Determining which travel insurance to purchase can be daunting. The medical and insurance lingo can make your head spin. And why do we need travel insurance anyway? While planning for this trip, we have come to understand a lot about travel insurance including the coverage, limitations, and some additional benefits. What’s the difference between travel medical, trip and international health insurance coverage? What the heck is a common carrier or a pre-existing condition? Hopefully I can shed some light to this complex topic.
Step 1: Are you healthy enough to travel?
Make sure you are healthy enough to travel. See you primary care provider and get a physical before traveling. Your health status plays a role in whether you can get health insurance and how much you will pay. If you have to file a claim, the insurance company can go back up to 3 years into your health history to find out if you have a pre-existing condition which could negate the claim. A pre-existing conditions is “any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan”. Some insurance plans exclude these pre-existing conditions entirely while others allow you to waive these if you meet certain criteria or if your condition is under control. With these waivers, you may see that there are limits to your medical benefits when it relates to these conditions.
Step 2: Do I already have international medical coverage?
Most people are surprised to hear that your current health insurance through an employer or the Affordable Care Act doesn’t cover you for international travel. If yours doesn’t, you may want to weigh the pro’s and con’s of purchasing additional insurance. There are four main types of travel insurance you can buy while traveling outside of your home country. One type includes comprehensive international medical which works more like your normal health insurance (PPO) with deductibles, co-pays, etc. Another option is emergency medical coverage which usually covers emergent inpatient/outpatient evaluations, medical evacuation/reparations, emergency dental, AD&D, etc. The next option is trip insurance which covers trip cancellation, interruption, delay and loss/delay of baggage. The final option is a combination of above types.
Step 3: Determine the length of your trip.
Knowing your trip length will help you narrow down which travel insurance policies are available. For example, we are traveling for 1 year and most plans to do not cover more than 3-6 months. The plan we chose only covers up to 364 days with options for renewal. If you are traveling for longer than 1 year, look for plans that are renewable. We did not run across any insurance coverage that lasted longer than 12 months.
Step 4: Determine the trip locations.
Insurance companies have the right to restrict coverage however they choose which will be outlined in the coverage plan description. Many countries like Afghanistan, Iran, Iraq, Syria, etc. are restricted because of civil/political risk and safety concerns. Areas with endemic outbreak such as Zika and Ebola may not be covered, so keep this in mind if you are planning on doing mission work or visiting infected areas. Other locations are sometimes not covered due to high claim frequency like Mt. Kilimanjaro or Nepal where high risk/altitude trekking is common. Also, if you are traveling in the US, insurance may have significantly higher cost than if you exclude the US from your plans. When we excluded coverage for the US from our insurance quote, it dropped by more than half.
Step 5: Do you need trip insurance, emergency medical/evacuation, or a combination?
Trip insurance includes trip interruption, delay, cancellation, or lost luggage. These features are nice if you can pre-book your entire trip, but they may not be applicable when doing an extended adventure since the costs need to be pre-paid. If you are planning a structured tour, trip insurance is probably a good idea. For example: We went on a trip to the British Virgin Islands at the beginning of hurricane season, and you can guess what happened. We got hit by Hurricane Fran which delayed our arrival to a chartered yacht trip. Luckily our trip insurance, which covered trip delay and interruption, saved the day. We were reimbursed for all of our additional costs including food, accommodations and the pre-paid unused portion of the sailing trip.
Know that if you are a long term traveler and US citizen, you need to look into the requirements under the Affordable Care Act. You may not have qualifying health coverage with travel insurance alone per ACA website. You are required to have “QUALIFYING HEALTH COVERAGE (“MINIMUM ESSENTIAL COVERAGE”) THAT SATISFIES THE HEALTH CARE COVERAGE REQUIREMENT OF THE AFFORDABLE CARE ACT. IF YOU DON’T HAVE MINIMUM ESSENTIAL COVERAGE, YOU MAY OWE AN ADDITIONAL PAYMENT WITH YOUR TAXES”. Fortunately, there is an exemption from required coverage if you are outside of the US for greater than 330 days in a consecutive 12 month period.
Step 5: What’s your hazard level?
If you are adventurers like us, you are planning on some higher risk activities such as trekking, shark cage diving, SCUBA, surfing, zip lining, caving, and other sports. If this is you, then you need to look for the optional hazardous sports rider or high risk activities rider. It is included in some plans and can be added to others for an additional cost. You may also want to increase your AD&D policy limits as well.
Step 6: What extras do I need?
Personal Liability Insurance – This covers the insured in situations where lawsuits or claims are brought for injury or negligence. This can also be covered separately by umbrella insurance through your home country provider. Many umbrella policies cover you internationally.
Special Case Scenarios – There are some situations where policies may not provide coverage such as for terrorism medical expenses. Some may offer an additional benefit (above your medical limits), while others have sub-limits if you were injured during a terrorism incident. Also look for additional coma and felonious assault benefits which could give you additional funds above your normal medical maximums.
Natural Disaster Stipend – Disasters can have a huge impact on your trip through rerouting or delays. You may also incur additional cost for new accommodations and activities. Look for additional coverage (usually $100-$250/day) if you are traveling to locations during hurricane or typhoon seasons or areas prone to earthquakes.
Non-Medical Evacuations – We also found that several policies specifically excluded benefits for some non-medical evacuation types, such as political or natural disaster. If a country becomes unsafe and a there is an official government recommendation to leave that country, then you could be eligible to use your political or other evacuation coverage to send you to your home country. Natural disaster evacuations may become necessary if your current location becomes uninhabitable. For reference, we were in New Zealand in October, 2016 just weeks before a 7.8 magnitude earthquake hit Christchurch and Kaikoura. We were in both of these locations for our honeymoon and just missed this disaster. Many tourists were trapped due to damage to roads and railroads. In this instance, we would have been able to claim for both evacuation and replacement stipend.
Accidental Death and Dismemberment (AD&D) – This is coverage for death, loss of limbs, or eye sight due to an accident on your trip. Common carrier accidental death covers death due to an accident occurring on your trip while riding on/in a common hired transport service (e.g. plane crash).
When researching travel insurance, I came across a helpful website called Insure My Trip which compares several different providers. While this was a great tool, I felt that it left out several companies which I would have liked to compare. Ultimately we narrowed our search to three policies including Seven Corners Liaison Majestic, World Nomads Explorer, and IMG Patriot Travel. See the below comparison chart with benefits based on the following assumptions: a couple in their 30’s, only traveling to countries outside the US, added hazardous activity option/rider, and policy term for 1 year. The following link will open up a separate .pdf chart detailing the benefits and exclusions for each of these three policies.
The below chart compares our final three insurance contenders based on their policy documents. The following are links to those respective companies policy documents: Seven Corners Liaison Majestic, World Nomads Explorer, and IMG Patriot Travel. The items with green highlights are the key components which positively set the insurance companies a part. The red highlights are items which you should consider carefully before a purchase.
***This chart was built with information taken from these three plan websites as of May/June 2017 and consolidated for ease of comparison. It is informational only and is not meant in any way to represent exact benefits for these companies, which can be found in the Policy Document. Please read each one carefully on the respective plan website prior to making a decision to purchase. Links to these plan documents are included below the chart. As of June 2018, Seven Corners has changed their policy options to include Liaison Economy, Choice, and Elite. The benefits are slightly different than those shown below. Please see their website for the most up-to-date policy information.***
This chart is also available as a separate .PDF using the following link:
***Travel Insurance Comparison Chart***
We also looked into Seven Corners Reside which is a more comprehensive international health insurance as opposed to travel insurance. It did not provide some of the evacuation/reparation benefits which we felt could be necessary. We researched several other companies including: International SOS, Travelsafe, Allianz, Nationwide, CSA, AIG (Travelguard), HTH (Geoblue), but all of these companies were limited to 6 months of travel or less. Most of the above companies also required you to have a final return ticket in order to purchase insurance. This was not possible for us due to the nature of our trip, leaving us with fewer insurance options. Travelex offered a 365 day policy, but only included evacuation coverage and not emergency medical.
After going through the above steps, we decided that the Seven Corners Liaison Majestic policy was the best fit for us. This ended up being the cheapest and also had the best variety of options to fit our needs. Our 364 day, 12 month term policy cost just $1075 per couple. The included benefits for terrorism medical up to medical maximum, several types of non-medical evacuation, and higher medical evacuation limits were key components of our decision for this policy. The World Nomads plan offered some enticing benefits for trip insurance and had no deductible or copay, but the exclusions and the cost outweighed these additions in our minds.
I hope this was helpful! Be sure to check out our posts on Trip Planning, including packing for an around the world trip, the world trip planning timeline, essential travel technology and pre-arrival travel prep which supplement this information!