Travel insurance is short-term insurance available specifically against travel-related emergencies and expenses. International travelers will almost always want to obtain travel insurance because it covers medical expenses, but even other travelers may find it useful depending on their plans. As coping with an emergency during a trip abroad can work out to be very expensive, in general, if you cannot afford travel insurance, you cannot afford to travel.
This article describes common items covered by travel insurance policies and what to check for on your policy. With any policy, it is important that you read the terms and conditions carefully and that you especially review the exclusions (things that the policy definitely does not cover).
This article is a general guide to travel insurance policies, including some possible terms but is not a substitute for careful review of the specific policy you may purchase. Travel insurance policies differ markedly in their terms and conditions.
Travelers sometimes feel they can skip being insured if they're not carrying valuables, have changeable/refundable tickets, and can afford to be stranded at their destination for a while. Here are four reasons that may not be case:
- Sickness or injury. Even though your health insurance costs may be covered at home by a government scheme or private insurance, it probably won't be valid outside your home country. Except for the occasional reciprocal agreement (such as in the EU), and the somewhat rare private worldwide policy, you won't have any health insurance abroad. A small number of countries extend free or mostly free public health care to tourists, but it may not be up to your standards.
- Medical evacuation back home or to the nearest suitable hospital can cost well over US$250,000 per evacuation. Even if you're covered abroad (per above), it's very unlikely to get you back home if you are seriously ill or injured beyond what can be handled locally or requires a lengthy recovery. This also includes children, infants, and pregnant mothers who should NEVER rely on their everyday health insurance for medical evacuation.
- Stranded in a connection city. Not all delays and problems occur at your destination. International airline hubs tend to be located in major cities such as New York, London, Paris, Tokyo, etc. The cost for accommodation and necessities in such places is quite high.
- Return travel at short notice can be expensive. Suppose you got an extremely good deal on an airline fare. Unfortunately, in the middle of your vacation, a non-traveling close family member passes away. It may well cost many times what you originally paid for airfare to get back home, in addition to forfeiting the remainder of your stay.
These situations, plus many others, are explained in greater depth below.
You can obtain travel insurance through your travel agent, your normal insurers, or any one of a number of specialist travel insurers. Shop around. Because travel insurance policies are somewhat interchangeable, there are a number of websites where you can compare policy costs.
Like most insurance, the lowest tier has the highest cost per amount of coverage. This occurs because every claim—no matter how large or small—feeds from the lowest tier. In comparison, very few claims go into the highest tier. If you want $250,000 of Medevac insurance, you're going to pay for it. But if you want $1,000,000 coverage instead, the premium increase is very modest. Of course it's a waste of money to insure your belongings for more than they're worth, but catastrophic injury or illness could happen to anyone.
You purchase travel insurance for international trips through an insurer in your country of residence, i.e., the country to which you'd want to be evacuated to or return to after a serious medical emergency and/or the country you'd need to travel to if a family member became very ill (these are assumed to be the same country).
Some credit card companies insure trips purchased with certain types of credit cards they issue; coverage will almost always be strictly limited to the costs of travel so purchased. And, credit card insurance, may be invalidated for travelers who paid travel deposits in cash rather than using the card. Many cruise and travel agencies offer travel policies for travel booked through them; costs and quality of coverage can vary widely, so examine terms carefully. Business travelers or university students on exchange may be covered by a company-wide insurance policy, but if you intend to take any side trips or have a personal holiday, check the cover: usually personal holidays on the side must be of a fairly short length to be covered by such a policy. Be sure to check any "existing deal" carefully and ideally get confirmation in writing of your cover.
If a member of a travel association or large professional group, you may find that it offers or endorses an insurance provider that provides extra cover or better rates. Failing that, you may find cover through on-line search. But take care that the company has a good reputation, e.g., from friends/family that have had to file claims, or local travel agents (mere on-line reviews/ratings may not be genuine). The discounts available here can be huge. A $20 membership of your local bridge club may save hundreds when you realise you can be covered under their annual travel insurance.
Very regular travelers taking three or more trips a year, may find that "ongoing" or "periodic" travel insurance, typically purchased a year at a time, can be cheaper than insuring each trip individually. Most major travel insurers offer such policies. Large businesses often purchase such insurance for their key or frequent travellers.
- Flight insurance, sold at some airports, is simply a very overpriced form of accidental death coverage policy valid only for the duration of your flight. Don't waste your money; even casino gambling and lotteries have much better odds than flight insurance. To put this in perspective, no one could have filed a claim in the U.S. for flying on a domestic jetliner flight since 2001 or 2006 for commuter airlines.
- Cruise insurance (most cruises should be insured, but not with this type of coverage). Temptingly modest in cost, many such policies cover few risks at very basic levels (rarely medical care or Medevac), only during your cruise, and for activities/tours sold by the ship. In reality, you'll likely have many risks before, during, and after your cruise that won't be covered, such as troubles before the trip starts, flying to/from embarkation-debarkation ports. In contrast, coverage from a major travel insurance provider (i.e. they insure not just cruises, but all major forms of travel) is usually much better.
- Airline insurance While far better than flight insurance (above), it is also very restricted. These policies are sold at the time of buying an airline ticket online. You will usually get better value with a more comprehensive policy. Exception: If you're flying one-way to stay somewhere for months or years, this type coverage might be the best. Always check the details for valuables and exclusions. Also, be sure to have insurance as a local resident would when you arrive.
When to buy
You will get the best value out of your policy if you purchase it as soon as your travel plans are final. Your travel insurance will only cover you from the day you purchase your policy, so if you are injured and unable to travel the day after you buy your ticket you won't be covered unless you have already purchased your insurance. Any medical conditions you have or may develop between booking your trip and buying your travel insurance will be considered pre-existing conditions. Any natural disaster or outbreak of violence at your destination that occurs before you purchase your policy won't be accepted as justification for a claim.
You can purchase travel insurance as late as your day of departure, although if you have pre-existing conditions (some that may need to be evaluated and accepted by the insurance company) you may be out of luck if you wait too long. Basically, good policies/coverage options can cover many or all pre-existing conditions (sometimes at modest costs for those options), but only if you buy coverage within a very short time after booking your travel ("booking", as distinct from when you pay for it); a few others may allow purchase of such coverage up to two weeks after booking. (See "Pre-existing conditions" below)
There are a number of factors that generally influence the cost of a policy.
- Committed cost of trip. This means those costs (to you) which will be forfeit/lost if any travel must be cancelled. For road trips, they may only include deposits or full payments for lodging. For flying trips, they at least include airfares purchased. For cruises, they can include flight costs plus those for the cruise. You would be wise to include a reasonable-worst-case estimate for possible, incidental costs induced by trip cancellation.
- Number of travelers. Some travel insurers will cover dependents and families at a reduced cost.
- Age. Once you/members of your party reach 55 to 60 years of age, premiums can rise (though it's common to give discounts to much younger travelers). At older ages, some companies refuse insurance entirely, or add a significant surcharge.
- Duration. Policies are general sold for date ranges, e.g., the defined duration of trip, or 7/15/30/90 days. If your trip is just one day over the limit, you may have to pay significantly more.
- Destination region. Exotic destinations may be cheaper than destinations like North America, where health costs are higher. But distance from home is a more basic determiner of risk to the insurer (and so cost to you), e.g., for medical evacuation.
- Pre-existing conditions. These are usually assessed by the insurance company once you make a claim. Coverage for them can result in an additional premium, seldom policy refusal. (Sometimes waived if you sign up soon after booking travel)
- Additional coverage. Example: How much do you need to cover a 24-hour delay? See the table of example coverages below.
- Valuables. There is usually a limit to value for loss or theft in the base policy.
Do not fail to declare to the insurance company all relevant details as you buy coverage; otherwise, they may not honor your claim.
Read your insurance companies procedures if you incur any expense that may result in a claim. If in any doubt, contact the insurer. Some insurance companies may require you to contact them before incurring any form of medical expense - they may have specific doctors and hospitals they will make arrangements with. If you require emergency treatment or are taken to hospital, inform them as soon as possible. Keep the expenses you incur to a minimum, and keep documentation for reimbursement.
Most policies require a police report to be filed for any items lost or stolen, but can offer an alternative in some cases, which can be useful in countries where it costs money to file a police report. You may need some proof of ownership to present with your claim.
Do not arrange your own evacuation unless your life is in danger and you or your companion(s) cannot talk to the insurer first. As explained below, your insurer may have fully-effective, alternate means to arrange what you need, and avoid one-time costs with Medevac companies they don't normally do business with. Your travel insurance won't pay (or pay fully) if evacuation is otherwise self-arranged. In case of unavoidable self-arranged evacuation, go no further than what's necessary to obtain proper care—not (in most cases) all the way home.
All claims should be filed promptly. Most insurers have a limited period of time after a given event for which you can claim associated expenses...usually no more than a year.
Your trip insurance is secondary coverage for your trip. That means you have to make every effort to recover your costs from other parties before making a claim. You need to ask for refunds from providers for all or part of the costs of tours, lodging, etc., that you had to cancel. You can only claim for the outstanding amounts.
You have a duty to avoid unnecessary costs as you arrange for the premature end of your trip, e.g., notify tour operators/hoteliers of your circumstances and cancel what you can to obtain all possible refunds, don't use (or make claims for) five-star hotels and first-class air for the rest of your group if that was not already part of your trip.
If you are incapacitated, your travel companions or contacts at home will need to deal with the insurer; make sure they have contact details. Many insurers have a 24-hour hotline that you can call. Often, this service is an advice hotline and the insurer may transfer you to their professional staff or those in your area to advise you about medical facilities and services available. If you or a travel companion can first inquire locally about medical capabilities, that can be useful information.
Things that can be covered
There are two major classes of travel insurance:
- International travel insurance, covering travel outside your country of residence. This is an essential part of international trips because many healthcare arrangements won't apply in other countries and you either need insurance or to be able to pay all medical bills out of pocket.
- Domestic travel insurance, covering travel inside your country of residence. These policies are generally cheaper than international policies because they usually don't include medical coverage – you presumably have other arrangements in your own country. They focus on compensating you for purely travel-related problems like cancellations and closures. They are also much less essential and you can consider their worth on a trip-by-trip basis.
When buying travel insurance, you should review the dates of coverage (include the day you leave and the day you arrive home; unavoidable delays are automatically covered), whether it protects you enough financially, and the exclusions.
As you digest the kinds of coverage discussed below, you may discover that you only need one or a few types, e.g., medevac (medical evacuation) from a trip location very far from home. With some research, you should be able to find separate coverage for each. If you need many types of coverage, you'll likely want an integrated policy that offers many kinds of "protection", some of which you may not need. But its cost is likely to be significantly better than separately buying all that you need. The "Example tables of coverage" below introduce you to the many risks that can be covered.
Usually, whatever standard health insurance you have will pay only claims for medical care in your country of residence. Therefore, medical costs incurred abroad in many cases won't be covered. Some countries with universal healthcare (such as Canada, UK, Australia) might have reciprocal agreements with other countries with similar health care systems. However, even if a country extends its subsidized medical care to tourists, what's provided may not be up to your standards or needs.
Unless you are covered by a reciprocal arrangement or your regular health insurance has international coverage, you may have to pay all medical expenses incurred while traveling out of pocket. In many cases, quality medical care can be extremely expensive. Therefore, all international travelers should be certain that they have medical coverage, usually via a travel insurance policy that covers unexpected medical expenses incurred during their trip. Unless you won't be far from home, you should also opt for medical evacuation coverage discussed below.
Some hospitals may only admit you if you evidence of a travel insurance policy or proof that you can pay.
When considering a travel insurance policy's medical coverage:
- Check the precise details of medical care that you will be able to claim. If your destination has a tiered health system with, for example, public and private hospitals, are you able to use a private hospital?
- Does your insurer offer 24 hour contact with emergency advice? These hotlines allow an insurer to assess a situation and give some advice about medical care as quickly as possible. Your insurer may have local knowledge that you do not have.
- If you take part in any adventure sports or activities like alpine skiing or scuba diving, check your policy for medical coverage related to accidents that happen while you're doing that activity and whether or not you need any formal training to be insured. If you can't find a general travel insurance policy to cover your activity of choice, you may be able to take out a separate policy from an insurer specializing in that activity.
- Is there coverage for illnesses that become apparent after your return? International travel insurance policies usually exclude medical costs incurred in your country of residence even if the costs stem from an injury or illness that happened while you were travelling. Medical costs in your home country are assumed to be covered by your normal healthcare arrangements. Some policies may cover tropical diseases such as malaria for up to a year. In rare cases, these can have long periods between exposure and illness.
- Does the policy have adequate coverage for dental expenses? There could be substantial amounts available for general medical expenses, but only a very small sum, (for example, only $500) for dental expenses.
Caution: coverage for medical care does NOT automatically include medical evacuation.
Pre-existing medical conditions
If you have, or have ever sought treatment for, a medical condition, you should read the policy procedures on pre-existing medical conditions carefully. The insurer may
- Refuse to insure you
- Require you to undergo a medical examination
- Charge you an extra premium
- Increase your excess/deducible, or cap the amount they will pay
- Exclude health care related to your pre-existing condition
- Exclude all health care costs
You may have difficulty obtaining travel insurance if you have a high-risk, pre-existing condition such as heart disease, or have been diagnosed with contributing factors towards disease, e.g., clotting problems or high blood pressure. If asked, you may be required to disclose information about major, existing conditions in your medical history to your insurer, even if you are not seeking coverage for pre-existing conditions; your policy may be completely invalidated if you fail to disclose something pertinent.
Some policies may cover you generally, but with some or all pre-existing conditions excluded. This is obviously undesirable if you have an existing condition that causes you significant problems or leaves you at risk. But, some policies will cover medical and other pre-existing conditions only if you buy coverage within a short time after booking your travel, perhaps just 24–48 hours; a few other policies may allow up to two weeks. This is after booking, not after final payment. For many people, it's worth some research to find such quality policies. For policies that offer to cover serious conditions, any medical assessment (as above) may well render last-minute policy purchase impossible.
If you are pregnant or are undergoing fertility treatment, you should read the policy information regarding pregnancy. Most policies consider pregnancy a pre-existing condition, even though they may cover with no additional information or cost required subject to certain criteria. The requirements vary substantially. Sometimes additional premium is required. Sometimes a letter is required from your obstetrician. Medical coverage may not be permitted beyond a certain stage of pregnancy. Different rules apply to multiple births, or IVF births. If you have ever been hospitalized due to the pregnancy, coverage may be denied altogether. Continued care of the infant might not be covered by your policy. Always have Medevac insurance in case of premature birth, or you will be stranded!
Refusal of medical coverage
Some pre-existing conditions will cause insurers to completely refuse all medical coverage, even for seemingly unrelated events. This will vary by insurer, but include conditions like terminal illness, being an organ donation recipient, having AIDS, and similar systemic risky conditions. Such people may not be able to travel secure of receiving affordable medical treatment for any condition at all.
When medical coverage is refused, typically the other provisions of the policy still apply (e.g., claiming the replacement cost of stolen items).
Medical evacuation coverage
Some travelers have international medical coverage as part of their everyday health insurance, though it is rarely included in government-provided health care (except for reciprocal agreements among nations). However, health insurance virtually never includes medical evacuation. Even if you are willing to forgo all other types of travel insurance, you should never ignore medical evacuation coverage. Costs for it are so high they can lead most families to bankruptcy. Unless you're a member of the billionaire club, you definitely need this coverage for long-distance travel (i.e wherever traveling by surface while sick or injured would be impractical).
A medical evacuation is often a chartered trip (usually a flight) for a patient who is not well enough to return home by other means to better facilities or to their home country. It typically involves traveling with medical personnel looking after you throughout the return home, along with any needed equipment, medications, etc. Though the need is rare, its costs can be devastating to most peoples' savings. On-balance, the cost of coverage is not terribly high. In most cases, you should consider geography, rather than national borders, in whether or not you need this coverage. For example, someone living in Buffalo, New York who wants to visit the Canadian side of Niagara Falls would probably not opt to buy. On the other hand, for someone living in San Francisco flying to Hawaii, it could mean the difference between returning to SF Bay area promptly (albeit still hospitalized), and remaining stranded in Hawaii for months.
There are multiple reasons a traveler would need medical evacuation. In simple cases, after local treatment, you may only require medical monitoring, possibly on a commercial flight in first or business class to provide for more room. In moderate cases, you may be just well enough to travel with medical assistance while lying down, but not well enough to use a commercial airliner--especially if you have or had a communicable disease. If jumbo jet travel is possible, five seats in a row may be removed to allow you to remain laying down during the flight. Either you or the insurance company pay for all five. Though much cheaper than exclusive medical evacuation, it's reported to be quite uncomfortable.
Some less-developed countries or the hinterlands of most countries may have no capabilities to treat serious injuries or illnesses. You might need to be immediately evacuated to the nearest suitable hospital for treatment, only to later be evacuated to your home country. The total price for this type of "double evacuation" can be extremely high, especially if the first hospital is relatively distant, and you're still very far from home.
Supplemental insurance (such as AFLAC in the USA) may cover medical evacuation, but only for about US$3,000. This is woefully inadequate for international travel. Domestic "medi-evac" is only intended to partly cover airlift to the nearest hospital (such as a helicopter serving an auto accident outside a major city), rather than evacuation to your home country while abroad. Make sure your policy covers at least US$300,000 or equivalent, and seriously consider opting for US$1,000,000 coverage (usually at modest added cost).
If you are incapacitated while traveling, some policies will pay for a relative or friend to travel to you and either stay with you or escort you home.
Lump sum payments
In addition to covering your medical expenses if you are ill or injured, some policies will pay a lump sum to you or your estate in the event of an accident or untoward event. For example, they may pay you a fraction of your salary for a certain time if you are injured while traveling and unable to work.
Cancellation and delays
Travel insurance will often cover expenses related to unexpected cancellations by your carrier or destination providers, e.g., costs associated with or induced by a canceled flight, including accommodations, meals and other incidentals. Cancellations due to emergencies are often also covered, some possible examples include the following:
- Medical advice telling you that you cannot travel
- A death or (sometimes) medical emergency in your family
- A major disaster at home such as a house fire
- Disasters or upheavals at your planned destination that occur after you booked your trip
Depending on what's happened, the insurer might pay re-booking fees, refund lost deposits, or pay for travel home. Travel insurance pays only for direct losses such as these. You won't get additional compensation for being disappointed due to your holiday being cancelled. Also, there is no compensation for planning, preparation, items purchased for your trip, etc. In extreme cases, if you would really be sacrificing a lot of money if the trip were cancelled—even if all travel-related deposits and non-refundable payments were reimbursed—you'll have to contact a specialty insurer such as Lloyd's of London. An example would be a performer who's rented an auditorium or theater with a hefty deposit, as no travel insurance would ever cover this. Contact the specialty insurer first, as they may offer the usual travel insurance at a discount in addition to whatever special needs you have, if you buy both.
High quality policies may cover your own discretionary cancellations if there is an exceptional circumstance: for example, there are some travel insurance policies that will pay you the cost of your ski lift tickets if a resort has shut due to lack of snow. Very good coverage (with payment for quality options) may include payment for a major portion of unavoidable costs even if you arbitrarily decide not to take the trip.
There are always a raft of conditions about acceptable and unacceptable cancellations based on your purchase of certain coverage options. Some examples of troublesome situations:
- You can purchase insurance covering a trip home because of the death of a family member, but a trip home due to the death of a friend almost certainly won't be covered, and even a de facto or engaged partner's death might not be;
- Family medical emergencies other than a death often aren't covered; for example the insurance might not cover a trip home to be with a family member who has been hospitalized or diagnosed with cancer – even if it's your own child;
- If the family member's emergency isn't in the same city as where you started your trip, you'll have to pay any increase in airfare. Upon reunion, your policy may no longer provide any coverage, and you're on your own.
- Many policies cover cancellations or delays due to terrorist activities occurring within the past 7 to 30 days prior to your arrival date, but very few, if any, will cover these due to the mere threat of terrorist activity. For example, if an attack occurred on 01 June, a good policy would allow cancellation for anyone whose arrival date is within the month of June. A "cheap" policy would only cover the first week. Should a subsequent attack occur, the clock would be reset--even if you booked after the first attack (assuming the destination is still covered by the company). Mere threats without an actual attack are not usually covered.
- If your transportation carrier shuts down, you may not get paid unless they declare bankruptcy. (Although bankruptcy protection is very commonly found in travel insurance polices, it only covers those of travel providers--never your own personal or self-employed business bankruptcy.)
- Although cancellation due to your home being uninhabitable (fire, flood, etc.) is usually provided, there is no coverage provided for renters or those leasing their home if the landlord wants you to move out. Do not take an extended trip if it would prevent you from having enough time to find new housing and move your belongings. Before booking a trip, always check your housing contract to find out how much advance notice the landlord must provide (may be superseded by more recent law), and important dates such as the end of the lease term.
- Likewise, if you are the landlord of a rental home, or own a second vacation home (but traveling elsewhere) there is no cancellation coverage provided in case of severe damage or destruction.
- Most policies will not cover a strike if you book travel after union members vote to approve a strike (which could be weeks or months ahead of the actual strike). Also, be aware of de facto strikes such as a "sickout" – usually by just one segment of the airline (such as pilots). A few policies may not cover this, or cover it only as a delay.
- It's easy to find cancellation coverage for being unexpectedly unemployed after booking a trip, with a minimum amount of time on the job (usually 3 to 6 months), but travel insurance does not cover lost wages if you're delayed in returning home. Instead, look for policies that pay a certain amount for each day of delay, without having to document expenses. If you travel frequently, save whatever you collect on claims for outbound delays. This can help make up for lost wages when you're delayed on the return trip.
- Some policies cover cancellations if a destination has recently become unsafe due to a state of war, but not due to a "travel warning" by your government. If an actual "declaration of war" is needed to file a claim, it's highly unlikely your situation will apply, as no country has officially declared war since the end of World War II in 1945. Virtually all conflicts post-1945 have been with one (or both) sides as non-state actors. Sometimes the United Nations uses "police action," and countries admit they're in a "state of war," but these fall short of the definition.
Take care with cancellation waivers offered by tour packagers or operators and travel packagers/consolidators who've arranged your travel. If you or they must cancel, such waivers typically cover only what you've paid them, and not induced costs or other related commitments you've made. They also may have no value if the reason for cancellation is bankruptcy of the packager/operator.
Key caveat: For any cancellation, you have a duty to minimize all induced avoidable costs/expenses.
Resuming your journey
If you have to cut your trip short for certain reasons (usually illness on your part or on the part of a relative) some policies will pay the cost of an additional return ticket so that you can resume your journey later. This may apply only before a certain time (they won't fly you back if you had only 48 h left of the holiday anyway!).
Loss, damage and theft
Some travel insurance policies cover the loss of or theft of your belongings while travelling. Those covering loss or theft of belongings are typically among more expensive policies, often aimed at business travelers. If claiming for theft, you must file a police report about the theft and get documentation, no matter how unlikely it is that the police will take any action. The insurance company will not pay your claim without a police report. In the Third World, always seek local advice before dealing the with police, especially for a relatively minor loss.
You may need to provide a list of items over a certain value and pay an extra premium to insure them. In the cases of expensive and easily disposed of items like cameras and laptops, policies may cover only violent theft or forced entry, e.g., if you leave your belongings in a room and they are stolen, coverage may be invalid if there was no forced entry. When considering claiming for damage, check the terms carefully: many expensive and fragile items are only covered if damaged while being carried by you. It is very common to exclude any damage done to your belongings if they travel as checked luggage--you must keep them on your person to be covered. Theft from unattended vehicles will have limited coverage, as will theft of, and particularly simple loss of, cash, money orders, travelers checks, and credit cards. For the latter two, contact the company, as they will usually reimburse your loss. (See the Money article.)
An insurance policy may cover expenses incurred by your estate related to your own death while traveling, such as the cost of arranging a local funeral and burial or cremation, or the cost of transporting your remains home. Having medical expenses covered by insurance is also very valuable to your next of kin in the event of your death as otherwise that person may be liable and your children and dependants may have their inheritance greatly reduced or canceled.
There may additionally be a lump sum benefit to your next of kin, though seldom anything approximating the amount of money a life insurance policy might pay.
Some insurers refuse to pay medical or any other expenses associated with particular activities. Some of these can result in significant costs that are not covered at all by insurance. Read the insurance policy carefully, but you may want to specifically consider:
- Riding a motorbike or scooter, although common in some south-east Asian countries will not be covered if you don't hold a motorcycle licence, and that licence is valid in the country where you are riding.
- Adventure sports, that lead to injury often aren't covered. This can including flying when not on scheduled commercial flight (such as general aviation).
- Third party theft, if you hire a bike, or a motorbike, don't necessarily expect it to be covered for theft - even though your rental car might be.
- Theft from checked luggage, and from cars. Valuables left in cars unattended, and laptops, cameras and other valuables checked-in to the aircraft often aren't covered.
- Sexually transmitted diseases, including HIV.
- Illegal activities Remember, this means whatever foreign country you visit defines as illegal. Laws vary greatly abroad.
- Accidents while under the influence of drugs or alcohol
Other exclusions also include anything that happened to you as a result of an act of war, insurrection. or rioting. Suicide or self-harm is nearly always excluded.
Some policies may exclude all coverage in certain countries or regions within countries. This is usually due to danger or serious health issues. Check the fine print of your policy, e.g., in one section of the policy it may explicitly list a country as eligible for coverage, and then in another section exclude coverage in any country listed on certain government websites, such as the World Health Organization or Britain's Foreign and Commonwealth Office. However, some insurance companies cater to this niche market.
Usually, as soon as your insurer repatriates you to your home country, their responsibility for your health care ends (though malaria might be covered for a year).
Travel insurance becomes increasingly difficult to get after age 65, with your age alone being considered something of a pre-existing condition. The precise cutoff for receiving insurance without an additional premium and/or medical examinations varies from 55 to over 70 for some insurers. As you age, you will face increasingly higher premiums and perhaps excess charges or deductibles on claims, and your existing medical conditions may be partly or totally excluded. This varies somewhat by insurance company and whichever country you reside in.
Some policies have an excess amount (also called a deductible), which is deducted from any claim you make, so that you will be paid the amount of the claim minus the policy's excess. In general, the lower the deductible, the higher the insurance premium. Travel insurance with a $5000 deductible can be as little as $10/month: that means that it will not cover minor expenses or even a mid-level problem like a broken wrist, but it will be a financial lifesaver if you have a serious accident.
Extending your trip
If there's any chance that your trip might extend beyond the period of your insurance, make sure that you know in advance how you can extend the policy and whether you can do this while traveling. It is generally much easier to extend a policy if you request the extension while you're still covered: obtaining a policy when you're traveling but aren't presently insured is difficult. In addition, if you let your policy lapse you will obviously not be covered for anything, including medical expenses, while you arrange a new policy. Many policies require that you apply for an extension at least 7 days before your policy expires.
When planning a trip, pay for your policy to cover a few days after your intended return. In the event of last-minute delays or changes of plan which extend your trip, you then have a few days to sort out any extension of the policy you need. Some policies will automatically extend if the delay is part of a problem that you could claim for: for example, if you have insured against delays and the delay extends your travel past the end of your coverage, the policy is automatically extended. This will typically not apply to pre-existing conditions or to high risk travelers such as the elderly, even if you fully disclosed pre-existing conditions when applying for cover.
Extensions to your policy are never guaranteed to happen. They will always be at the discretion of the insurer and may be refused based on your previous claims and any other information that you disclose when applying for the extension (and you will usually be required to disclose anything you think might be relevant lest the policy be void). Some insurers treat all applications for an extension as an entirely new application and will re-evaluate your circumstances before insuring you. Medical problems that occur during your holiday may count as pre-existing conditions when applying for an extension and certainly will if applying for a second policy.
Cautions about coverage
As noted above, quality coverage can be crucial. The legal terms will be declared in the detailed contract. You should be offered a copy before you purchase the policy, and carry it (in some form) with you while traveling.
To judge one part of that quality, review carefully terms that could "excuse" the insurer from paying benefits, e.g., going to destinations declared especially dangerous by your government, medical or medical evacuation costs induced by a terrorist act, or whether you have the option to cancel or cut-short your trip due to what you may (rightly or wrongly) perceive as too much danger...even an unforeseen forecast of terrible weather. If in doubt, call and discuss details of your trip and coverage with an agent of the insurance company.
Example tables of coverage
In concert with the above discussions, these tables reflect coverages under three kinds of multi-coverage policies currently offered by one reputable insurer. The first table reflects “top level” coverage items. You should see most/all such features (and perhaps others) immediately mentioned by a policy. You'll notice that the "Moderate Coverage" (Cvg) and "Deluxe Cvg" examples here are better oriented to international travel.
|Feature||Basic Cvg||Moderate Cvg||Deluxe Cvg|
|Emergency accident & sickness medical expense ($50 deductible)||10,000||50,000||150,000|
|Pre-existing medical condition||None||Included||Included|
|Baggage & personal effects ($50 deductible)||750||1,000||2,500|
|Missed connection/itinerary change||None||500||750|
|Emergency evacuation, medically necessary repatriation & repatriation of remains||100,000||500,000||1,000,000|
|Renter’s collision insurance (for liability, optional extra cost)||50,000 for $7/day||50,000 for $7/day||50,000 included|
|Accidental death & dismemberment (AD&D)||None||10,000||25,000|
|AD&D air only||Optional||Optional||100,000|
|Children under 17||One free per covered adult||All free||All free|
|Cancel for any reason||None||75% of trip cost||75% of trip cost|
|Medical & legal assistance||Included||Included||Included|
|Political evacuation||None||Included with optional Medical||Included|
|Lost baggage retrieval||Included||Included||Included|
|Passport replacement/visa info||Included||Included||Included|
|ID/credit recovery assistance||None||Included||Included|
This next table reflects sometimes hidden details of coverage, in this case just for “Trip/flight cancellation or interruption". A good insurer will explain any qualified details/exceptions behind every major/top-level type of coverage offered.
|Feature||Basic Cvg||Moderate Cvg||Deluxe Cvg|
|Pre-existing medical condition||None||Covered||Covered|
|Bankruptcy (of travel provider)||None||Covered||Covered|
|Weather (hurricane, etc.)||Covered||Covered||Covered|
|Accident enroute to destination(s)||Covered||Covered||Covered|
|Natural disaster at destination||Covered||Covered||Covered|
|Evacuation at destination||None||Covered||Covered|
|School year extension||None||Covered||Covered|
|Jury duty (non-postponable)||Covered||Covered||Covered|
|Job loss (w/min. time employed)||Covered||Covered||Covered|
Some coverages may be increased by paying additional premiums, e.g., for rental car liability. Others must be obtained through a separate policy, e.g., under "Injury" you may have no coverage if you voluntarily participate in risky or violent activities such sky-diving or rugby...unless you opt and pay for a special option (or rider), perhaps after describing the activity to the insurer. If they decline, you face getting a separate policy, perhaps from the same insurer...if you're so inclined. Having already bought a policy, some insurers may allow you to later increase coverage...almost always except for pre-existing conditions.
As discussed above, look at the details thoroughly, especially if contemplating a trip to distant lands. Once you have done so, have taken your trip and were happy with the insurer, for a subsequent big trip you may only need to quickly consider their same policy and options before buying it.
Many insurers specifically exclude travel to countries and areas known to be extremely dangerous. As a rough guide, if the US State Department or your own country's government recommends against any travel to a particular country or area, you will find it difficult to get insurance coverage or benefit from what you already have. As above, always, check the terms carefully, and if you are traveling to an unstable region, keep an eye on the travel warnings for any updates that might invalidate your insurance or "neutralize" its coverage while there.
Make and carry copies of your policy and your insurer's contact details with you. They need to show the insurer's e-mail address and international phone numbers for advice/authorizations and making claims. Have another copy in your luggage or online. Also give policy/contact copies to traveling companions and relatives or friends at home willing to help if needed. If you are incapacitated, someone else will have to deal with the insurance company on your behalf. They must know with whom, and how you are insured. If you are traveling to more remote areas (especially alone), give a copy (or at least basic information) to whichever local person is most responsible for hosting your visit, such as the resort manager or tour guide.
Also, don't forget to legally authorize medical care to any of your minor children and teens not traveling with you. In many countries, minors cannot consent to medical treatment, and doctors can only give live-saving care--nothing more--without your permission. Be aware that grandparents and other close family are not automatically authorized to consent. If there were a delay in contacting you (especially abroad), medical personnel cannot set broken limbs, give pain relief, etc. This applies to both minors staying at home without a custodial parent, and trips where minors and their parents will be in different locations at times during their travels. If this is a frequent occurrence, consider making a legal power of attorney document, where you chose another adult to make such decisions. This can be any competent adult, and doesn't have to be (and usually isn't) an attorney.