by FPA member, Debra S. McDonald, CFP^®  

I am excited that more and more of my clients are taking “trips of a lifetime”. Many are taking their children and grandchildren to remote localities seeking adventure. As I write this, a 74 year client is on an African Safari, and one of our firm’s founders just came back from a trip to Holland.

In planning these trips, many clients of all ages do not take the time to consider what coverage is available if some unforeseen medical event happens while traveling. Unexpected medical events can place a serious damper on your trip and could have a large impact on your assets. For example, my friend’s mother recently had a heart attack while on vacation in Mexico. Before the ambulance would take her to the local hospital, she had to provide her credit card number to the driver. Although she is back in this country and on the road to recovery, my friend and her family had to spend a lot of time, tears, and money trying to arrange their mother’s return to the United States. Before you travel, it is a good idea to take a few moments to make sure that you have adequate medical and medical evacuation coverage in place.

Medical Insurance - Medicare coverage is not available for hospital or medical services outside of the United States so you should check if these services are covered by your supplemental or group medical policy. If your supplemental or group policy does provide coverage outside of the United States, there may be limitations. Some questions to ask your provider prior to traveling include:

• What pre-authorizations are necessary before they would provide care? Do they provide a toll free number to call to receive authorization? Will they still provide coverage if the medical condition was life threatening and your pre-authorization was not obtained?
• Will they reimburse foreign health care providers directly or will you be expected to pay the full cost upfront and file for reimbursement when you return?
• Does the policy cover high-risk activities such as mountain climbing, scuba diving, parasailing, off-roading, etc?
• Does the policy cover expenses such as return transportation to the United States for treatment?

Medical Evacuation - If you are traveling to a remote location where the quality of medical care may be substandard compared to the United States or if you have a pre-existing condition, you should consider purchasing Medical Evacuation coverage. This coverage will provide air transportation via medical ambulance to the nearest major hospital or back to the hospital of your choice in the United States. The State Department estimates that the cost of a medical evacuation could be in excess of $50,000 whereas the cost of a typical medical evacuation policy is under a few hundred dollars. Not all policies are the same, so when evaluating these policies, consider the following:

• Who makes the decision that you need to be evacuated?
• From where will you be evacuated: the initial point of injury or the initial treatment facility? Would you need to pay to be transported to an airstrip?
• Where will you be taken: to the nearest major hospital, to the nearest hospital in the U.S., or to the hospital of your choice in the U.S.?
• Will this policy cover a pre-existing condition?
• Does this policy cover only the duration of the trip or would it be more cost effective to have an annual membership?

So, if you do not have adequate international medical or medical evacuation coverage, where can it be obtained? The State Department has put together a list of providers at www.travel.state.gov, or you could use a travel insurance broker such as www.insuremytrip.com where you can easily compare policy features and costs in one place.

A couple of years ago, I learned that a Caribbean hospital was happy to take my credit card deposit before treating my four year old son’s broken finger and that we needed to remit the full amount before we could leave the Emergency Room. Luckily, this was a minor inconvenience to our trip and cost less than our medical insurance deductible for emergency room visits in the U.S. This incident taught me to revisit those extra insurance coverages while planning travel outside of the United States. The experience led me to discuss this issue with all of my clients so I can be assured of their smiling faces when they return from their “trips of a lifetime”.