As the world begins to reopen to tourism, Americans are finding that some countries, including many Caribbean nations, now require arriving passengers to document that they have medical coverage. And a few, such as Costa Rica, are even demanding special policies that cover up to $2,000 for the expense of quarantining in a hotel if a visitor tests positive for COVID-19, as well as at least $50,000 of expenses relating to coronavirus care.
"We're seeing this more and more,” says Brook Wilkinson, an editor at travel-advice website WendyPerrin. “If someone wants an easy-breezy trip 2019-style, that's going to be tricky."
You may already be covered by a health insurance plan in the U.S. A health insurance policy for international travel may be necessary if you don't have your own health plan, if your plan doesn't cover medical care outside of the U.S. or if your destination requires a special country-specific plan.
Here are questions to ask when considering whether you need to purchase travel health insurance.
Does the country you're visiting require travel health insurance?
Before COVID-19, some countries already required visitors to prove they had health insurance coverage, and now a growing number are requiring a special country-specific policy related to the pandemic.
While Western European countries haven't adopted the requirement, countries that have include Cambodia, which requires visitors to buy COVID-19 insurance from a local company ($90 for 20 days); Aruba; the Bahamas; the British Virgin Islands; Dubai; Egypt; Grenada; Jordan; Mauritius; Namibia; Rwanda; Saba; St. Martin/Sint Maarten; the Seychelles; Sri Lanka; and Thailand.
Entry requirements are changing frequently. Ask your travel agent or search online for the latest updates. The best source of information is usually the country's tourism office and the U.S. State Department. Other helpful resources include CanITravel.net and WendyPerrin.com, which maintains a comprehensive list. The sites also have the latest traveler requirements for COVID-19 vaccination, testing and quarantining. Note that the Centers for Disease Control and Prevention (CDC) advises delaying international trips until you are fully vaccinated.
If a country requires special health insurance, you must bring written proof, sometimes specifically mentioning coverage for COVID-19, which the insurer can provide. Without it, airlines may not let you board and some countries may not admit you.
Travel Insurance Terms
Travel health insurance covers medical issues that arise while you're traveling. You may need it if you don't have another form of health insurance, your health insurance doesn't fully cover you outside the U.S. or your destination requires visitors to purchase a particular plan.
Medical evacuation insurance covers transportation to a medical facility if there isn't one in your immediate destination. It may be included in a travel health insurance policy or bought separately.
Trip cancellation or disruption insurance allows you to recoup the nonrefundable portion of a trip canceled for a covered reason. Sometimes it covers cancellation in case of illness, but it doesn't cover medical care. It may or may not cover cancellation due to disease outbreaks (such as COVID-19) in your destination.
Does your current health insurance policy cover medical care outside the United States?
Even if you have health insurance and special coverage isn't required for entry to your destination country, you may still need a travel health policy. Many traditional health insurance policies, including basic Medicare plans, do not provide coverage outside the U.S. And while some Medicare supplement polices include overseas coverage, it may be limited.
"A lot of U.S. travelers really aren't aware of how much medical coverage they have when they're traveling internationally,” says Stan Sandberg, cofounder of TravelInsurance.com. “They're assuming that health insurance travels with them, but in many cases it doesn't."
If you don't have health insurance (travel or otherwise) that covers you in your destination, you could face bills running many thousands of dollars if a health emergency arises.
Will you be particularly vulnerable during your travels because of a health condition or high-risk activities?
The CDC recommends travel health insurance for international travel, particularly for those who “have an existing health condition, are traveling for more than six months, or doing adventure activities such as scuba diving or hang gliding.”
You can find travel health insurance plans that cover preexisting conditions, but you often need to purchase one shortly after paying for your trip (usually within two or three weeks). And some plans won't cover medical care for injuries resulting from activities that are generally considered high risk. So be sure your plan does if you want to be adventurous and, say, skydive.
Do you need emergency evacuation coverage?
Even if your health insurance includes medical transportation, it may just cover the cost of getting you to the nearest appropriate medical facility. For example, if you sustained a serious injury on a safari in South Africa, your carrier may pay for transportation to a hospital in Johannesburg but not the cost to fly you back home.
Some travel health insurance policies include emergency evacuation home, and other companies, such as Medjet (MedJetAssist.com) and GlobalRescue.com, sell stand-alone plans that provide the coverage.
Choosing a travel health insurance plan
Travel health insurance generally isn't super expensive. A policy for a 65-year-old going to Europe for two weeks could cost less than $35 for $50,000 in coverage, Sandberg says. Paying just a bit more can bring higher policy limits and extras like lost-baggage coverage. (By contrast, trip cancellation insurance is pricier, costing up to 10 percent of the price of your trip. And coverage that lets you cancel for any reason runs even more.)
Shop around. Sandberg's company offers quotes from multiple plans, as do platforms such as InsureMyTrip.com. These companies also sell travel cancellation insurance, but you can narrow your search for travel health insurance policies by entering $0 as your total trip cost.
And, as noted above, you may want to consider whether a policy covers medical care for preexisting conditions or for COVID-19 and whether it includes emergency evacuation.
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Virginia native Larry Bleiberg is president of the Society of American Travel Writers, a frequent contributor to BBC Travel and the creator of CivilRightsTravel.com.