When an unexpected medical emergency happens while traveling, it can be costly and stressful if you are not prepared. This may be the last thing you want to think about when planning your trip, but it is worth consideration. The out-of-pocket expenses could be astronomical in the event of an emergency medical evacuation or medical treatment while abroad.

Many U.S. health insurance providers may cover what they deem as “customary and reasonable” expenses for medical costs abroad, but very few cover an emergency medical evacuation. They may also limit you to specified doctors and hospitals that may not be close to where you are staying, and payment is required before services are rendered. Medicare does not cover medical expenses outside the U.S.

These expenses can be avoided with proper coverage.

For those of you who are not in the best of health or are traveling with a medical condition, having coverage for a medical emergency is a good idea.

What is an Emergency Medical Evacuation?

You may be wondering exactly what is involved in an emergency medical evacuation. A field rescue is done at the location where a person has been injured or seriously ill. They are then transported to the nearest medical facility for diagnosis and treatment until they become stable. This is done via ambulance, helicopter, or plane. Once the patient has stabilized, they will then be flown to a medical facility closer to home, which may entail medical staff and special equipment on board.

Potential Costs involved in an Emergency Medical Evacuation:

The costs can run upwards of $25,000 within the U.S., $50,000 or more from a cruise ship (if outside U.S. waters), and in remote areas, the costs can escalate upwards of $100,000 to $250,000 or more. In essence, the further you are from a reputable medical facility, the higher the costs.

Having coverage for a medical evacuation is something to consider whether you are traveling in the U.S. or abroad. Without it, you could receive substandard medical treatment, or be forced to spend your recovery in an unfamiliar environment. It has been proven that patients have a faster recovery when in a familiar setting surrounded by friends and family.

Serious Illness/Injury On Board a Cruise Ship

If a passenger’s illness or injury is not life-threatening, the ship’s doctor may recommend that the patient be taken to the nearest port of call and transported by ambulance or helicopter to the nearest medical facility.

If the patient is in critical condition, then a helicopter would be required to airlift them from the ship to the nearest medical facility.

If the ship is in U.S. waters, the Coast Guard would be called upon to perform the evacuation. The Coast Guard does not charge for this service. However, if the ship is outside of U.S. waters, or if the person will be transported to a hospital at the nearest port of call, then another medical evacuation service would be required.

Passport:

Even though not all cruises require passengers to have a passport (closed-looped sailings that start and finish in the same U.S. port with travels to Mexico, Canada, the Caribbean, and Bermuda), it is highly recommended that you travel with one. If you have to disembark in a foreign country because of an illness or injury (or for other reasons), a passport will be required to fly back home. If you do not have a passport, you can request a temporary one for re-entry into the U.S., but it may delay your return by a few days or so. During stressful times, that can seem like an eternity.

3 Steps on How to be Financially Prepared for a Medical Emergency:

Step 1:  Check with your Health Insurance Provider:

Find out exactly what is covered on your policy when traveling in the U.S. or abroad, and if you are required to use designated medical facilities. If so, check the proximity of the facility to your vacation spot.

Questions to ask your provider:

• Does your policy cover emergency medical treatment by a foreign hospital? Are there stipulations on what doctors are covered under your plan when traveling abroad or within the U.S.?
• Does your policy include coverage for an emergency medical evacuation? Many do not.
• Does your insurance company offer a supplemental travel medical insurance plan that can be purchased for travels abroad? If so, find out if the supplemental coverage would then be secondary to your health insurance plan. For example, Blue Cross Blue Shield offers a travel supplemental plan called GeoBlue.
• Find out how payments to medical care providers abroad will be handled. You may have to cover the costs up front and get reimbursed later.
• Will you be covered for high-risk activities such as parasailing, mountain climbing, scuba diving, or off-roading?
• Is pre-authorization or a second opinion required before emergency treatment can begin?

Step 2:  Look into Purchasing Travel Medical Insurance:

Travel medical insurance is a policy that can be purchased for an individual trip (or for several trips) that covers expenses your health insurance plan does not. If your insurance policy does not cover you abroad, then it becomes your primary insurance. Check on the stipulations regarding previous conditions.

Many travel medical insurance policies offer emergency medical evacuation, but clarify what the policy includes and if there are any stipulations.

Several travel medical insurance providers offer direct billing if the medical facility is one of their contracted members. You would be responsible for the deductible at the time of service. If direct billing is not an option, you will be required to pay the costs upfront and get reimbursed (usually within seven to ten days).

You may be refused medical treatment when traveling abroad, if you do not have proper coverage or cannot guarantee payment.

An advantage with travel medical insurance is that you will receive foreign-language interpretation if the medical providers do not speak English. The travel medical insurance companies employ medical personnel (available 24/7) who can assist you in finding the closest reputable medical facility in a foreign country. They will be in communication with the treating physician to discuss your condition and treatment plans.

Find out if high-risk activities are covered — you will most likely be charged a higher premium to include these types of activities on the policy.

There is also travel insurance available that covers trip cancellation and delay, lost or stolen luggage, and more.

Step 3:  Services that offer Emergency Medical Evacuations

Not all emergency medical evacuation services are equal, so it is important to determine which service provider would be best for your needs.

Option 1:  Travel Medical Insurance Plans

• A medical evacuation is based on the patient’s condition and location. The attending physician and the medical advisor of the insurance company will determine if an evacuation is required.  You may not have the option of being transferred to a facility back home. If the closest facility is inadequate, you may get transferred to another reputable one.
• The evacuation is set up by the insurance company.  It may be via a commercial airline, ground ambulance, or an air ambulance transfer.  Find out if the travel insurance provider will cover the cost of airfare for those accompanying the injured/ill person to the medical facility.
• Some policies may offer a ‘hospital of choice’ benefit.  Even though it allows you to make a decision as to what hospital you want to be transferred to, it does not guarantee that you will be automatically be transported home. You may be transferred to the closest hospital, and when your life is no longer in danger, they may transfer you closer to home.

Option 2:  Emergency Medical Evacuation Membership Programs

Some emergency medical evacuation companies (like MedjetAssist, Global Rescue, AirMed, and more) offer coverage through a membership program where you pay annual dues. Their rates are based on individual, family, or business options.  Some offer travel insurance and travel medical insurance options as well.

Basically, if you meet the criteria for evacuation, these companies will arrange a medical transfer to a hospital back home. They are not an insurance company. Here is what you can expect:

• They arrange medical transportation from basically anywhere in the world. Their medical personnel monitor your condition with the attending physician.
• Provide communication with family members and business associates back home.
• Some companies may offer the option of including medical expenses in the form of a cash advance for emergency medical treatment that you would have to repay.
• Some may include a crisis response that would entail an evacuation to a safe location in the event of political unrest.

Before purchasing travel medical insurance or emergency medical evacuation coverage, check the fine print to see what is covered and be sure to find a reputable company. To compare the costs and coverage options of several companies, check out Insure My Trip. For insurance company ratings, visit A.M. Best Company.

Option 3: Credit Card Companies

Some credit cards offer emergency medical evacuation coverage, but you are generally responsible for making the arrangements. If you are in a foreign country and do not speak the language or have resources at your disposal, this could prove difficult in a stressful situation.

  For more travel insight, check out my book,

Know Before You Go: Traveling the U.S. and Abroad