carry the following information on your person:
- your name, address, telephone number
- blood type, religion
- list of medications and allergies
- contact information for your primary care physician; travel insurance; medical evacuation policy; funeral home, administrator of your will, person designated to make health care decisions and your financial planner