Avoiding pit falls with your travel health insurance

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This section of our international travel guide  covers all you need to know to find a travel health insurance fitting your personal needs. We describe the minimum coverage you should look out for and give advise on common pit falls waiting in the fine print. Once you know what to look out for, it is easy to judge the many offers available.

We hate disclaimers, but we need to point out the following before we start: The content of this page describes our personal view. We advise you to contact a professional insurance agent before signing any insurance policy.

Why it is necessary to have a separate health care / accident insurance when traveling?

While one can argue about the necessity of a travel cancelation insurance, health and accident insurance simply is a must. No matter how tight your budget, this is the one insurance you need. Unless you have a few millions on the side, the story of a colleague of mine will probably get you convinced as well:
After a head on collision with a truck, he had to undergo several surgeries and was hospitalized for several weeks in a foreign country. As soon as possible he was repatriated and after several months of rehab, he slowly started to recover. Without proper health insurance he now would be facing medical bills of several hundred thousand Euros.

Wherever you live and whatever health insurance you have, very likely this insurance policy only covers medical bills in your home country. Therefore, whenever you are leaving your home country, this insurance will not pay for any health related expenses. Even if your travel destination and your country of residence agreed to accept international medical claims, your compulsory insurance usually only covers the standard rate. Unfortunately, if you are in a foreign country, doctors love to treat you as a private patient and will charge the higher rates. You will have to pay for the difference.

Let us repeat the most important message: You will have to pay for visiting a doctor, medicines or being hospitalized unless you get an additional insurance! No matter if it is a chipped tooth, a car accident or a broken shoulder, you have to pay the bill. Ignoring this risk can easily mean your financial ruin and turn your holidays into a nightmare.

As with many things, the most expensive solution not necessarily is the best, but proper coverage will have its price. A price you gladly pay once you need to get hospitalized or need repatriation.

The minimal needed coverage

As stated in the introduction, we want to enable you to select an insurance which provides the coverage suiting your personal needs. After explaining why health and accident insurance is important, it is time to give an overview on the necessary coverage. 

Below we list the requirements we deem absolutely necessary. By intent, they are very demanding and will rule out many insurance providers if applied rigorously.

For each of the requirements, we give some additional background information. These should help you to judge if and how you might adjust the requirement to your personal situation. Repatriation costs for example will be significantly lower if you visit a neighboring country. In that case an unlimited coverage for repatriation is would not be necessary.

Duration of insurance cover

Duration of insurance coverage probably is the most important point to look out for when reading the fine print. Not paying close attention to the details may require you to cover medical bills even if you have an insurance. The reason is: If the coverage ends while you are for example still hospitalized abroad, you have to cover any costs occurring beyond the date of coverage.

This easily happens with insurance coverage from the date you leave your country until your planned return date. If now you get hospitalized for several days on the day of your planned to return, the insurance coverage stops at midnight of day one. You will have to pay any additional day in hospital yourself.

Suggested coverage:
If any medical reason prohibits you to return to you home country on the planed return date,  the insurance coverage automatically is extended until you are able to resume traveling home or until they have you repatriated. A possible work around would be to choose a coverage period extending at least two weeks beyond your planned return date. Getting a different insurance probably is cheaper, though.

Coverage for repatriation

Repatriation means getting you transported back home in the case of accident or illness. This might require ground transportation or an air ambulance and can easily cost 200 000 € or more. Please keep in mind, that your travel insurance only has to pay for medical expenses outside your home country. Therefore, they will only get you repatriated, when it makes sense economically. 

Depending on the fine print, this means they will only repatriate if medically required. As a consequence they might make you choose between leaving your hospitalized child in a foreign country at your planned return date or have you pay for its repatriation yourself.

Therefore ensure your insurance is covering any costs related to transporting you back home. As mentioned above, insurance companies are doing their math here. If the policy states that repatriation is only paid for if it is medially required, you might get stuck in a hospital far from home. Double check with your insurance that they will pay the transport not only if it medically required but as soon as medically possible and justifiable. This ensures you can claim a transport as soon as it is possible from a medical perspective.

Suggested coverage:
Unlimited coverage as soon as medically possible and justifiable.

Pre-existing conditions

Excluding pre-existing conditions is regular business with health insurances, otherwise their business model would not work out. Nevertheless be sure to understand if and how pre-existing conditions are excluded from coverage. Unlike regular health insurance companies, the travel insurance company usually does not ask any medical questions to get you covered but in return excludes any pre-existing conditions.

This can be especially tricky with companies advertising their flexibility and promoting the possibility to extend your coverage any time. This sounds great if you are unsure about the duration of your travels as it implies you can extend your coverage when you spontaneously extend your travel. Unfortunately, most of the time this is not an extension of an existing contract. Instead you sign an entirely new contract with the company and in the worst case, any claim which started under the first contract is not covered.

Suggested coverage:
The insurance should allow you to extending your policy every year without rechecking your health status. This ensures that any illness you might acquire in the years to come, is covered. Many illnesses not necessarily prevent you from traveling but you want to prevent the lack of insurance coverage to keep you from doing so.

Accidents

Usually health and accident insurance are two separate things, even if many companies offer both in the same policy. In case you already have an accident insurance (in Switzerland it is mandatory), chances are good you are already covered world wide and opting out of this coverage might save some money.

In addition pay close attention what kind of activities the insurance covers. Usually risky activities like sky or scuba diving are excluded.

Suggested coverage:
Make sure the policy is covering your planned activities. If in doubt get the confirmation in written form.
 

Additional details to look out for

Below a short list of additional details you want to ensure your policy is covering

  • Free choice of medical practitioner
  • Coverage of drugs and medical bills (including hospital)
  • Basic filling and pain treatment at the dentist
  • Does it provide coverage for your age? 

Things to consider when you need a doctor

Even with an excellent coverage there are certain procedures you should follow if you need medical assistance abroad.

  1. Except for life threatening emergencies, contact the insurance before making use of any medical services. Sometimes your insurance can help you to find a doctor and in many cases you need the approval of the insurance in the first place. Getting medical advice without contacting your insurance runs the risk they won't fully reimburse your expenses.
  2. When visiting a doctor, you have to pay the bill directly and the insurance will reimburse you. Please make sure to keep all bills and related documents and make copies of these before handing them in. Only destroy documents after all claims are settled.
  3. Ensure bills and documents contain the following information.
    • Billing date and confirmation of payment
    • Name and address of the doctor or hospital
    • Date of birth of the person being treated
    • Details on diagnosis and therapy
  4. Precipices should contain
    • The address of the prescriber
    • Prescribed drugs
    • Price and confirmation of payment

A real world example

A few companies make an incredible job when it comes to marketing and come with a very competitive price tag. One example is World Nomads, the recommended insurance company of Lonely Planet.

As with World Escapade, World Nomads is a retailer for Bupa Global. Therefor any claims have to be submitted to Bupa directly.

Both retailers provide slightly different coverage and even if they are not fulfilling our rigorous requirements, we can't say that their coverage is inadequate. On the contrary, especially for young backpackers, with a tight budget and on the lookout for a one covers all solution, both are worth a look. One should consciously decide for this policy though, as the competitive price comes with certain limitations. Please use the affiliate link below if you want to sign up with World Nomads.

The following review only covers the premium policy "Explorer" from World Nomads and focuses on the health insurance only. Coverage details and costs strongly depend on your travel details and your country of residence. Therefore our results can only be seen as a guidance.

  • Duration of insurance cover
    In point 32.4, their policy states: The insurance period can be extended up to 48 hours with no extra premium charge if your return is delayed without you being responsible for the delay.
    Essentially they offer you two days of slack on the expiration date should anything happen, afterwards you are without coverage.
  • Repatriation
    Only included for certain countries of residence. Coverage sum is quite large but not unlimited. The decission upon repatriation solely lies with the insurance.
    Pay close attention if repatriation is included in the offer. Depending on your destination, it might be helpful to recheck with the insurance if the provided coverage is sufficient.
  • Pre-existing conditions
    In addition to the regular exclusions be aware of the following policy statement:
    Any medical condition you suffer from or are treated for during the insurance period will be considered a pre-existing medical condition on any extension of this insurance.
    Essentially in non legal terms: Replace the term "extension" with "new contract".
  • Accidents
    They clearly state: You're not covered to participate in paragliding, mountaineering, base jumping, professional sports, races, competitions or motorsports on any plan.
  • Extract from their policy concerning the additional details
    • Free choice of medical practitioner: "Doctors, physicians, dentists (...) must be licensed in the country of practice."
    • Coverage of drugs and medical bills (including hospital): "We will pay for dental treatment, prescribed medicines, outpatient treatment and/or hospitalisation expenses (...)"
    • Basic filling and pain treatment at the dentist: See above
    • Maximum Age: "66"

Conclusion

Health insurance while traveling is a must. Unfortunately one can easily get in trouble  if unaware what to look out for in the fineprint.

As a final show case let us explain how we resolved the issue for ourselves. In Switzerland, in addition to the mandatory coverage, you can get additional health policies covering for single bed rooms in hospitals etc. Most of these policies also offer the option to get you covered while outside Switzerland. This way we have all minimum requirements covered year round without ever thinking about the subject. Maybe you want to check if your insurance back home offers a similar option.