You Really Should Get Health Insurance When Traveling Abroad

Don’t assume emergency or routine medical care is covered when you’re traveling in a foreign country.

We all know people who declare every flight cancellation or delayed bag a travel “nightmare.” You’ve probably done it once or twice on social media or in a family group chat.

You Really Should Get Health Insurance When Traveling Abroad

Carol Gebhardt is here to share a real travel nightmare, in hopes it drives home the importance of a good travel-insurance policy. (She made me a convert. More on that later.)

Gebhardt is no insurance salesperson. She’s a 71-year-old retired broadcast journalist who broke her pelvis in three places on a solo trip to Spain in March. Her bills totaled $120,000, and it was all covered by her Travel Guard policy, which cost about $650.

Few things can wreck a vacation like an unexpected trip to the doctor or emergency room, especially in a foreign country where your health-insurance coverage may be limited or nonexistent.

Last year, emergency medical expenses topped all other travel-insurance claims in volume and dollar amounts for the first time in a decade, according to travel-insurance comparison site Squaremouth.

They accounted for 27% of claims, edging out trip cancellation at 26%. The average claim was $1,654, but the highest was $61,976, Squaremouth says. The data is based on payouts from one provider, Tin Leg, so overall expenses vary widely, especially if medical evacuation from another country is needed.

Carol Gebhardt took a solo trip to Spain this spring and took in all the sights, including a monastery outside Barcelona, until she fell and fractured her pelvis.

Gebhardt’s bill from a tumble down a flight of restaurant stairs soared because she had to be flown from Barcelona to Erie, Pa., in an air ambulance after a two-week hospital stay. That bill was more than $100,000.

When she was comparing coverage ahead of her trip, her eyes fell on the medical-evacuation line.

“I actually thought to myself, ‘That’s sort of obscure. I’ll never need that,’’’ she said.

Plan for the worst

No one likes to think about getting sick or injured on vacation, but it happens. That’s why it should be part of the budget equation when trip planning, especially if you’re going out of the country, says Sandy Altamirano, a travel adviser with AAA Northeast in New York.

One client broke her shoulder and three ribs on a trip to Spain this year. Her policy covered the medical bills and the costs associated with her travel itinerary blowing up midtrip. That ranged from canceled hotels and tours in other countries to a new flight home.

Altamirano makes clients sign a waiver if they decline coverage. The State Department even warns travelers to make sure they are covered and links to a CDC guide to travel insurance.

More than half of Altamirano’s clients buy travel insurance, she says. Those who don’t say they are covered by their premium credit card or health-insurance policy.

Others gamble that the cheaper medical coverage they’ve heard about in other countries is a built-in safeguard.

Credit-card and U.S. health-insurance providers may offer you some coverage abroad. But it’s critical to read the fine print and talk to a representative ahead of a trip to see exactly what is—and, most important, isn’t—covered, says Jeff Rolander, vice president of claims for Faye Travel Insurance.

“Some policies may offer as little as $25,000 of medical, which can be exhausted really quickly,’’ he says. “Or they don’t have enough transportation coverage. You might get stuck with the remainder of an expensive air-ambulance bill.’’

Medicare’s website says it doesn’t usually cover healthcare while you are traveling outside the U.S., but it does list some exceptions. (Good luck deciphering them!)

What you’ll pay

Prices for stand-alone travel insurance vary widely depending on the coverage, your age and cost of the trip, among other factors. Plan on about 5% to 10% of the trip cost as a rough estimate. That range doesn’t apply to “cancel for any reason” policies, the priciest option out there.

Some policies even cover medical issues of people who aren’t on your trip. Altamirano says the trip-interruption portion of her policy for a coming trip to Singapore will cover travel-related expenses if she has to cut her holiday short should something happen to her 80-year-old father or elderly in-laws.

Trip-cancellation coverage offers similar protection should a covered relative get sick ahead of your trip.

Conversely, if your main concern is an overseas mishap bankrupting you, you can buy a policy that mainly offers medical coverage.

One travel agent I spoke with says one of her 64-year-old clients is paying just $75 for such medical coverage, including evacuation, for a trip to Antarctica. It starts the day of the trip; should the client break a leg before the trip, it isn’t covered as it would be with a broader policy.

Squaremouth says policies with medical-only coverage are so far this year running around $88 for an 18-day trip outside North America, compared with around $440 for broader coverage with cancellation on a $7,700 trip.

Confused, yet? Me, too.

But I do know this: I will no longer travel abroad without travel insurance. I’ve stupidly done so on two trips out of the country this year, including one with my 83-year-old mother. Blame penny-pinching or a sense of infallibility.

Yes, we’re both healthy. The problem is neither of us has the reserves to foot a medical bill like Gebhardt’s.

I have some insurance coverage through the American Express Platinum card, but even an artificial-intelligence bot couldn’t help me figure out whether it’s enough. And my healthcare provider was similarly vague when I reached out about coverage abroad. So I’ll soon be shopping for a policy for a trans-Atlantic cruise we’re planning for later this year.

Write to Dawn Gilbertson at dawn.gilbertson@wsj.com

You Really Should Get Health Insurance When Traveling Abroad