A reader asks, “Is it a good idea to purchase travel medical insurance for international travel?”

First, don’t assume that your usual health insurance will provide adequate coverage (or even any coverage) when you’re traveling abroad. It’s important to note that if your parent is on Medicare, his or her medical coverage is severely limited—if it’s even covered at all—in a foreign country. In a few highly specific situations, your parent may receive coverage for medical care abroad (but usually only for Medicare-covered services):

  • If she has a medical emergency while traveling within the USA and the nearest hospital is in a foreign country.
  • If she has a medical emergency while taking a direct route through Canada to get to or from Alaska, and a Canadian hospital is closer than a U.S. one. (So if she’s sightseeing in Canada and not traveling directly from one U.S. state to another, expect a fight from Medicare.)
  • If she’s on a cruise ship either at a U.S. port or within six hours of a U.S. port.
  • If she requires emergency (not regularly scheduled) dialysis in a hospital.

At the U.S. government’s official Medicare website, you can find more information on what Medicare will—or more than likely won’t—cover. (Just remember that foreign hospitals are not required to file Medicare claims, so you are responsible for submitting an itemized bill to Medicare for reimbursement.) If your parent has a Medicare supplement plan (Medigap), he may be in luck: many Medigap plans offer additional health care coverage for travel outside the USA, so be sure to check his plan’s coverage and limitations.

Combs & CompanyWith all of that in mind, I spoke with Susan Combs, president of Combs & Company, a full-service insurance brokerage firm based in New York, about what she considers essential protection when taking an aging parent outside of the country. According to Combs, an individual with medical insurance in his home country is covered on an emergency (a.k.a. “sudden or serious”) basis only if he is outside an area where his carrier has a network. For example, if your mom has medical insurance, she would typically be covered anywhere in the world for a heart attack or serious injuries sustained in a car accident, but not if she came down with bronchitis and needed to see a doctor. (Also keep in mind that prescription drugs are not covered under Medicare plans when filled outside the USA.)

Travel medical insurance, on the other hand, can encompass many more medical situations than just emergency care. “If you have travel medical insurance,” Combs explains, “many carriers have negotiated contracts with doctors, hospitals, and pharmacies outside of your home region or will reimburse your out-of-pocket expenses.”

When traveling with an aging parent (even a generally healthy one) outside of the country, Combs recommends purchasing a travel medical insurance package that includes evacuation, which covers costs associated with transporting Mom back to a hospital in her home area if she falls ill or is injured during her trip. Although evacuation insurance usually covers remote areas, they tend to exclude war zones or politically unstable areas. So before signing up for a policy, make sure it includes your destination.

Combs also suggests purchasing trip cancellation insurance in case illness forces you and your parent to cancel your trip. Coverage levels vary from policy to policy, but this type of insurance usually makes purchasers eligible for reimbursement of trip deposits and other prepaid fees in the event they have to cancel.

Some people mistakenly believe that their homeowners’ policies include travel insurance. Combs points out that most homeowners’ policies (and even some renters’ policies) do have some sort of travel insurance—but it generally covers only items in transit (e.g., lost or stolen luggage, or in some cases even a limited amount of stolen cash), not medical costs. Insurance protection offered through credit cards operates similarly: most reimburse for baggage loss and sometimes trip cancellation, but don’t cover medical costs or emergency evacuation.

So here’s the big question: how much does travel medical insurance actually cost? The price varies a great deal, depending on factors including the traveler’s age, whether he or she has pre-existing medical conditions, the length of the trip, deductibles, maximum coverage limits, and types of coverage. Combs’ website has a handy tool that offers rough quotes for various options. Another site to explore is Insure My Trip, a travel insurance aggregation site that includes most of the major providers (and many of the smaller ones).

To give you an idea of costs, I tried different variables in the Patriot Travel Medical Insurance online quote calculator (accessed through Combs’ website) and found that a 75-year-old American woman would pay approximately $107 for a zero-deductible $50,000 travel medical insurance policy for a two-week trip to China. An 85-year-old American woman would pay about $440 for a policy with similar travel conditions and zero deductible but with a $10,000 limit instead. Keep in mind that these rough estimates don’t take into account pre-existing conditions (which usually require separate waivers) and that these numbers can change dramatically with different deductibles and maximum limits.

If you’re planning a trip with an elderly parent, I highly recommend investigating all the different types of travel insurance. If Dad is frail or you’re concerned about Mom’s health, definitely take a close look at travel medical insurance in particular. Fortunately, you don’t have to rush any of those decisions: most providers allow purchase of travel insurance up to twenty-four hours before a trip begins. So you have plenty of time to do your homework and find the option that works best for you and your parent!