Trip insurance

Make sure you understand the different kinds of insurance people inquire about and obtain, from medical/health policies (if your home coverage is of no help) to trip interruption and cancellation insurance.

I am in the camp of "no trip insurance" other than anything that may come with a credit card, with one big exception: I do carry an annual Medjet assist policy for emergency medical evacuation to my home in the US given that the out of pocket expense for that can run into 6 figures...I more or less self insure for everything else. Knock on wood, in over 40 years of travel without trip insurance I have never needed it, and at my age now I am mostly concerned with covering myself for medical evacuation, but not too much else bothers me.

Also, my Medicare supplement provides some emergency care coverage overseas, and while I hope I never need it, at least I have that in my wallet...

You will hear plenty from people in the other camp...

Start with deciding on exactly what circumstances and costs you want to be covered. Are you concerned about a death or illness in the family, your own medical issues, or just a need to cancel for any reason? You won't be reimbursed for things for which you get refunds or credits for, like cancelled reservations or flights.

Many people just want to be covered for unexpected medical costs, and/or repatriation to home if a medical issue occurs on the road. Check with your current medical insurance to see if you are covered (i.e., reimbursement) for medical costs overseas.

When checking out various policies, read the fine print! The devil is always in the details. For example, some policies will only get you to the nearest hospital that can treat you. Others will bring you back home under certain conditions. Again, read what is and is not covered very carefully.

First, check your current health insurance to see if it covers you overseas. My health insurance covers me worldwide (but out-of-network) so I don’t buy travel medical insurance and would rely on my employer-provided plan if I were hospitalized overseas.

Medical evacuation is unlikely but it can cost hundreds of thousands of dollars. I do buy medical evacuation coverage. I know two people who have used medical evacuation coverage after injuries. For example, a friend’s daughter broke a number of bones in her foot and ankle and had to have surgery in Europe. Afterwards, her insurance paid for her to travel back to the U.S. in business class, provided a nurse to accompany her on the trip, and covered transportation from the airport to her home.

I generally don’t bother with trip cancellation or trip interruption, but I am fully prepared to eat those costs if I were to have to cancel or change my trip. Total up the costs of your trip that are non-refundable and decide if you want to risk that amount of money. If something were to happen before or during your trip such that you were unable to travel, would you be ok with losing the money you had paid upfront? Would you be able to afford to fly home on a last-minute ticket?

These are some of the things to consider.

My husband and I have never gotten trip insurance, and have never needed it. Reading various posts on this forum over the years, it seems that many, many people see it as essential. Unless someone was concerned about being airlifted home in a medical emergency (not so far), or for a possible Antarctica group trip that we didn’t take but the tour company made it mandatory, it hasn’t even been a consideration.

If you’ve booked your transport and lodging with reputable companies, and don’t have a severe medical situation, what will having trip insurance do for you?

I book lodging and air/transportation with reputable companies... most often with some cancellation allowed up to a specific date or the option to apply some or all of the cost to another trip. I am healthy. So why do I buy trip medical insurance?... just like friends, family and neighbors, I also purchase homeowner insurance, but year after year never submit a claim. As others have stated, it is for peace of mind that if I have an accident or become ill, I will not give up my retirement savings to pay for medical services and the cost to fly me with a personal nurse home,... or to send my remains.

So why do I buy trip medical insurance?... just like friends, family and neighbors, I also purchase homeowner insurance, but year after year never submit a claim

Not really an apples to apples comparison to the decision taken in the purchase of trip medical insurance or any other form of trip insurance.

For one thing, if you have a home mortgage, you have to insure the property per your lender. With homeowners insurance, you can choose a high deductible / low premium policy, and self insure for smaller losses (which is what I do), but it would be foolish to not have homeowners insurance to cover a catastrophic loss. Finally, with homeowners insurance, you are getting a very important protection: liability insurance in case someone is injured on your property, or by you or your property (a tree on your property falls on a neighbor's house, for example).

And all of the reasons for having homeowners insurance apply to car insurance, although in addition car insurance is required by law as far as I know in all states whereas homeowners insurance, unless required by your lender, may be optional. If you have a car loan, just like with a house, your insurer will require you to have minimum coverages.

Trip medical insurance is not legally required, except perhaps in cases of long term stays abroad, maybe if you have a visa, where the host country mandates you have acceptable insurance that can be used in their country, For the vast majority of people who travel, trip insurance is optional, not required. A "peace of mind" thing? I am comfortable self insuring for costs I have sunk in a trip, but I do obtain emergency medical evacuation insurance for peace of mind and should I need it.

Crystal, I posted an evacuation insurance thread in May and lots of people joined in with very good information. It may help you. https://community.ricksteves.com/travel-forum/general-europe/evacuation-insurance-why-to-buy

If you’ve booked your transport and lodging with reputable companies, and don’t have a severe medical situation, what will having trip insurance do for you?

Maybe because "stuff happens"? For two months, using various modes of transportation, what happens if you trip on a stair, break a bone, and are immobilized for a week? Beyond the medical expenses, which you may or may not have coverage for, by interrupting your schedule you may have to change travel and lodging arrangements - can you change them, or were they prepaid? Are you prepared to eat the costs?

For medical coverage, to cover pre-existing conditions, you must typically buy your policy shortly after making the first deposit or payment for a trip component.

It is possible to buy a policy that covers everything except for trip cancellation, I did this recently and the premium was much lower with the cancellation removed.

Only you can decide your tolerance for risk. Please keep in mind that you can't buy insurance after it turns out that you need it.

Purchasing travel insurance depends upon whether I am traveling on my own, or on a prepaid tour costing thousands of dollars. I use American Airlines frequent flyer miles to book my airfare, so if I need to make a change or cancel, there is no penalty. I always purchase the offered Allianz travel insurance, which is minimal, and offers minimal coverage. If we travel on our own, I make sure every hotel we stay in has a generous cancellation policy. Last year due to the transportation strike in France, six days before we were to leave, I canceled the air reservation and all the hotels without any penalties, and rebooked a trip to Berlin. I was not out a dime.

If we take a set tour, which requires pre-payment of thousands of dollars, I always purchase travel insurance to cover most of the expense. Only once did we need to file a claim for trip interruption since we were delayed a day due to our flight being diverted, and had to unexpectedly fork over $300 for a night at an airport hotel, and rebook a more expensive connecting flight for $200, and the $500 expenses were covered. I think it is worth paying a little extra for European connecting flights that have a refundable cancelation policy. As others mentioned, I make sure the trip insurance covers medical evacuation if I am on a package tour, but If we are traveling on our own, I purchase med jet for the year, which by the way, you can receive a $50 deduction if purchased through AARP..

We always have trip insurance. I am not worried about delayed luggage etc, but rather for medical in case of anything. Things happen, and I can attest to that as I managed to fall down a stairway at Versaille about 15 years ago. I ended up with knee surgery, but did wait until we were home. I was in my early 40's at the time. On another trip we watched a poor lady trip on the cobblestone and go down face first, and she was not able to break the fall with her hands and her glasses/face took the brunt of it. An ambulance came to get her. On a trip in September, we were horseback riding and one of the horses bucked the guy off and dragged him about 50 feet. You don't think these things are going to happen, but they do. Our medical insurance does not cover us overseas, so we would be stupid to not buy it.

Well, I am squarely in the Peace of mind camp. Particularly as we grow older, something we do on a daily basis, whether at home or overseas. I know of friends who have experienced complicated health emergencies requiring weeks of hospitalization abroad and some whose simple injury required exceptional medical care and expense to return home as the physicians would not release them otherwise. And I can assure you our friends just a few months ago did not plan on detaching a retina in Cartagena. Six figures is not a pie in the sky exaggeration. I’m not a fan by any means of Clint Eastwood, but his “Do you feel lucky, punk?” line resonates loudly with me whenever we plan a trip. Unlikely and impossible are two very different things. Review your choices carefully and make the informed decision that’s best for you. Safe travels.

Also keep in mind that with a US medical policy that does cover you in Europe and with a great many other policies, even European policies, odds are the best you can hope for is reimbursement. You had better have cash in the bank or credit cards to pay the medical bill.

Same with cancelation insurance. It is resolution when you get home, not reimbursement coverage while traveling.

So am I correct in assuming that if trip medical insurance is secondary, as most policies seem to be, that you pay for the costs upfront while on your trip and then are reimbursed only for those expenses that are not paid if you have primary coverage (employer, Medicare Advantage plan, etc.) ? If no other coverage exists, then the trip insurance would become primary and reimburse your expenses after you return and submit the required paperwork in your claim. In either instance, it seems you have to come up with the initial payment for any medical services received at the time they are rendered.

If this is the case, then does it make sense to buy the trip medical if one has other insurance that covers reimbursement for foreign medical expenses. It seems that one must always need to be financially prepared to pay for medical costs at the time of service while traveling and then be reimbursed, if covered.

I do understand and agree with the necessity of medical evacuation insurance, but that is another thing, I think.

Will, you have figured it out. You will have to pay the medical providers or hospital abroad for services received, and then submit it to your insurer (your primary insurer back home - or to your trip insurer policy) to get reimbursed. It makes little sense to me, given that I have Original Medicare and a supplemental with emergency care covered, for me to purchase a trip medical policy.

Now if you truly have no home based primary insurance that covers some amount of emergency medical care abroad, it probably makes sense to get the insurance coverage. In either case, you will need to be prepared to pay for medical care received abroad regardless for reimbursement later, and hopefully no one is buying a trip policy thinking somehow they will not have to do that.

Are you prepared to pay if you don’t have it. I had a friend who went to Europe with her husband. He had a major cardiac event. It was only about $20,000 cheaper than it would’ve been at home but she had two options work with her insurance company or write a check

I also went on a trip one time with a woman who broke her shoulder in three places the first day of our trip. She had to be flown home in business class with a nurse in attendance. Otherwise she wouldn’t have been able to go home and would had to have surgery in London at her own expense. And unfortunately, the tour was leaving London, so she would have been completely on her own. I was leading the tour and I could not stay with her And most of the other people on the tour were under 18 so they could not stay with her. Luckily the insurance paid to fly her home where she got surgery with her doctors, etc.

In both of the above cases, we were able to get the insurance companies to work directly with the hospitals in Europe to pay them so that people didn’t have to pay out-of-pocket.

One note if you are a Medicare part a you have no coverage outside of the United States and its territories. No, you cannot bring your bills home and get them submitted for payment. If you have a supplement or you are on replacement plan, you may have coverage you will have to check that

https://www.ricksteves.com/travel-tips/trip-planning/travel-insurance Very simplistically, comprehensive travel insurance usually includes TRIP coverage (for cancellations, interruptions, and I mentally lump delays, baggage, etc here too) and MEDICAL coverage for medical care (but usually NOT evacuation back to US.) Given your school age kid, I'm going to assume you are both covered by employer/family/commercial health insurance (not Medicare). Most US commercial health insurances have emergency coverage outside the US, but check your own plan for sure! Therefore, if you are travelling independently and booking refundable/creditable airfare/transportation and refundable or not-charged-until-you-stay hotels/lodging, then you may not "need" to buy additional insurance. If you have a credit card with good travel benefits, you may already have trip insurance included; check your cards! If you belong to AAA, you could look at their travel insurance product from Allianz, but there are many other companies used by travelers on this forum. If you only would like to up your medical coverage and add evacuation, then consider something like GeoBlue or similar. My niece traveled all over Asia independently and her mom bought her a GeoBlue plan to stack on top of their own medical insurance. Note GeoBlue's evacuation is for MEDICAL reason (GeoBlue is a BCBS product). Since you're planning to travel in western Europe, I doubt you need to worry about evacuation for unrest, etc; but if it makes you feel more secure, you could sign up for STEP https://mytravel.state.gov/s/step Finally, I saw in your "Sampler" post that you are planning on para-gliding? Most travel insurances exclude coverage for injuries from "extreme" activities, so I suggest clarifying your coverage for this scenario! Wishing you an incident free trip, and please post your trip report after!

You may be able to get your US insurance company to work with the European Health Care provider, given you plan on being in the hospital long enough. Even in the US it takes days to reach the right person and days to accomplish anything. Then if it isnt in a English speaking country you will have verbal problems and documentation problems. You will probably have to pay for an official, or at least good, translation of everything.

Then eventually someone here might point out that there are European healthcare policies that do pay direct to certain hospitals in certain countries. I have one such policy from Alianz and I have to admit that it has paid 100% of my bills since moving here two years ago. Even a couple of out patient procedures. Walk it, get sliced and diced, say thank you ma'am and walk out. BUT! Do research their list of "hospitals" because the hospitals listed in my country and the other country that i checked on are not hospitals in the U.S. understanding of the word. They are outpatient clinics. Darn good ones, but not where you will end up if you are in a major accident. So back to paying cash.

Some policies will advance you cash for medical emergiencies. The fine print on the one policy I read said you had to prove you could pay it back. Not sure how you do that in the hospital with a tube down your throat. Not sure if you could prove it how long it would take to get the money. Maybe best to have a travel Credit Card with a really big limit on it. Or just have a lot of cash in the bank. Things are cheaper here and I would suspect between credit and cash if you had $25.000 there isnt much that you coldnt pay for. Not like they are going to lock you in the hospital or the country for that matter till you pay the bill.

Then there is the qulity of care issue. Many countries quality of care, even EU countries, even Western EU countries; will shock you. By quality I guess I mean "comfort" as the doctors here are generally very good and I suspect that they will save your life to the same degree as in the US, but the experience might be quite a bit less to your liking (buy your own food, toilet paper, medications; large multi-bed wards, staff that speaks no English). But not to worry, cause you got MedJet Evacuation Insurance.

The potential need for translation of medical documents is something to be discussed with your insurance company while you're still in the country where you've had medical treatment. A really cautious person would check on that even before traveling. It's likely translation services will be cheaper in most places in Europe than in the US, if only because there would be more demand for such services there, thus more suppliers. (No guarantees in really expensive places like Switzerland and Scandinavia.) If you've had significant medical treatment, it would be prudent to have translations for your own records; you might need follow-up care in the US if something goes wrong.

I have two experiences with insurance claims filed with regular US health insurance companies (not travel medical policies):

• I needed medical outpatient medical treatment for a bacterial gastrointestinal infection in Ljubljana (Slovenia) in 2015, very near the end of my allowed 90 days in the Schengen area. I didn't have time to do anything about a translation before escaping over the border to Croatia (which wasn't Schengen at the time). I returned home with my Slovenian medical documents and was very, very happy to hear from my Blue Cross/Blue Shield plan that a translation wasn't needed. BC/BS paid up without push-back. I imagine getting a translation in the US would have cost more than the medical treatment for which I was requesting reimbursement. I'd be rather optimistic about acceptance of foreign-language records by GeoBlue, but I think in many cases it would be prudent to get a translation of the medical procedures performed.

• My mother nearly died of pneumonia in Greece in 1995 or 1996. Her insurance company (she also had an employer-supplied plan, but it wasn't BC/BS), required a translation of the billing documents. I arranged that while we were still in Athens, waiting for my mother to regain sufficient strength to travel home. I don't remember the cost, but it was very nominal--Greece being a comparatively low-cost country.

I’m also in the peace of mind camp.
As a Canadian, I never leave our borders without full medical and trip interruption and cancellation insurance.
I don’t have any real health issues, but if something came up I want to be sure I have a good safety umbrella over me.
I have made two claims in recent years.
The first: my husband had a sudden serious health issue two weeks before a trip to Italy and we had to cancel.
We were able to claim back every last penny for flights, accommodation and train tickets, including non -refundable airbnb’s in two places.
The second time was when I got Covid on my last day in Italy.
I had to stay extra days and rebook my flight home.
Insurance paid back most of what I had spent for that.
So yes, research insurance and do buy some.
It’s not worth it, to me anyway, to gamble.

The cancelation insurance i am sort of on the fence about. In literally hundreds of trips I have never lost enough to make the cost of the insurance rational. Hotels I almost always get with cancel 24 hours prior. Flights are generally changable for a fee about equal to the insurance cost. Had to do that twice if memory serves me. Lost theater tickets and the like. Sure I could be out a hundred bucks. But if insurance were $100 and I do 3 trips a year for 10 years and claim for nothing but theater tickets or a $250 rebooking fee ... doesnt work for me. Not at all being critical of those who do prefer it. I get it.

The medical and the evacuation policy. YES. At least a very basic medical to reimburse the me for the costs before the evanucation plan kicked in. But do rememeber medical is cheap in a lot of Europe. We had a woman with a collaplsed lung here last year and about a week in the hospital cost her under $100. There is a trip report if you search for it. But that was here. I dont know about Germany or the UK or ...... there is no European "norm" for medical care or costs.

Hi all! Thank you for taking the time to respond, share your own experiences, and to offer suggestions or ideas. I'm looking into each for our travels. It's a bit overwhelming, but I have some time to figure it out. The what ifs, the things we might be doing, all the variables--all food for thought and things for us to consider. I'll be rereading this thread with a fine tooth comb as I contemplate my next move. Thank you all again! Crystal