Broken Leg, Malaria, SARS

When divers contemplate injuries while traveling, we may first think about the bends or other diving-related accidents, but an out-of-country traveler is more likely to trip and fall heading into an unfamiliar bathroom in the dark or have a taxicab run over a foot in a busy city than have a dive-related accident.

Of course, there are also plenty of health problems unrelated to accidents, like a ruptured appendix or a malaria attack. Do you know if you’re insured against all misfortunes when you’re traveling abroad? You may not be.

Dive Insurance Offers Little Protection

First, you can’t rely on dive travel insurance to cover you for medical problems not caused by an accident. It won’t. DAN and PADI policies, for example, pay reasonable and customary charges for medically necessary treatment of nondiving accidents once your primary insurer has covered its obligations. However, these benefits are limited, and without primary coverage Broken Leg, Malaria, SARS — beware: your insurance may not cover you you won’t get much. DAN’s Preferred and PADI’s Gold plans afford a $10,000 lifetime maximum benefit with a $250 deductible. PADI’s Platinum boosts this to $15,000.

For other problems, however, you’re on your own. Betty Orr, director of insurance services at DAN, told Undercurrent that nondiving illnesses like a heart attack or complications from SARS or the flu are not accidents and not covered. That means that, if you have to be evacuated from your dive resort to Sydney and then you spend two weeks in the hospital recovering, you will have an enormous medical bill. Air evacuation alone costs a small fortune. A medical evacuation from Cozumel to Mercy Hospital in Miami, FL, can run as much as $20,000, while evacuation from Indonesia could easily hit $35,000. Dan Nord, director of DAN medical services, told us of an $80,000 tab for an emergency evacuation from southern Africa.

Health Insurance Usually Inadequate

So you need insurance that will cover you for health problems sustained outside the country. But the truth is, many policies don’t provide that coverage. Those that do may have special limits and higher deductibles for these claims. Furthermore, few pay for medical evacuation home. Basic Blue Cross/Blue Shield benefits typically do not include foreign medical emergencies, though more advanced plans at higher premiums may. If you are covered under a Health Maintenance Organization (HMO) or a kindred plan, you may be out of luck abroad. So, before you travel, verify your coverage, and get it in writing.

If Medicare is your primary medical insurance, you are not covered for medical care while in a foreign country, so you need a supplemental plan, such as those offered by the American Association of Retired Persons (AARP), Blue Shield, and other carriers.

Even if you are insured for out-of-country medical attention, you may be required to pay your medical bill—or at least provide acceptable proof of the ability to pay—before you are released from the hospital (and in some hospitals, even before you are admitted). Many countries won’t allow you to return to your home country until the hospital approves it. To complicate things, many health insurance policies will neither make advanced payment nor preauthorize treatment; they pay only after medical services have been rendered and they have reviewed the itemized bill. So, whatever your coverage, carry a credit card or other financial instrument with a sufficient ceiling to keep you in motion. For a serious medical problem, a tenthousand- dollar limit may not be enough. If your primary health carrier does pay for hospital and medical costs incurred outside the United States, be sure to have your health insurance identification card and a claim form with you while traveling. Even if you happen to be in a country where the government provides health care for citizens and visitors, medical attention can be slow. A credit card and private payment may speed things up.

If injured abroad, the nearest U.S. embassy or consulate will have a list of local physicians and medical facilities. They can also help with a transfer of funds from family or friends back home. The International Association for Medical Assistance to Travelers (IAMAT, on the web at www.iamat.org) maintains lists of English-speaking foreign doctors, and many names of local physicians and hospitals can be obtained through major credit card companies.

One way to assure that you are insured is to purchase insurance to cover you while you are abroad. A useful website called “Insure My Trip” (www. insuremytrip.com or 800-487- 4722) allows you to compare 62 different travel insurance plans from 14 different companies. This is a good place to find short-term travel coverage if your primary insurer doesn’t cover you. When comparison shopping, get a full copy of the policy and study the exclusions in the fine print. Coverage should include emergency medical care and emergency transportation and evacuation costs (in case you need to be flown to another country for care), and documents should include a contact number for evacuation instructions in case of emergency.

If a travel agent booked your trip, he or she can also provide you with an application for trip insurance. Some of the agencies listed above are good sources of information or quotes, or you can contact the travel insurers directly.

— Doc Vikingo