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Larry Bruner never imagined a dream cruise could so quickly become a medical nightmare. Along with his wife, Barbara, and another couple, the 70-year-old retired accountant boarded a Princess cruise ship last February for a two-week voyage off South America. The next day, doubled over in pain from a perforated colon, Bruner was transferred to a hospital in Puerto Montt, Chile.
Immediate surgery repaired the problem, but complications required he be put on a ventilator. Though Bruner received excellent care, all he and Barbara wanted was to go home for treatment in familiar surroundings. Two weeks later, a Medjet air ambulance staffed with a respiratory specialist and flight nurse arrived. Fifteen hours and two refueling stops later, the jet brought Bruner home to San Antonio. Total cost: $350.
Emergencies, accidents, and just bad luck can occur when you're on the road. Yes, most of us have some form of health insurance, but step across U.S. borders and your policy may not be worth much. Even a trip to the ship's infirmary can lighten your pocketbook, because once you set sail, you're considered in international waters. If your illness is deemed serious, the ship may put you off at the nearest port.
In general, medical plans will cover you for emergencies or urgent care regardless of location, says Amrita John with Cigna HealthCare. What's an emergency? "Anything a prudent person concludes that by not seeking care would jeopardize his or her life," she explains. So chest pains, broken bones or dehydration caused by food poisoning probably would be covered; toothache, sunburn or a mild case of the flu probably would not.
Those with basic Medicare coverage are essentially uninsured outside the 50 U.S. states and District of Columbia. Supplemental Medigap (plans C and above) may provide some international coverage, but watch out for deductibles and lifetime benefits as low as $50,000, says Peter Evans, with InsureMyTrip.com, an online travel insurance aggregator.
Assurance, not insurance
There are alternatives. Comprehensive travel insurance covers medical services and hospitalization abroad up to a set limit as well as reimburses anything your private plan won't. In addition, you're covered for trip cancellation, delay or lost luggage.
Though Sharon Dendurent's employer provides medical coverage, she invested $220.50 in a TravelSafe policy before a 10-day tour of Peru. Bronchitis and altitude sickness meant an overnight stay in a Cusco infirmary and one lost day of touring. Of the $848 in medical expenses, her insurer paid $244. TravelSafe reimbursed the rest, plus $298 for the lost tour day.
Amanda Sheronas' family vacation in Italy was cut short when she ended up in a hospital after her bladder became blocked.
"I was being wheeled from doctor to doctor clutching my Italian-English dictionary," remembers the bridal-company publicist. "No one at my HMO would return my calls."
Luckily her mother had invested $100 in travel medical insurance. Not only did the company arrange for Sheronas to be flown to her home in Los Angeles on commercial flights (upgraded to business and first class), but they also sent a nurse to accompany her until she was safely back in her apartment.
"Mom boasts it was the best $100 she ever spent," Sheronas says.
"The insurance company was in constant contact, unbelievably professional and comforting. They covered all of my expenses, about $22,000." The flight alone was $16,972.
For those with no need for full travel insurance, stand-alone policies cover medical care, medical evacuation or both. They're worth considering since regular insurers rarely offer evacuation coverage and the handful that do will only transport you to the nearest major hospital.
The Bruners subscribed to MedjetAssist, which specializes in medical evacuations.
"The entire time Larry was hospitalized, someone at Medjet was talking to me, arranging our trip back to Texas," Barbara Bruner recalls. By all estimations, the air ambulance flight cost at least $50,000.
Do the math
You've heard it before, but it pays to be prepared before traveling overseas:
- Check first with your own health insurer. Ask what they cover during international travel and what they consider an emergency.
- With that information in hand, decide what's important to you. Is your investment in the entire trip something you want to protect? Or do you want only extra medical or evacuation coverage?
- Do some comparison shopping. Try InsureMyTrip .com or Squaremouth.com. After asking questions (such as age and trip details), each displays a variety of policies and lets you compare them by price and benefits.
One tip from Squaremouth CEO Chris Harvey: If you want only supplemental medical, put $0 in the trip-cost box. By doing so, we found that for $42 we could buy $100,000 in dental and medical coverage and $500,000 in evacuation for a 70-year-old on a three-week trip to China.
- Evacuation companies typically sell annual subscriptions. MedjetAssist (www.med jet.com) starts at $250 for an individual annual membership, $385 per family (up to seven members).
Air Ambulance Card (www.airambulancecard.com) is $195 per year, $295 per family. AirMed (www.airmed .com) costs $250 per year, $350 per family. Shorter plans, starting at 14 days, might also be available.
- Expect to pay any on-scene expenses up front, even in countries with nationalized health care. Though Sheronas never saw a bill in Italy, Dendurent owed $800 to her Peruvian clinic, while Bruner's tab was a whopping $33,000 upon discharge (his health provider did reimburse him).
- Save every receipt, letters proving medical necessity, physician's diagnosis, X-rays, lab results or other scrap of paper to prove your case to the travel insurer and your health-care provider.
Medical emergencies far from home are never pleasant, but planning can save you from an unexpected financial wallop.
Now fully recovered, Bruner is ready for more overseas travel, with a Mexico vacation already under his belt. But, as he notes, "I'm not even leaving my driveway without my Medjet membership card."
Laura Daily
Source: Dallas Morning News
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