Overseas travel insurance — magnifying the fine print

This item appears on page 34 of the April 1994 issue.
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What are the most important factors to consider when choos­ing a travel insurance policy or considering not to buy one? (The proposed Clinton health plan is reported to provide over­seas travel coverage, but don’t hold your breath.)

For medical emergencies

Well before your trip, review the variety of types of assistance to which you already have access.

For medical emergencies, your regu­lar health coverage probably will cover expenses anywhere, reimbursing you for your out-of-pocket expenses. Be sure to bring back adequate receipts and treatment records (in English, or you’ll be required to provide transla­tions).

Get the details from your agent or 

employer; especially inquire about medically required air evacuation.

Blue Cross and Blue Shield (known in the insurance industry as the “Blues”), for example, have agree­ments with 182 hospitals in 52 coun­tries where members can be admitted with their membership cards. Mem­bers will be treated as if they were in a Stateside hospital, with the billing going directly to the “Blues.”

(Incidentally, the “Blues” comprise regional, independent companies and stame do not provide this service. Ask your employer or insurance agent whether or not you have this specific overseas coverage.)

Blue Shield of Northern California has a small brochure entitled “Pass­port” that can be taken along, offer­ing detailed instructions on how to utilize their overseas coverage. Your insurer may have a similar guide.

In most cases, if you have regular health insurance, buying an addi­tional travel policy is oflimited value, since most of these provide only “sec­ondary” coverage; that is, they pay only what your normal insurance does not.

The only advantage is that they may pay your bills overseas and then settle later with your normal insurer.

Credit cards, especially “Gold” cards, have “hotline” phone numbers that provide a variety of assistance functions and in emergencies can increase your credit limit.

They often will assist in “arrang­ing for” more-expensive services, but the cardholder usually is responsible for the cost.

You must make sure to take along the “hotline” phone or fax numbers for contacting whatever assistance serv ces you have available.

Medicare does not provide over­seas coverage, but many “Medi-Gap” policies do.

Medical evacuation

You are likely to find that you al­ready are reasonably well covered for health/accident emergencies, with the exception of transportation to an appropriate medical facility or for very rare — but also potentially very expensive — air evacuation back to the U.S.

F or those of us whose regular health insurance will pay for overseas care, a new (in 1992) service, Traveler’s Emergency Network (P.O. Box 238, Hyattsville, MD 20797-8109; phone toll free 800/ASK-4-TEN, or fax 301/ 559-5167), offers an outstanding package of services for $30 per year, or $50 for a family.

Their most important services fol­lows (with preexisting-condition exclusion of any kind!):

Traveler’s Emergency Network will supply and pav for emergency evacuation to the nearest facility ca­pable of providing proper care. When the patient is stabilized, they will transport him or her back to the United States under medical supervision, if necessary, with no upper limit on cost.

When a member is traveling alone and is to be hospitalized for more than seven days, economy round-trip transportation to the place of hospitalization will be provided, without charge, to a person chosen by the member.

Admission to a hospital will be guaranteed — so that the member will be admitted promptly — by ei­ther validating insurance or advanc­ing funds (which must be repaid within 45 days).

Plus, without charge, they’ll re­fer you to an English-speaking doc­tor, supply critical-care monitoring, deliver medications that might not be available locally, keep you in touch with your family, provide legal refer­rals and provide pretrip up-to-date health precaution recommendations for your destination.

And, grim note, but it can hap­pen: they will provide assistance for and pav for the cost of return of mortal remains.

Travel insurance policies

ITN has received numerous let­ters from readers, since our last travel insurance article (May ’91, pg. 28), describing individual experiences with claims.

To summarize, their experiences generally were very good, as long as they had valid, properly documented claims.

Most problems seemed to be with the details of trip cancellation/inter- ruption claims. Here’s where a travel agent can be a great asset in helping to deal with the sometimes lengthy and complex negotiations with an insurance company.

Use the “800” numbers supplied in this article to request descriptive bro­chures; most policies can be ordered over the phone with your credit card or through your travel agent.

The “preexisting condition”

If you have a preexisting medical condition, be careful in your choice of insurers.

Some policies (including trip can- cellation/interruption) are restrictive in coverage of claims that are related to preexisting medical conditions within various periods prior to your trip. (They may be a good value for someone in good health — because of higher limits, more features and/or lower costs.)

Some companies will cover prob­lems related to preexisting medical conditions if that condition has been “controlled” during the period pre­ceding the trip.

Look for the carefully worded sec­tion of the brochure entitled “Exclu­sions” or “Preexisting Conditions.”

The ground rules may be different for the health/accident portion of the coverage and the trip cancellation/ interruption portion.

“Controlled” usually is defined as “exhibiting no symptoms or not re­quiring the adjustment of treatment 

or medication.” Look for that word “controlled” in the text, if this is an area of concern for you or your trav­eling companion.

If you have been taking medica­tion, or have been treated by or have even seen a doctor for any medical condition within the previous six months, make sure that you get a policy that uses the “controlled con­dition” language.

scribed dosage of your medication in the months before your trip would jeopardize your coverage for a re­lated problem.

Don’t be intimidated by “fine print”; most brochures clearly describe the principal details and exclusions. Take the time to read carefully before you sign up.

Tour company offerings

Tour companies are increasingly offering trip insurance (or its equiva­lent) that covers medical and/or can­cellation features; look for the same “controlled” preexisting-condition language. These plans can be a good value if the price is significantly lower than standard insurance policies.

If the tour company is making the guarantees instead of an insurance underwriter, the guarantee would be of questionable value if the tour company suddenly closed up shop.

Don’t worry unnecessarily about this hazard; the likelihood of com­pany failure is reasonably remote and tour operators contribute to a fund of last resort that will reim­burse customers for at least a portion of their lost funds.

Discuss this with your travel agent; you can spend an unreasonable amount of money trying to insure against every single possible eventu­ality.

Trip cancellation/interruption insurance

Health and accident problems are the most common causes for claims under these coverages. The preexist­ing-condition exclusions and recom­mendations are especially important here.

Look for a policy that will provide coverage for rescheduled flights home; many tour packages utilize special fares that do not provide for schedule changes. Also be aware that frequent-flyer-supplied flights are not insurable (refundable) by the insurance company.

In case of anv emergency problem, it is worthwhile to contact the public relations representative of the air­line (even if it requires a few calls from overseas) to see if he or she might make some accommodation because of the special circumstances.

Trip cancellation/interruption in­surance is rather expensive: 5% to 8% of the insured amount. A couple spending $2,000 each for a trip will pay $200 to $300 for cancellation coverage.

The insurer will pay up to the cov­ered amount and may have to pay as little as a fraction of the cancellation fee or your pretrip deposit, depend­ing on when the cancellation is made and why.

A logical strategy, whether or not you purchase cancellation insurance, is to avoid making the required in­cremental payments for a tour until shortly before the deadlines. . . to minimize your exposure, in case something unexpected comes up.

Final thoughts

In considering travel insurance, make a choice with which you will be comfortable. Then you can enjoy your trip, confident that you won’t be wor­rying about “What if?” 

Follow the Scout motto of “Be prepared.” You can go without addi­tional coverage, go “bare-bones” or buy a “deluxe” package that will cover you even if you should get bitten by a penguin in the Amazon (slight exag­geration). For the Wirtanens’ next overseas trip, I’ll feel very confident about the possibility of confronting an emergency by having a good supply of $100 bills in a money belt, my Blue Shield “Passport,” a year’s coverage from Traveler’s Emergency Network and credit cards with a healthy un­used balance.

And we’ll take our chances without cancellation/interruption insurance. Life’s a crapshoot — we just do the best we can to keep the odds reason­ably in our favor.

Thanks to all those who wrote in with their travel insurance experi­ences; please continue to write to ITN, to my attention, with travel insurance comments, problems and recommendations.

This is a complex facet of travel and we all can learn from the shared experiences.

Please login or subscribe to ITN to read the entire post.

What are the most important factors to consider when choos­ing a travel insurance policy or considering not to buy one? (The proposed Clinton health plan is reported to provide over­seas travel coverage, but don’t hold your breath.)

For medical emergencies

Well before your trip, review the variety of types of assistance to which you already have access.

For medical emergencies, your regu­lar health coverage probably will cover expenses anywhere, reimbursing you for your out-of-pocket expenses. Be sure to bring back adequate receipts and treatment records (in English, or you’ll be required to provide transla­tions).

Get the details from your agent or 

employer; especially inquire about medically required air evacuation.

Blue Cross and Blue Shield (known in the insurance industry as the “Blues”), for example, have agree­ments with 182 hospitals in 52 coun­tries where members can be admitted with their membership cards. Mem­bers will be treated as if they were in a Stateside hospital, with the billing going directly to the “Blues.”

(Incidentally, the “Blues” comprise regional, independent companies and stame do not provide this service. Ask your employer or insurance agent whether or not you have this specific overseas coverage.)

Blue Shield of Northern California has a small brochure entitled “Pass­port” that can be taken along, offer­ing detailed instructions on how to utilize their overseas coverage. Your insurer may have a similar guide.

In most cases, if you have regular health insurance, buying an addi­tional travel policy is oflimited value, since most of these provide only “sec­ondary” coverage; that is, they pay only what your normal insurance does not.

The only advantage is that they may pay your bills overseas and then settle later with your normal insurer.

Credit cards, especially “Gold” cards, have “hotline” phone numbers that provide a variety of assistance functions and in emergencies can increase your credit limit.

They often will assist in “arrang­ing for” more-expensive services, but the cardholder usually is responsible for the cost.

You must make sure to take along the “hotline” phone or fax numbers for contacting whatever assistance serv ces you have available.

Medicare does not provide over­seas coverage, but many “Medi-Gap” policies do.

Medical evacuation

You are likely to find that you al­ready are reasonably well covered for health/accident emergencies, with the exception of transportation to an appropriate medical facility or for very rare — but also potentially very expensive — air evacuation back to the U.S.

F or those of us whose regular health insurance will pay for overseas care, a new (in 1992) service, Traveler’s Emergency Network (P.O. Box 238, Hyattsville, MD 20797-8109; phone toll free 800/ASK-4-TEN, or fax 301/ 559-5167), offers an outstanding package of services for $30 per year, or $50 for a family.

Their most important services fol­lows (with preexisting-condition exclusion of any kind!):

Traveler’s Emergency Network will supply and pav for emergency evacuation to the nearest facility ca­pable of providing proper care. When the patient is stabilized, they will transport him or her back to the United States under medical supervision, if necessary, with no upper limit on cost.

When a member is traveling alone and is to be hospitalized for more than seven days, economy round-trip transportation to the place of hospitalization will be provided, without charge, to a person chosen by the member.

Admission to a hospital will be guaranteed — so that the member will be admitted promptly — by ei­ther validating insurance or advanc­ing funds (which must be repaid within 45 days).

Plus, without charge, they’ll re­fer you to an English-speaking doc­tor, supply critical-care monitoring, deliver medications that might not be available locally, keep you in touch with your family, provide legal refer­rals and provide pretrip up-to-date health precaution recommendations for your destination.

And, grim note, but it can hap­pen: they will provide assistance for and pav for the cost of return of mortal remains.

Travel insurance policies

ITN has received numerous let­ters from readers, since our last travel insurance article (May ’91, pg. 28), describing individual experiences with claims.

To summarize, their experiences generally were very good, as long as they had valid, properly documented claims.

Most problems seemed to be with the details of trip cancellation/inter- ruption claims. Here’s where a travel agent can be a great asset in helping to deal with the sometimes lengthy and complex negotiations with an insurance company.

Use the “800” numbers supplied in this article to request descriptive bro­chures; most policies can be ordered over the phone with your credit card or through your travel agent.

The “preexisting condition”

If you have a preexisting medical condition, be careful in your choice of insurers.

Some policies (including trip can- cellation/interruption) are restrictive in coverage of claims that are related to preexisting medical conditions within various periods prior to your trip. (They may be a good value for someone in good health — because of higher limits, more features and/or lower costs.)

Some companies will cover prob­lems related to preexisting medical conditions if that condition has been “controlled” during the period pre­ceding the trip.

Look for the carefully worded sec­tion of the brochure entitled “Exclu­sions” or “Preexisting Conditions.”

The ground rules may be different for the health/accident portion of the coverage and the trip cancellation/ interruption portion.

“Controlled” usually is defined as “exhibiting no symptoms or not re­quiring the adjustment of treatment 

or medication.” Look for that word “controlled” in the text, if this is an area of concern for you or your trav­eling companion.

If you have been taking medica­tion, or have been treated by or have even seen a doctor for any medical condition within the previous six months, make sure that you get a policy that uses the “controlled con­dition” language.

scribed dosage of your medication in the months before your trip would jeopardize your coverage for a re­lated problem.

Don’t be intimidated by “fine print”; most brochures clearly describe the principal details and exclusions. Take the time to read carefully before you sign up.

Tour company offerings

Tour companies are increasingly offering trip insurance (or its equiva­lent) that covers medical and/or can­cellation features; look for the same “controlled” preexisting-condition language. These plans can be a good value if the price is significantly lower than standard insurance policies.

If the tour company is making the guarantees instead of an insurance underwriter, the guarantee would be of questionable value if the tour company suddenly closed up shop.

Don’t worry unnecessarily about this hazard; the likelihood of com­pany failure is reasonably remote and tour operators contribute to a fund of last resort that will reim­burse customers for at least a portion of their lost funds.

Discuss this with your travel agent; you can spend an unreasonable amount of money trying to insure against every single possible eventu­ality.

Trip cancellation/interruption insurance

Health and accident problems are the most common causes for claims under these coverages. The preexist­ing-condition exclusions and recom­mendations are especially important here.

Look for a policy that will provide coverage for rescheduled flights home; many tour packages utilize special fares that do not provide for schedule changes. Also be aware that frequent-flyer-supplied flights are not insurable (refundable) by the insurance company.

In case of anv emergency problem, it is worthwhile to contact the public relations representative of the air­line (even if it requires a few calls from overseas) to see if he or she might make some accommodation because of the special circumstances.

Trip cancellation/interruption in­surance is rather expensive: 5% to 8% of the insured amount. A couple spending $2,000 each for a trip will pay $200 to $300 for cancellation coverage.

The insurer will pay up to the cov­ered amount and may have to pay as little as a fraction of the cancellation fee or your pretrip deposit, depend­ing on when the cancellation is made and why.

A logical strategy, whether or not you purchase cancellation insurance, is to avoid making the required in­cremental payments for a tour until shortly before the deadlines. . . to minimize your exposure, in case something unexpected comes up.

Final thoughts

In considering travel insurance, make a choice with which you will be comfortable. Then you can enjoy your trip, confident that you won’t be wor­rying about “What if?” 

Follow the Scout motto of “Be prepared.” You can go without addi­tional coverage, go “bare-bones” or buy a “deluxe” package that will cover you even if you should get bitten by a penguin in the Amazon (slight exag­geration). For the Wirtanens’ next overseas trip, I’ll feel very confident about the possibility of confronting an emergency by having a good supply of $100 bills in a money belt, my Blue Shield “Passport,” a year’s coverage from Traveler’s Emergency Network and credit cards with a healthy un­used balance.

And we’ll take our chances without cancellation/interruption insurance. Life’s a crapshoot — we just do the best we can to keep the odds reason­ably in our favor.

Thanks to all those who wrote in with their travel insurance experi­ences; please continue to write to ITN, to my attention, with travel insurance comments, problems and recommendations.

This is a complex facet of travel and we all can learn from the shared experiences.