Before You Go: Insurance
Travel (Health) Insurance
Your company's HMO-driven health insurance is not likely going to cover you or your children's hospitalization overseas. Check with your insurance carrier to find what coverage if any you will have outside the U.S. Even if they will cover a claim abroad it is darn near 100 percent certain that the local hospital will not accept your insurance card as payment and insist on cash up front and leave it to you to seek reimbursement when you get home (assuming that the hospital's non-itemized bill in Swedish makes your insurance claims adjuster do something other than giggle when you file the claim).
The sad thing is that in some circumstances in some countries your child will not even see a doctor without money up front. You don't want this, so instead of reading any further here, stop for moment and talk to your insurance agent or travel agent and arrange special traveler's insurance. I'll wait here.
Travel health insurance is usually pretty cheap and very necessary. Be sure to ask about deductibles, about whether you'll need to pre-clear a hospitalization overseas (meaning at 4 am Marrakech time you will, in addition to helping your child, have to find a phone and a way to call the insurer).
It is also very important to find out what the insurer will do in the event your child will need to be medically evacuated back to the U.S. In many developing nations and even in some developed ones, local medical care is lacking, and you may want to call on local doctors only to stabilize your child's condition well enough that she can fly back to the U.S.
If your child needs to travel laying down, say on a stretcher, most airlines will require you to purchase several seats, which they will then remove to make room for the stretcher. Some airlines may insist on, or the local doctor may require, a nurse to accompany you and your sick child on the flight. This means additional, significant costs. A full medical evacuation can cost $10,000 or more, and care may under some circumstances be contingent upon payment up front.
Hospital conditions and expertise can vary greatly from place to place. While not definitive, this site pulls together links to hundreds of hospitals world-wide. What information is available on a particular institution varies greatly, as most of the links are to sites created by the overseas hospitals themselves.
Travel insurance should start making a lot of sense by this point. Double-check that it will cover the costs of evacuation back to your home (some coverage ends at the Port of Entry, a term that usually means the first airport stop you get to inside the U.S., not helpful if you thought you'd connect at JFK back to Columbus with the insurance company picking up the tab).
If you do have medical bills overseas, be sure to get the best receipt you can. “Best” may mean that it is not in English, or is not itemized as specifically as is common in most hospitals in the U.S. Do your best with this. You can always tackle the translation issue once home, or try and negotiate with your insurance carrier about accepting a non-itemized bill. If you leave totally empty handed from the hospital abroad you have little to work with later when tackling the insurance problem.
A note for our friends in the EU…
I don't pretend to know all the details of the various national health plans, but before traveling, you should check out what coverage if any you have away from home. To get you started, a private insurance company named Bupa International passed to me the following advice:
If you fall ill or have an accident in a member state of the European Union, you and the members of your family are entitled to receive medical care on presentation of an E111 form. Medical and dental treatment is then refundable, although this can be an onerous process and remember that fees such as hospitalisation, outpatient treatment and ambulance travel are not reimbursed.
For older parents or grandparents traveling with kids, note that Medicare/Medicaid benefits are not available outside the U.S.
A couple of places for your research into travel insurance are listed below, but begin with the company who provides your current health insurance. You might be able to buy a one-time policy or, if you and kids travel frequently, a yearly policy. Some credit cards offer some form of travel insurance. Check with the card issuer but ask lots of questions; some cover the health costs only if you used the card to buy the tickets, or other special rules that might leave you stranded.
Here are a couple of places to get you started:
Ask lots of questions before spending any money. Read the fine print carefully. Overseas you will have expenses that at home might not come up. You will almost certainly be making lots of expensive international calls—will the insurance help with the costs? In some parts of the world you will be expected to provide food for the patient, which without a kitchen will be hard and therefore expensive. You'll eat more meals at restaurants close to the hospital, whether they are cheap or not.
It can be real close to impossible to call a U.S. toll-free number (800-, 888-) from abroad. Be sure you have regular non-toll free numbers for the insurance company so you'll be able to call from a clinic pay phone in Argentina. Obtain and write down the insurance company's phone hours. Remember, daytime in China is night on the U.S. East Coast so 24 hour available service is important.
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