If you were among the hundreds of American tourists who’ve been trapped in politically volatile Egypt, how would you get out? Some Americans have relied on a type of insurance that can extract a bewildered traveler from a politically unstable country like Egypt or pluck an injured climber off a snow-covered mountain in South America.
New Hampshire-based On Call International just evacuated 65 of its American customers — students, business travelers and vacationers — from Egypt to Greece and the Czech Republic. Those evacuees eventually will wind up back in the United States. On Call International provided similar services to more than 25 U.S. and Australian citizens who were in Mumbai, India, during a series of deadly terrorist attacks in 2008.
Actually, coverage like what’s offered by On Call International isn’t insurance. Rather, it’s a membership plan. Whatever it’s called, some travelers swear by it, particularly since it’s relatively cheap.
Some of these membership plans — such as Air Ambulance Card and MedJet Assist, both of Birmingham, Ala. — provide members with medical evacuation to either a hometown hospital or any hospital of their choice if they need care than 150 miles from where they live. Both companies boast a network of health care providers as well as medically equipped jets and aircraft carriers.
On Call International rescued about 65 of its members from Egypt after political protests erupted there.“Typical travel insurance is based on medical necessity to the nearest appropriate facility, and the insurance company makes all the decisions. In our case, it’s your decision if you want to go back home,” says Stan Bradley, managing partner at Air Ambulance Card.
Byron Vickery, a malpractice attorney in Ohio, didn’t require emergency evacuation back to the United States, but he did require emergency gallbladder surgery while he was visiting his daughter at the University of St. Andrews in Scotland. The surgery left him with a 10-inch incision and in extreme discomfort. At his request, Vickery’s MedJet Assist membership provided a surgical nurse escort and first-class air transportation for his trip back to the States.
“The nurse was a take-charge-type individual and made my transfer from Scotland to my hometown of Columbus, Ohio, as comfortable and safe as possible,” says Vickery, who remains an avid international traveler.
An emergency lifeline
Along with medical evacuation, Singapore-based International SOS maintains 31 of its own health clinics in developing nations, such as Azerbaijan, Mongolia and Uganda. Members can visit these clinics for Western-style care. Other services include translation services and legal advice.
For serious illness and injury, International SOS has established a network of 70,000 health care providers around the globe. U.S. members needing assistance are served by a call center in Philadelphia, one of 25 such centers worldwide.
“Most consumers, myself included, are spending time on the Internet looking up to see what the best restaurants to go to, where can I get the best deal on a hotel. You could spend a couple of hours on that,” says Suzanne Garber, International SOS’ chief operating officer for the Americas. “You might want to do the same for medical preparation as well.”
During a vacation with his wife to the French-speaking island of St. Maarten in May 2007, Philadelphia businessman John Friel suffered internal bleeding that led to heart failure, pulmonary edema and pneumonia. Fortunately, he had a membership with International SOS through his employer’s corporate plan.
The Friels didn’t speak French; they had no idea where to go. A phone call to International SOS helped them locate the nearest company-recommended medical facility. After being flown from St. Maarten’s Medical Center to Hospital Martinique, International SOS’ team of doctors and Friel’s American cardiologist determined that the only way to ensure Friel’s survival was to take him to the University of Pennsylvania Medical Center.
“I would be dead had International SOS not flown me from the Caribbean,” says Friel, who’s now retired. “I tell all my friends, acquaintances and anyone else I meet that they are foolish if they do not sign up.”
‘Nobody is left behind’
Along with standard medical evacuation, companies such International SOS and Boston-based Global Rescue offer something akin to a SWAT team.
“Whether it’s in Beijing or Kuala Lumpur or at the top of Mount Everest or even in a firefight somewhere, we’re Johnny on the spot,” says Stu Richards, vice president of Global Rescue. “No insurance company can help you at the top of Mount Everest or in a firefight.”
During the devastating 2010 earthquake in Haiti, International SOS and Global Rescue dispatched teams to locate and evacuate their customers, including corporate clients, missionary groups and educators.
“Our motto is, ‘Nobody is left behind.’ We’ll send people to get you help whether by raft or aircraft,” Richards says. “We have an exclusion that says if we think it’s too dangerous, we won’t go. But we’ve never been asked to go somewhere we’ve been unwilling to go.”
Numerous sports organizations and extreme adventure groups maintain corporate plans through companies like International SOS and Global Rescue.
Ben Clark, an executive producer of “extreme skiing” videos, had access to Global Rescue membership through his affiliation with the American Alpine Club, broke his ankle in May 2010 while walking along the Baruntse base camp in the Himalayas at 17,600 feet. Not only was the high altitude a problem, but at the time there was a labor strike in Kathmandu, Nepal, so vehicles weren’t allowed on the roads. Global Rescue sent a rescue helicopter to fetch Clark.
“I’ve been running around mountains professionally for over a decade and nothing else comes close to this level of service and commitment that works out in minutes, not days,” says Clark, who captured the rescue on his blog.
Assistance in familiar and foreign lands
Even if you’re not venturing to an exotic place like Nepal, membership in one of these plans can come in handy. At Air Ambulance Card, transfers within the United States have represented about half of the company’s medical evacuations in the past five years. At MedJet Assist, though, 90 percent of members buy coverage for big international excursions, says John Gobbels, the company’s chief operating officer.
“They take their big trip to Africa and then come back fine. Then they go to the beach for a week and have some type of event or get really ill and they want to get back home as well,” Gobbels says.
He adds: “We have no exclusions for adventure travel. A lot of our members are in the jungles, doing zip-lining or things where you could fall and have orthopedic injuries. We have an older population who is predisposed to heart disease and stroke. So it’s anything a member could have that places them in a hospital scenario.”
Typically, medical evacuation plans even cover the cost of an additional passenger to accompany you. They also pay for transportation of your remains back home if you die.
These membership plans don’t cover actual medical expenses, such as treatment at a hospital — things that your health insurance policy may or may not cover. International SOS does offer medical insurance for an extra charge, however. These plans also don’t cover travel interruption costs — such as hotel or luggage fees — in the event of an evacuation.
Furthermore, some plans have age restrictions. For instance, Air Ambulance Card caps coverage at age 75. At Global Rescue, the age limit is 85.
The costs and the benefits
So what do these “extreme travel” services cost? Not as much as you think. Unlike traditional travel insurance, there are no bills, claim forms, co-pays or deductibles. The plans could spare you from out-of-network costs if you’re hospitalized away from home as well.
At On Call International, for example, a one-trip membership costs $55. For an annual membership, the price tag jumps to $225. These plans also sell memberships to Americans studying abroad or Americans living and working abroad.
For some people, that’s a small price to pay, given the fact that a recent medical transport from the Philippines to the United States ran up $173,000 in costs for Air Ambulance Card. At Global Rescue, an evacuation from China totaled $200,000.
MedJet Assist’s Gobbels says: “Most people don’t have that kind of money, so they end up having to stay in a foreign country until they can recuperate enough to be able to take a commercial flight back home. This membership, while it can certainly save your life, it can also certainly save your life savings.”
–Rita Colorito
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Filed under insurance by on Feb 3rd, 2011. Comment. 
It sounded so simple. Two weeks along the Amazon. How could you say no? You dreamed, you packed, you departed. But you got malaria. You ended up sick and out of money.
You don’t have to let that happen. There’s a little something you should pack in your luggage before traveling outside the United States: your health insurer’s contact information and a supplemental health insurance policy. A travel journal, with key phone numbers and contact information, is vital as well.
No one wants to plan for a bad turn of events, but these precautions can reduce complications during a health emergency.
The U.S. State Department can contact your family and help route private money and your medical history to you. Still, the State Department emphasizes that you should call your health insurance provider before leaving.
Supplemental health insurance can be a lifesaver if you become sick in a foreign place like Costa Rica.The department advises you to ask whether your policy applies overseas, and whether it covers emergency expenses, such as medical evacuation (which could cost up to $50,000). If it does not, consider supplemental insurance, the department suggests.
Health costs can mount quickly when you’re abroad. Supplemental health insurance policies for travel generally aren’t cheap. For a couple around age 50 planning a two-week trip — with a $50,000 coverage limit for each person — the total cost ranges from about $80 to $120 (including evacuation coverage). However, that policy may be priceless if a medical emergency arises.
Insurance professional Peter Evans says: “When you’re going overseas, the first thing you’ve got to look at is, ‘How am I going to be covered if I get into trouble, from a health perspective?’”
Evans is executive vice president of InsureMyTrip.com, an online provider of travel insurance information, including policy comparisons.
“Before you go, take stock of what you have and find something that will supplement it, to cover you while you’re sick abroad, and cover your evacuation,” Evans says. Most policies don’t cover foreign emergencies to the extent consumers may expect. “They provide only partial coverage, if any,” Evans says.
Several types of insurance are available—coverage for one trip, ongoing travel or long-term residence. There’s also medical evacuation coverage, something that’s critical when you’re hundreds or thousands of miles from a good health care center.
The U.S. Centers for Disease Control and Prevention points out conditions that could affect your health when you’re traveling abroad, such as high altitude, pollution and availability of medicine. One phone number to jot down in your journal — the CDC’s international travelers hotline: 1-877-394-8747.
The American Society of Travel Agents knows the risks.
“We suggest member agents make their clients aware of the importance of purchasing travel insurance, which may include some health coverage, depending on the policy,” said Kristina Rundquist, a vice president at the travel agents group.
The U.S. State Department recommends that you call your health insurance provider before jetting off to a place like Sydney, Australia.The travel agents group doesn’t make recommendations about any insurer. Consult your health care provider or an insurance advisory group for assistance with health insurance for travel.
InsureMyTrip.com’s Evans offers these insights:
• Review your current policy and know its limitations.
“There are policies that don’t cover you at all while you’re overseas; some HMOs don’t,” Evans says. “Be prudent, and make the small investment in a travel medical policy. If your policy only covers half of your medical costs, you have exposure.”
• Know that medical evacuation coverage is critical.
“If you fracture your leg in China, you may need to get from inner China back to Beijing to be properly treated,” Evans says. “No medical policies will cover that; you need to get a travel medical policy.”
• Realize that accessing money can be difficult.
“Some policies will provide money upfront, because many foreign countries will not accept a U.S. ID card. So they’ll do a prepaid certification to the hospital you are being admitted to. Most of your travel medical policies provide that,” Evans says.
• Keep in mind that a reputable insurance provider is important.
“Read the (policy) details. Read the fine print,” Evans says. “If you don’t have time, lean on folks like us. We can go through it with you and get the right plan for your particular trip.”
• Prepare for a language barrier.
Wherever you are, you may need an English-speaking doctor. InsureMyTrip.com and the State Department provide lists. Print one out and take it with you.
• Be aware of Medicare limitations if you’re a senior.
“Medicare’s basic plan doesn’t cover you overseas. You need to buy a supplemental Medicare plan, Plan C or above,” Evans says.
Medicare has a lifetime maximum of $50,000 and only covers 60 days outside the United States. It generally covers 80 percent of costs after a $250 deductible, but does not provide evacuation coverage.
–Ann Connery Frantz
Filed under insurance by on Jan 20th, 2011. Comment.
Are you planning to attend the inauguration of President-elect Barack Obama, or do you know someone who is? Hopefully you already have lodging and transportation arranged, because it may be very difficult to find them at this point. However, if you thought those issues and the crowds were your only concerns, you could be mistaken.
Before you jump in the car or catch a plane, take a few minutes to make sure your trip is stress-free.
If you thought transportation, lodging and the crowds were your only concerns, you could be mistaken.
Leave your valuables at home
Whether you’re a seasoned traveler or a first-time visitor to the District, it’s a good idea to travel light. Bring only the electronic equipment you can carry comfortably and never leave anything in your car, your hotel room or a private residence. A recent announcement from the District of Columbia Insurance Commissioner urged people renting out their homes for the inauguration to contact their homeowners insurance company to see if they would be covered. If you’re considering renting out your home, remember that homeowners insurance may not cover a one-time rental of your house. That means that people who are renting a private residence should take extra care about what they leave in the home.
Make sure your car insurance covers out-of-state travel
Traveling from state to state doesn’t usually raise any issues for your car insurance company. Policies in most states will automatically provide you with the legally-required insurance for other states. However, laws can vary by state, so be sure to check that your policy will cover you when you travel. For example, some Massachusetts policies only cover travel within the state. Also, think about public transportation once you arrive. It’s easier and safer.
Buy rental car insurance if you have no other coverage
Most car insurance policies will cover a vacation rental car, as long as you have comprehensive and collision coverage. If you don’t have car insurance, you might think about purchasing a non-owner’s policy that will cover you when driving other people’s cars. Also, your credit card company may cover damage to the rental car. Finally, no matter what insurance you have or purchase, remember that coverage will not be extended to a driver who is not listed on the rental contract.
The decision about whether to purchase waivers or the rental company’s insurance is one of the more confusing and often asked insurance questions. For more details, see our article, “Should You Buy Rental Car Insurance?”
Get travel insurance when you fly or have health issues
Travel insurance can be a lifesaver when unexpected issues arise. Depending on the type of policy you buy, it can provide coverage for your belongings, emergency medical care, accidental death, and trip cancellation. Although many of these coverages can be purchased elsewhere, possibly for less, it’s important to make sure that your other insurance policies will give you the coverage you expect. Credit card companies will often offer or automatically provide a small amount of travel insurance, but it may not match exactly what you need.
Travel insurance can pay for lost or damaged luggage and other personal possessions, hospital stays and medical treatment, lodging for a trip extended due to a medical emergency, and travel expenses for a nurse to accompany you on a return trip if needed. Not all of these coverages are offered with all types of travel insurance, and the amount the insurance will pay can vary as well, so it’s important to read and understand the contract.
Even if an injury sustained is relatively minor, it can result in significant travel problems. Airlines and other transportation carriers can elect to not allow you to travel, or require permission from a doctor before they will allow you on board. This alone can add significant unexpected additional expenses to your trip, and is just another reason to consider travel insurance, especially if you’re traveling a great distance.
If you are planning on a trip to the inauguration, we hope it is safe and enjoyable. Take lots of pictures!
Do you have any questions or comments? Please let us know.
Filed under insurance by on Dec 29th, 2010. Comment.