Don’t Leave Home Without It
by Michael J. Manyak, MD, MED 92
There has been a tremendous increase in travel for educational, recreational, or adventure purposes including travel to previously inaccessible sites. The exploration community is thriving with expeditions to all corners of the globe. Travelers now have electronic access to travel health information, though differing opinions for prevention and management of medical problems sows some confusion about proper preparation and insurance coverage. The recent announcement that TEC members have travel assistance and other services through Global Rescue gives us an opportunity to revisit the importance of appropriate medical coverage while traveling.
To review the travel insurance landscape, one must understand that protection for travel problems has one or more components: 1) travel assistance for logistics (lost luggage, trip cancellation, lost or stolen documents), 2) medical coverage for treatment, subject to policy limits, and 3) evacuation. Not all may be included in a policy. To be properly prepared, medical treatment and evacuation must be covered.
Do not assume that tour operators or travel companies offer more than very basic services for security and medical care. They carry liability insurance to protect themselves for an adverse medical event on their activity, but services for the client often do not exceed basic temporary medical care and transport to a regional medical facility. Without evacuation insurance, the victim must arrange evacuation or transport home often at tremendous cost. Nearly all credit cards and medical insurance policies do not cover evacuation.
Why is proper medical insurance and evacuation coverage necessary? Travel health issues are more common than suspected because up to two thirds of people who travel to the developing world report medical problems. Many of these resolve but about 8 percent of the estimated 50 million annual travelers (4 million) become ill enough to seek medical care abroad or upon return home. While a small percentage actually require evacuation, several thousand each year are evacuated for medical reasons.
There are good private facilities in many large cities where good care can be rendered but without a medical evacuation company or someone knowledgeable about local medical resources working on your behalf, these may be hard to identify. There is sound basis for evacuation back to the US. Surgical mortality is almost 20% higher in western Europe, 30% higher in Eastern Europe, over 70% higher in Latin America compared to the U.S. There are scant data available for the rest of the world.
Three aspects matter when it comes to travel and evacuation insurance: the quality and capability of the organization contracted to protect you from risk, determination of what services are covered, and the exclusions for coverage. Some important points to consider include:
- Private medical insurance coverage generally has similar coverage for international travel. Check your existing policy before travel.
- Medicare and most health maintenance organizations do not provide coverage for international travel.
- You need a separate policy for medical evacuation. Even comprehensive medical insurance policies do not cover evacuation.
- Check the exclusions for any policy you have. Many adventurous activities are excluded from policy coverage and alcohol or drug-related incidents often are not covered.
- Medical evacuation occurs by the decision of the insurance company. Evacuation occurs if medically necessary and is not triggered by natural disasters or outbreak of hostilities.
- A medical evacuation company will help determine the destination for the victim. It helps to establish before departure what would happen if a serious medical event occurs.
Details of the Global Rescue-Explorers Club agreement include the use of a 24/7 hotline to receive medical consultations and referrals to local medical providers and more than 200 certified medical centers throughout the world; access to the travel intelligence system for medical and security issues in 190 countries; travel assistance for legal referrals, lost passports and travel documents, logistics assistance for lost luggage; field evacuation to the nearest hospital or clinic for up to $5000. TEC members who opt for full coverage (which this author advises for expeditions and international travel) will receive a discount. This is an important member benefit!
Nothing brings clarity to an issue like a tragedy. The devastating toll from the recent Nepal earthquake claimed several climbers but also trekkers and many regular tourists in addition to thousands of inhabitants, paralyzing the country. Many more were stranded and had travel disrupted. Medical services were crippled and overwhelmed.
In the case of a widespread disaster like in Nepal, basic infrastructure and standard resources may not be available and, even if you had medical evacuation insurance, operations may be delayed. The traveler must understand that expectations of immediate evacuation may not be met. But with such coverage, a reliable medical evacuation company will assist with medical management on site and have quicker access to evacuation resources when they become available. That was confirmed for Global Rescue clients caught in Nepal.
You don’t know what you don’t know about medical treatment and evacuation. So be prepared and learn about your personal situation and coverage. At least now you have a partial safety net.
This article was published in The Explorers Journal
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