Precaution is better than cure. ~Edward Coke
Before studying abroad, you should make certain that you and your students have adequate health and emergency insurance that will cover you internationally. In some cases, it may be provided by your home institution, and in other cases, it may be included with your fees to a third-party provider. Still in other circumstances, it may be covered by the government of the country you are visiting, after you register for classes and pay your fees. Whatever coverage is provided, look over it carefully because it may not be enough for your particular needs.
Medicare/Medicaid doesn’t cover services outside of the US, and your regular health insurance company may not provide sufficient travel-specific coverage and limits. An emergency medical evacuation can cost over $100,000, far beyond what is customary and reasonable according to most insurance companies. In addition to coverage, you should look at your financial resources and whether you need a direct-pay service, en lieu of reimbursement after you submit receipts.
I once heard about a man whose appendix ruptured while he was in Europe. He was relying on the insurance provided by ISIC. Because ISIC does not pay hospitals directly, and he didn’t have enough money to pay the bill at the hospital, they confiscated his passport and refused to treat him or let him leave after surgery. Luckily, a friend traveling with him was able to collect enough money to pay the hospital bill, get his passport back, and have him released. While he did get ISIC to reimburse him later on, the situation that he forwent in the hospital was dreadful. Moral of the story…if you don’t have insurance that can pay hospitals directly for major medical issues, then make sure that you have a substantial emergency fund available and accessible by a third party.
There are lots of different insurance companies and policies with advantages and limitations. Before you start shopping, it’s important that you know what you need. Major medical, medical evacuation, and repatriation insurance are necessary! You may consider trip interruption insurance to protect the investment you made, in case something prevents you from going or requires you to return early. It’s also not a bad idea to consider security evacuation for natural disasters, outbreak of war, and terrorist attacks (otherwise, you will depend on your local US embassy). If you are traveling to an area where kidnapping or terrorism is common, then think about buying kidnapping and terrorism insurance.
You can shop for insurance online and compare rates through many websites. However, purchase directly from the company that provides it, not from a third party. If you purchase from a third party that goes under, then you’ll need to stand in line with all the creditors, which might prove difficult from across the ocean. Don’t fall for a great price at the sacrifice of good quality and reputation. Read the fine print, especially exclusion clauses. Many companies exclude pre-existing conditions, high-risk activities, care in the US (pre, post, or any stage in your trip), accidents involving alcohol or drugs, etc. Also, look closely at the amount of coverage. The following minimum coverage is recommended, but there is always room for more:
- Medical Expenses – 100K per incident
- Prescription Drugs – 80% to 100% coverage
- Emergency Medical Evacuation – 100K preferred, 75K acceptable (per occurrence, not per person) with flexibility in accommodating different needs, such as low altitude flight capacity for head injuries.
- Repatriation of Remains – 100K idea, 50K preferred, 25K acceptable (per person)
- 24-hour traveler assistance hotline
- Emergency Family Reunion – $2,500
- No pre-existing conditions clauses (if possible)
- Some mental health benefits (if possible)
- Coverage for your return to and care in the US
If there is a pre-existing conditions clause, then look at the period to which it pertains, because it may not be a problem. For example, if the period is six months in length, and you haven’t had any consultations or treatments for your shoulder problem during the six months prior to purchasing coverage, then it’s not a pre-existing condition according to their books. Think ahead when you plan your study abroad program, and act accordingly.
For travel insurance, you should try to secure coverage right after you purchase your trip. Some insurance companies will waive the pre-existing conditions exclusion, if you purchase within a certain number of days. I heard about a man who didn’t do this; instead, he bought trip insurance at the last minute. He ended up having to cancel for medical reasons, and the insurance company refused to cover his loss because he had diagnostic tests prior to purchasing the insurance.
In most cases, the way non-emergency consultations work abroad is similar to the way they work in the States. If your provider is not in-network with your insurance company, and most are not, then you’ll need to get an itemized receipt and present it to your insurance company for reimbursement upon return. Since medical consultations are more affordable in other countries, paying up front is usually not a problem for minor issues. It is the major medical and hospitalization that sometimes becomes an issue if you don’t have a direct-pay arrangement. Most facilities also accept credit cards, unless you’re in a remote location, but credit cards have low limits. Don’t mess around when it comes to your health. Get the best coverage, and go with a company that has experience and a good reputation in international health care.
Below are four charts comparing different types of insurance. These charts are provided only to give you a reference point and show you a few of the many, varied options available to students. Do not use this information, which could be inaccurate and out of date, to make decisions about your insurance policies and providers. Read the policy information and the fine print carefully, before you decide to purchase. Pay very close attention to benefits, coverage, and exclusions. Finally, make your decision wisely.
Note, many insurance policies will overlap (i.e. emergency evacuation with health insurance). If you have more than one insurer, know which is primary and secondary.
Student Card Comparison
|ISIC (Basic)||iNext (Basic)||iNext (Premium)|
|Approximate Cost||$22 per year||$25 per year||$45 per year|
|Emergency Medical Transportation||300K||250K||500K|
|Basic Medical||$165 per day (up to 61 days)||$165 per day||$250 per day|
|Accidental Death||1K to 5K||5K||10K|
|Lost, Stolen, or Damaged Baggage||No||No||$500|
|Cost||$225 per year||About $413 per year but varies|
|Medical Evacuation and Repatriation||Yes – but you decide where you want to go. If hospitalized, no cost limitations.||Yes – but they decide on the nearest medical facility, capable of required treatment.|
|Evacuation for Security Reasons||Optional||Yes|
|HTH Worldwide||CISI (Upgrade)|
|Approximate Cost||$34 to $90 per month||$31 to $261 per month plus $100 to $200|
|Deductible||$50 per incident||$100 per incident|
|Emergency Medical Transportation||50K||50K limit combined|
|Major Medical||100K/yr to 250K||50K|
|Basic Medical||10K after deductible||Above|
|AIG Travel Guard||Travelex Travel Plus|
|Approximate Cost||5-7% of total trip cost||6-7% of total trip cost|
|Trip Cancellation||Up to 100K||Up to 100K|
|Notes||Option can be added to cancel for any reason||Option can be added to cancel for any reason|
|Trip Interruption||Up to 150% of trip cost||Included in Medical Expenses|
|Missed Connection||$250||Included in Trip Delay|
|Medical Expenses||Up to 50K||500K for emergency|
|Emergency Medical Transportation||Up to 1 million||Included in Medical Expenses|
|Evacuation||Home or Hospital of Choice||Included in Medical Expenses|
|Lost, Stolen, or Damaged Baggage||$1000||$2500|
|Accident Death Dismemberment||25K||50K|
|Flight Accident||Up to 500K||Optional, different levels|
|Car Rental Collision||35K||50K|
Other major companies include:
Aetna Student Health – www.aetnastudenthealth.com
AssessAmerica – www.accessamerica.com
Assist America – www.assistamerica.com
CMI Insurance Specialists – www.cmi-insurance.com
Compass Benefits Group – www.compassbenefit.com
Harbour Group – www.hginsurance.com
Lewer Agency – www.lewer.com
Marsh Affinity Group – www.gatewayplans.com
MedAire – www.medaire.com
Multinacional Underwriters – www.mnui.com
RustInternationalAssociates – www.rustassoc.com
Summit Insurance – www.summitamerica-ins.com
Travel Insured – www.travelinsured.com
Universal Travel Protection (UTP) – www.utravelpro.com