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at what point should one get health insurance

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Old Oct 1st, 2014 | 08:26 AM
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at what point should one get health insurance

I've posted before that in a few years time my wife and I might be able to travel for long periods of time in Europe. Others have mentioned the importance of having valid health insurance for this, as usually one's US insurance won't be valid. My question is, if one should get special insurance for a long trip, say of 3 months, what about a short two week trip like so many US visitors take. Shouldn't they also look into this? What should be the cutoff for the trip length?
It does seem ridiculous to get health insurance for a 14 day trip, but if one should get covered for a long one, why not a short one?
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Old Oct 1st, 2014 | 08:37 AM
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Although we have always been reimbursed for our medical expenses in Europe, we would be willing to be self-insured--costs are so much lower. The one possible exception is repatriation if necessary--and yet we are not insured for that.
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Old Oct 1st, 2014 | 09:00 AM
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I always make sure that I have some type of comprehensive travel insurance while traveling overseas. And I totally don't understand why it would seem ridiculous to get health insurance for a 14-day trip as if it's impossible for something to happen within 14 days? I've known people who have had all types of medical and accident emergencies over many decades of travel. On one trip, a girl in our group had a nervous breakdown and had to be hospitalized and another, on the same trip, slipped and fell and hit her head on a cobble-stoned street. I was the one who called for medical help to get her to a hospital. It all happened in a slit second.

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Old Oct 1st, 2014 | 09:05 AM
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Yes, it does make sense for a shorter trip. I don't know about the US, but over here there is commonly some cover for at least catastrophic accidents bundled in with cancellation insurance and the like. Often that's sold with a ticket or travel package, or some credit cards offer it as an extra, or there are plenty of specialist travel insurance companies.

Of course, for a reasonable premium you commonly have to accept an excess that would probably mean you'd be paying the most likely medical expenses abroad anyway. But you would have cover for something horrendous happening.
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Old Oct 1st, 2014 | 10:17 AM
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Have you checked your own medical insurance? I have a pretty standard Blue Cross?Blue Shield policy and it covers urgent care world-wide. You have to pay the hospital or provider, but it reimburses in full. Don't assume you aren't covered if you haven't checked.

As we all know, Medicare will not cover expenses outside the US. But often, Medicare supplemental policies will cover. If you are on Medicare, shop for a supplemental policy that will cover urgent care outside the US.

The other coverage you might want is med evac. I buy a policy by the year - it covers the two of us for $55 a year.

Comprehensive travel insurance strikes me as a bad deal. I know some people have really benefitted by having it, but I'd rather self-insure. If I had circumstances at home that might require me to cancel a trip or to make an unexpected speedy return, I'd consider it.
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Old Oct 1st, 2014 | 11:29 AM
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The type of insurance that PatrickLondon describes is not generally available in the US, much to the surprise of our UK friends. They have the benefit of NHS as a base coverage, so it is relatively cheap to offer supplemental insurance.

My Medicare supplement insurance through BCBS does what Kathie describes, but I would love to know where she gets Medevac insurance for $55 a year. Kathie?

As Guenmai writes, all it takes is a moment's inattention by you or someone else to leave you helpless. I will quote the figure again of $70,000 up front for a Medevac from the Adriatic to Washington, DC, but that was several years ago and is probably way low today.
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Old Oct 1st, 2014 | 11:43 AM
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Interesting, I get travel insurance in the UK, as a Brit I get access to low cost national health european medical support in the EU countries for roughly free.

On top of this travel insurance includes break down of the the service on the holiday, superior medical support and the hidden service costs (taxis, hotels etc) up to flight return to UK by air aimbulance (if deemed necessary). Generally this is an annual service and I get it for..... free (my bank gives it to me for free for the pleasure of giving me a FREE bank account). Is that not available in the US?

Just to test this, Mrs Bilbo broke her wrist in Northern Finland a few years back, after a small excess they picked up all the costs (but none of the pain).
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Old Oct 1st, 2014 | 01:00 PM
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You could fall down the airport stairs minutes after landing and require medical treatment immediately. If it is serious, an evacuation home would cost a bundle. Carrying supplementary insurance is not a gamble with time and fate. I practice what I preach: Entering the US is a short commute and I can go for dinner on impulse, so I value my supplementary insurance (and also value never having to use it -- yet.)
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Old Oct 1st, 2014 | 01:28 PM
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We always get some kind of health coverage when visiting the US, where the costs of an accident or illness could be magnitudes higher than they would be in Europe. The only time we've ever needed to use the insurance was a time when, to save time, I just got the cheap travel insurance offered by Expedia when I bought the plane tickets. I was afraid we were going to have problems because of that very cheap and basic coverage, but apart from the deductible (or excess as they call it in the UK), it covered everything with no problem. Another insurance I've used is Liaison, but I've never had to file a claim.

Almost all of the carriers will offer you an annual plan. I never know if I'll be making another trip in the year (I'm a last minute, seize-the-day type of planner), so I've never bought it. However, if you'll be traveling a lot, that would be the best option.

I often have friends and relatives visit me in Italy, and I've had to take people to the emergency room here three times. Once the person was admitted for observation and spent two days in the hospital. All three times the visitor had health insurance. Once (for a dog bite that required minor surgery) the hospital didn't bill at all. The other times, the cost was so small that they didn't think it worth filing a claim. One of those times there were all sorts of tests: electrocardiogram, EEG, echocardiogram, and others that would have cost a fortune in the US.
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Old Oct 1st, 2014 | 02:23 PM
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No, bilbo, the US still has too many people who think that health care is a privilege, not a right. They are busy trying to undo the poor excuse for "universal" coverage we just acquired.

Until this year I have always had a US policy that covered me abroad. Now I have Medicare and Medigap plan F (the top of the line plan - don't ask me why it's F not A), but there are significant limitations. 60 day max coverage, $50,000 lifetime cap, 20% co-pay. So, since my current trip is 79 days, I bought medical coverage from the same company I have used multiple times for medical evacuation coverage - Seven Corners. I believe you are using DAN, Kathie? Is that right? I was unhappy with their responses to my questions - they will evacuate you to the nearest medical facility, but they will not necessarily get you home.
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Old Oct 1st, 2014 | 02:39 PM
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Ackislander, as thursdays (above) notes, I use DAN (Divers Alert Network) for my Med Evac insurance. Your membership ($55 a year for a couple) gets you the Med Evac - this isn't one of the insurance policies they sell, just membership. I don't know if it is only available in the US or if citizens of other countries can join. (No, we are not divers, just learned about this from some savvy travelers a decade or more ago.)

I know some people want to be flown home if they get ill or injured, but I'm perfectly ok with being flown to the closest appropriate medical facility. Most of our travels have been in Asia, so I checked with them on our Burma trip, and they would med evac to Bangkok; from Java they would med evac to Singapore. Those options are fine with me, but they may not be fine for everyone.
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Old Oct 1st, 2014 | 02:56 PM
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I always get something like Travel Guard insurance. It just makes sense.
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Old Oct 1st, 2014 | 05:53 PM
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I want to be taken to the hospital of my choice if medical evacuation is needed, and that is true regardless of the length of my travels, so I do get trip insurance with specific health options that are not covered by my everyday health insurance. Check squaremouth.com or insuremytrip.com to see what the options are and decide what you are willing to pay for the ones you want.
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