Andy, if you require cover for repatriation in the event of a medical emergency it is essential that you check with the insurer before purchase whether you will be covered for any pre existing conditions. The provisions written into most, if not all policies require the policy holder to full disclose all relevant information regard all persons covered by the policy. If this is not done then almost certainly the policy will be regarded as null and void and would probably not cover accompanying passenger either. The cost of replacing tickets will be minimal when compared with the costs of a medical repatriation which can run into tens of thousands of $$.

There are many specialist providers in the UK that provide access to cover (at a price) although, for a number of reasons, our travel insurance market is a lot more developed than the US. If you google the subject you will get loads of results in the UK but maybe a similar US search will yield results:

"http://www.cancerhelp.org.uk/coping-with-cancer/coping-practically/money/travel-insurance

I may be out of date but 2 years ago when I was adding a few thousand dollars in trip insurance on to a $$15k+trip to get $150k med. and 1 million evac to hospitl of choice and then return home when recovered through travelGuard Icontacted dan. The representatibe told me those atractive coverages were ONLY in affect for a diving or snorkel related injury. I pressed her and whar she sent me then supported that. therefore a heart attack at dinner was not a cobered condition unless i had been diving.snorkeling that day and reported some affect from that activity.

lcuy, that seems very reasonable

Stan, the med evac insurance provided by DAN as a benefit of membership covers ALL illnesses and accidents. The optional insurance available through DAN covers only diving related illnesses and injuries. It can be a bit confusing.

As the years pile on--and as we've had different friends and family have a variety of experiences where trip insurance was essential, we've started getting it for trips to more distant locations (Vietnam, Cambodia, South Africa, Botswana, etc.) Medical evacuation is likely to be the most expensive possiblity, and just about all comprehensive travel policies cover it; if anyone is on medicare, it will not cover any health/illness/injuries occuring internationally and neither, then, will one's supplemental insurance so having some kind of medical coverage for us is essential. Squaremouth.com provides the most comprehensive information on travel insurance of any of the sites giving comparative information and also provides a zero complaint rating evaluation.

Generally, the pre-existing condition qualification is based on buying the insurance w/i a specific time limit after making the first deposit on a trip. Frequent flyer fees are considered a deposit. The definition of pre-existing condition, however, in most travel policies differs substantially from those in most traditional health insurance policies--and, surprisingly, it is much looser in that if one has had a medical condition for some time and has been receiving treatment and taking medication for it for some time, AND the condition is stable and has NOT changed for a specific period (usually 60 to 120 days) before purchasing travel insurance it is NOT considered a pre-existing condition. So there is more leeway than generally understood.

Some of the other considerations that I don't believe have been mentioned in this discussion are that trip insurance can cover situations like the cost of delays caused by the volcanic eruptions in Iceland, or strikes, or illness of a family member that prevent one from travelling, and a number of the kinds of situations that have occurred over the past few years that couldn't have been foreseen.

Gpanda your situation is very specific and I suggest that if you haven't already decided on a company that you check out squaremouth.com as it is very thorough.

Katie; Are you saying if you are a DAN member, some $50/yr., and you take out extra medical evacuation insurance and your trip is a total land voyage, no diving or snorkeling, to Thailand and in a town 75 miles north of CM you have a stroke you can be covered by the $50k medical and $250K medical evacuation plan coverage? If so, I was miss-lead by the DAN rep. because they said that wiould not be covered.

DAN offers two categories, Dive Accident Insurance presumably for dive related issues and Trip Insurance that need not be dive related. I believe the maximum on the latter is $40,000, but I may be misreading it.

http://www.diversalertnetwork.org/insurance/index.asp

This is separate from the "TravelAssist" benefits that are automatically part of a DAN membership. These include
"Emergency Evacuation and Repatriation
Covers up to a maximum of $100,000 per person (if a Family Membership) for an emergency evacuation, or medically necessary repatriation."

As I understand it, once you are evacuated to an appropriate hospital your local medical insurance takes affect.

I bought MedJetAssist before my last trip and I think that is what you need to do. As far a I know, it is the only policy that will evacuate you to the hospital of your choice. < I am curious if Platinum Amex does this(??)>

This is more important for you than losing the price of the airfares if you need to postpone the trip.

"As I understand it, once you are evacuated to an appropriate hospital your local medical insurance takes affect."

So does the DAN benefit-of-membership emergency evacuation insurance just get you to a hospital, or will it get you from a foreign hospital to your home or home hospital? E.g would it have flown me home from Switzerland when I broke my wrist?

Thursdaysd, that's the part I don't understand. There are two components, evacuation and repatriation. DAN make it very clear that in the case of an emergency they will transport you to the nearest adequate facility, based on medical considerations.

<i>DAN TravelAssist will not pay Transportation to
transport the Member or Covered Family Member
to their place of permanent residence if there are
closer medical facilities which are capable of
attending to the Member’s medical condition.</i>


Then there is language about "medically necessary repatriation," which is vague:

<i>Repatriation means that, due to Medical
Necessity, the Member or Covered Family
Member requires transportation to either:
• the person’s primary residence as listed in the
DAN database; or
• the region where the member is living and/or
working at the time of the injury; or
• a different medical facility for further care or
evaluation.

Medical Necessity includes any situation where
it is judged medically appropriate to move the
Member to another location either for treatment
or follow-up.</i>

A generous interpretation of the repatriation would be that it's always medically appropriate to move a stable patient to a facility closer to home for treatment or followup, though not always necessary.

My guess is that's not the interpretation the insurer would favor. It's probably the case that DAN will not clarify the policy in writing and that any verbal assurances from agents have no merit. It's cheap so we're members but I'm not sure if it's enough now that we've dropped the Amex Platinum Card.

What do the lawyers here say?

Stan, as a member of Dan you have $100,000 of med evac insurance any time you are more than 50 miles from home. period. No medical insurance is involved in the membership, only med evac. I expect you were asking their rep about the medical insurance they offer.

My understanding (from a case I know about) is that DAN takes you to the nearest appropriate medical facility (for much of SE Asia, that would mean a hospital in Bangkok or Singapore). If necessary, they may also send you home. The case I know of was one in which the woman broke her ankle in Nepal. They flew her and her husband to Bangkok for surgery, then flew them home as they could not continue their trip.

However, I note that the wording says Medical evacuation OR repatriation, so it's possible it may have changed. Call them if you have questions. I've had excellent telephone assistance from them. Do be specific about what you are inquiring about - the TravelAssist which is part of membership or the insurance.

I'm one of the worried well who takes out trip insurance and uses InsureMyTrip online. In Andy's situation, I'd definitely pay the premium and think of it as part of the trip cost, like boarding the dog, I mean Panda. My personal equation is that peace of mind is worth the cost of the insurance; someone else might have a different calculus. DH and I had to cancel an expensive ski trip because of an eye injury that precluded me flying. Travel Guard covered the full cost of the fully prepaid hotel and air, more than many premiums combined.
One thing I recently learned is that you can buy a small amount of insurance within the 14 days of initial purchase of any part of a trip and later call InsureMyTrip and increase the insurance. So you don't need to know all the costs you want to insure up front.

We've been using STA Travel insurance for many years now (we're both over 60). We've submitted only one claim (non-medical) and had no problems at all. They are less expensive than the well known travel insurances and their pre-existing exclusion is much more liberal (see item #1). The following is from the STA brochure:

The Pre-Existing Condition exclusion will be waived provided you meet all of the following:

1. the payment for this plan is received prior to/or within 24 hours of your final payment for your Covered Trip; and

2. you are not disabled from travel at the time you make your plan payment; and

3. you insure 100% of all prepaid Covered Trip costs that are subject to cancelltion penalties.

But read the fine print to see if it is the right policy for you. Good luck!

STA travel used to be a great deal when the rates were the same regardless of age. We've used them several times for insuring safaris. Unfortunately STA now takes age into account when calculating rates.

Marija, that's true about STA but I still think it's a good deal especially given its liberal pre-existing waiver clause. We are 62 and 65 and just paid $226/person for an upcoming 4 week trip to Colombia which is costing us about $10K each. Comparable policies at insuremytrip.com start at twice what we paid.

You're so right about STA being a great deal when the rates were not age dependent!

am i the only one who self insures?

how do you self insure for an international trip?

And why does no one else think Met Jet Assist is a good idea, since it does fly you home?

Med Jet Assist is an excellent idea but it costs a lot more than the other options. Dan is $55 for a family for a year while Med Jet Assist is $385. Surely as someone who orders fractions of a duck and virtual apertifs you value thrift.

Did anyone call DAN to get answers?

One self-insures by not buying trip insurance. For our Hong Kong Trip, we did not buy insurance. The hotels are partially refundable and we figure we can get a refund from the airline with maybe a relatively small charge. Didn't make sense to pay for insurance.

Two different issues: evacuation and trip insurance. Self insurance usually makes sense for the air/hotel parts, unless it's an expensive nonrefundable trip like an African safari. For medical evacuation self insurance may not be the way to go.

We're covered for evacuation through DAN which has been lauded on this forum many times.

Not to go in circles or anything but that was the question. Will DAN evacuate to "home base" at some point? They clearly state:

DAN TravelAssist will not pay Transportation to
transport the Member or Covered Family Member
to their place of permanent residence if there are
closer medical facilities which are capable of
attending to the Member’s medical condition.

I know you're enrolled in a clinical trial but do you know whether return to the facility administering it would fit under "acceptable level of care"?

I'm really hoping we won't need to read the small print on the DAN contract. I will only go to Hong Kong or Thailand if I'm feeling good. I may have to get some blood drawn in Thailand, but my Health Insurance will cover that. I did just run a triathlon. There's some evidence that my physical self continues at a healthy level.

I would hate to be a test case for coverage.

Gpanda, it would be terrible to be a test case for an evacuation policy, especially after what you've already been through and now that you seem to be doing so wonderfully well.

A friend of mine recently had the following experience after being diagnosed with a torn retina while at a conference in Nairobi. He had to have a medical evacuation from Kenya to AZ, but IMG has contested his claim despite his having had a $500,000 policy from IMG (which included medical evacuation. So even though he had a Drs. letter from the physician in Kenya stating that the surgery could not be performed anywhere in Kenya, IMG disallowed his "evacuation" expenses and has refused to airfare etc. He plans to appeal, but the odds of his winning aren't strong. He put in a claim for
about $4,000 of which IMG was originally going to pay only $51. He may now get about $800 out of them toward his primary
health ins. deductible stuff. It's been a medical and financial nightmare for him, however, as it took him 40 hours to get to AZ and it's likely that that affected the outcome
of the surgery. He very nearly went blind in the affected eye and is still having vision problems.

MedJet reportedly would be much faster and not have had him sitting around in airports........ Supposedly they
take one out of country in a private jet with trained medical staff on-board. The airlines refused to bump him up to
business class, even after his showing them the drs. letter that stated he needed to be horizontal.

It would certainly seem worth checking specifics out with DAN--and with Medjet.

520, who does IMG use for med evac? One of the issues with med evac insurance is that the insurance specifies who must be used to arrange the med evac. For policies like TravelAssist (through DAN) and Medjet, these are companies that are accustomed to arranging med evacs. I read of another case where someone had a big policy from a big insurer. When they contacted the insurer to arrange the med evac, the person they talked to didn't know how to arrange it and told them it would be a day or two(!). The person opted to get themselves to a medical facility in a nearby country and the insurance company then wouldn't cover it.

I just got a clarification from DAN on repatriation.

I sent an email with this query: "If I were traveling alone and broke my wrist, would the insurance cover the cost of a flight home after medical treatment, given that I was unable to continue to travel alone?"

The emailed answer wasn't clear, so I called, and the (very helpful) guy on the phone said that the answer was "no". The TravelAssist will get you to the nearest medical treatment, but it will NOT get you home after treatment.

I would renew my existing insurance with tenweb.com, which DID get me home in that situation, except it's not good for a trip lasting more than 90 days. Off to investigate Medjetassist...

Thanks, thursday. Guess I won't renew my DAN membership until I'm going again to someplace that needs evacuation.

Right, Marija. My broken wrist happened in Switzerland, and I didn't even call tenweb until I was in hospital after the surgery. DAN would have been useless.

Very interesting. I wonder what the difference was between your scenerio and the one I mentioned with the broken ankle... Thanks for doing some additional research, Thursdays.

thursdaysd, Medjetassist will let you determine the final <b>inpatient</b> facility. I believe you would not have been covered since you weren't going hospital to hospital.

That's an interesting question, Kathie. I did point out to the guy on the phone that I would not have been able to continue to travel, but that didn't seem to make a difference. I really wish tenweb didn't have the 90 day limit, as I was pleased with them (they sent a car and driver to get me to the nearest airport, and provided economy class tickets home). Maybe I'll call and see whether I can pay extra for additional coverage - they did that one time, but then refused last time.

And Marija, your point is interesting. See all the things we don't know about med evac?

i do not consider either a broken ankle or a broken wrist to require med evac, and i would not ask for it unless i was in the jungle with no medical facilities at all.... i also do not feel that either would end my trip to most places... for sure the ankle would severly alter it but not end it...

In the case I cited, Bob, it was a complex ankle fracture which required surgery.

Hi Gpanda,

As you are aware, I recently had to cancel a trip due to an accident that I had. I had trip insurance and cannot speak more highly of Travelex. (http://www.travelex-insurance.com/) I bought trip cancelation insurance as well as "cancel for any reason" insurance. I had an accident so 100% of my trip cost was reimbursed with no hassle whatsoever--I was amazed at how little hassle I got. Cancel for any reason increases the price of the premium by 50%, and pays out 85% of the cost, so it is worth it to me, it may or may not be worth it to others. There are some time limits for "cancel for any reason" and preexisting conditions, like with any insurer, but I am very happy with Travelex.

However, for a recent,real life experience with trip insurance, I was completely happy with Travelex.

Also, you can pay a tiny bit more for evacutation to a hospital of YOUR choice. It is really inexpensive.


Cheers,

Your Friend,

Boston Harbor

My wrist also required surgery, plus follow-up care hardly compatible with a three month solo trip with a backpack - I was having trouble dressing myself, never mind coping with train travel. I have traveled with a badly sprained ankle (instructions to put no weight on it), but that was on a group trip and was still very difficult. No way would I try that solo. How many pieces of luggage can you handle with crutches, Bob?

I guess it's definitely different strokes - I had a hassle with my Travelex policy - I had to return home after I broke my foot and couldn't continue my trip in Japan. Because of the weekend and being unable to reach a Japanese speaking doctor, the travel emergency assistance person was unable to approve my repatriation so I paid for it on my own. He did tell me, however, what to have the doctor write in a letter to show the necessity of my return. When I first filed my claim they treated it as a trip interruption/cancellation not a repatriation. I had to call numerous times and submit an appeal to get the monies due me. It took almost a forest to be cut down for all the paperwork I had to provide. But I did end up with almost all I requested.
Reading this thread and looking at some of the policies mentioned makes it very clear that one must read the small print of the policy - also I am thinking that it might depend on which claims rep processes your claim.....when I first called Travelex and said I wanted a form to claim for repatriation, the rep told me that was just for dead bodies....

i would hire someone when necessary....i was sure my comments would make you mad, and i see it did, but i did not mean it in a mean way....my point was its a broken wrist, not a heart attack or a blood clot, etc....

Bali trip report, not what you'd expect --- Posted by: David on Dec 12, 08 at 12:58am
Posted in: Asia