Travel insurance can protect your health or wallet on vacation By Michelle Andrews, Kaiser Health News "Insurance is for pessimists" seems to be the attitude of many people planning a vacation overseas. No one wants to dwell on the mishaps that might land you in a foreign hospital or, worse, require an emergency air evacuation from your dream vacation. Travel insurance is worth considering, however. For a relatively modest outlay, you can buy coverage that protects you if you have to cancel before or during your trip because you, your traveling companions or even a family member not traveling with you becomes ill and requires care. These policies also cover cancellations for non-health-related reasons, such as a weather-caused flight delay that makes you miss a cruise launch. The policies cover prepaid, nonrefundable trip expenses that an airline, hotel, cruise line or other travel vendor doesn't refund if you must cancel. They typically also provide emergency medical/evacuation coverage in case you get seriously ill while traveling, and a hotline to English-speaking physicians and facilities that can best handle your medical problem. Coverage is usually available either for a set annual fee or on a per-trip basis, generally about 5 to 7 percent of the price of a trip. Travelers can also buy stripped-down policies that provide only medical coverage and medical evacuation services. "The driving force of a [comprehensive] plan is the cancellation coverage," says Damian Tysdal, a travel insurance agent in Hingham, Mass. You can get a good travel medical plan for $2 to $4 per day. Although it's highly unlikely that you'll need to be airlifted out of a country and returned home, it can be a devastating expense, often running $50,000 or more, say experts. Related stories from Kaiser Health News Less-dramatic emergencies that don't require evacuation can still send you to the hospital and ruin your trip. In 2009 Robert Brucato took one misstep in the ancient town of Egmort, in southern France, and ended up in a local hospital with a broken thigh bone. Following surgery and five days in the hospital, he and his wife, Margaret, were flown home to Tucson first class by way of Montpellier, Paris and Dallas. Their travel insurance company, HTH Worldwide, oversaw all the medical and travel details. When Margaret, now 60, had questions, she called the customer service representative assigned to their case. "They knew more about Robert's status than I did," she says. Robert, 71, needed a wheelchair to get through the airports. A company representative met them at each stop and escorted them to the gate. The Brucatos, who are retired, take two or three overseas trips a year. Their comprehensive travel insurance policy costs $350 annually for the two of them. Is it worth it? Robert can't say how much they might have had to pay out of pocket for his medical care and their flights home if they hadn't had travel insurance because, he says, "we never got a bill for any of this." Many people think that their regular health insurance policy will cover them if they get into medical trouble overseas. Don't bet on it. Some plans, such as those under the Blue Cross Blue Shield umbrella, give their members access to networks of hospitals and physicians around the world, but a domestic health insurance plan generally covers only emergency care overseas, say experts. In addition, members often have to pay upfront if the local medical provider doesn't recognize their plan. Traditional Medicare doesn't cover care overseas, either, though some Medicare supplemental plans do. People in private Medicare Advantage plans may have access to some services outside the United States; it depends on the plan. Before you travel or buy travel insurance, find out what you can expect from your existing plan if you need medical care on a trip. Although travel insurance can fill many of the gaps in coverage left by domestic health plans, there's one big problem area that is the source of many complaints: preexisting medical conditions. Travel insurance plans typically don't cover care or reimburse expenses for a canceled trip if the problem is related to a medical condition you or your family members already suffer from. However, you can sidestep this problem, if you're on your toes. "Most policies, if you purchase them within a set amount of time after booking your trip, will cover preexisting conditions, provided they're under control," says Linda Kundell, a spokeswoman for the US Travel Insurance Association. The time frame varies. Travelers who buy one of Travel Guard's core retail plans, for example, are eligible for coverage of preexisting conditions if they buy insurance within 15 days of making their initial trip deposit, says Carol Mueller, a vice president at the company. The preexisting condition coverage applies not only to the traveler but also to family members at home who might become ill and need care. For example, let's say a traveler's mother has heart trouble and suffers a heart attack while her son is on vacation: A travel insurance policy would cover trip cancellation costs so he could go home and care for her if he had purchased the preexisting condition coverage in the designated time frame. If not, the traveler would have to absorb any lost deposits and additional airfare charges. When in doubt, call the insurer or a broker before you buy a plan and discuss your concerns. Please send questions or ideas for future topics for the Insuring Your Health column to questions@kaiserhealthnews.org.