Trip Cancellation vs Medical Insurance thoughts

[Hlitner]

Having spent a working lifetime in the health insurance industry we find some of the discussions on this board (and elsewhere) very interesting. So here are a few thoughts to ponder. When you book a trip you plan on spending X amount of money on that trip and are prepared for this expense. Your trip liability is essentially the cost of the trip which is a known amount that you can afford (or you would not have booked the trip). A good trip cancellation policy is quite expensive and for those who do a lot of travel can be very expensive. For example, on an upcoming cruise our cost for a typical trip policy would be in excess of $1200....and that is just for a single trip. Many of us choose to self-insure trip cancellation since losing that money leaves us in the same financial situation that would have existed if we had taken the trip. So although it hurts to lose that money it is not catastrophic.

 

Medical is a whole different story. Your potential liability for medical issues is essentially unlimited. Yet folks will worry about insuring a $5000 trip (where there maximum loss is $5000) but not give as much thought to good medical coverage (where your liability could easily be in the hundreds of thousands of dollars). Many of the commonly sold trip cancellation policies have lousy medical insurance but folks do not seem to care. A couple can purchase an annual trip medical policy for as little as $150 (from companies like American Express) or you can buy a $250,000 policy from companies (like HTH) for about $350 a year (per couple).

 

We think travelers need to give a lot more consideration to their medical coverage and not be nearly as concerned about trip cancellation. Just one person's humble opinion :)

 

Hank

[6rugrats]

 

We think travelers need to give a lot more consideration to their medical coverage and not be nearly as concerned about trip cancellation. Just one person's humble opinion :)

 

Hank

Totally agree. And, the only times I've had to cancel a trip and file an insurance claim, was due to medical reasons.

[CruisinGerman]

I totally agree with this thread. HTH's full-fledged expatriate permanent health insurance policy is very good. Their travel policy is so-so.

 

I would stay away from the American insurers (with all of their peculiarities included) for this type of annual, high-limit medical cover. Some of the European insurers that accept insureds worldwide do this kind of insurance much better.

 

IMG (I think the ultimate parent company is from the U.S.) has a higher limit travel medical policy than HTH.

 

BUPA (http://www.ihi.com) has unlimited medical cover and is considered the Rolls Royce of this type of annual policy. The same policy can be purchased on a less expensive basis and as a group policy through http://www.worldnomads.com (which is actually an Australian company recommended by Lonely Planet).

 

For you Americans lucky enough to have international coverage included in your health insurance, I would be very suspect of this coverage if the services of an assistance company are not provided as part of this coverage. If you don't have the services of an assistance company included, I would personally purchase supplementary international coverage. An assistance company will arrange medical care overseas in an emergency, and provide payment guarantees to hospitals so that you do not have to arrange the care yourself, foot the bill, and then pray for reimbursement.

 

Also, just because your Blue Cross or United Healthcare may provide reimbursement for overseas coverage, evacuation and repatriation insurance is not necessarily included, so please be careful to make sure you have this coverage.

 

Do look beyond the standard American practice of only consulting insuremytrip.com. There are companies beyond that website that provide worldwide policies, have higher financial ratings, and provide better service than some of the companies selling through insuremytrip.com.

 

I hope this turns into an interesting, informative thread.

 

Kind regards,

 

Gunther and Uta

[Hlitner]

Gunther and Uta, Have enjoyed reading your posts over the years and do treasure a lot of your trip advice. You got my interest with the world.nomads info so I did check it out. I specifically looked at an annual policy (which makes sense for those of us who take multiple trips in a year) and was not impressed with the results. There maximum limit was only $100,000 max and have some awful limits such as $50 a day for a hospital room ($100 in their higher cost policy). But the wost part was that they do not cover any pre-existing conditions....which those of us who have been in the medical insurance industry know....is the kiss of death for most policies. The reality is that older travelers always have some pre-existing conditions and insurance companies will often use the clause as a way to deny many claims. And it can get nasty. We have seen insurance companies refuse to pay for any treatment related to a stroke because the claiment had a history of hypertension. And this is just one example....and why we always suggest that folks find policies that will cover pre-existing conditions (HTH does cover pre-existing conditions on many of their policies). Although IHI does have excellent policies, their cost can be prohibitive for many travelers (you can easily spend more then $5000 per person on premiums). There policies seem to be directed towards those who need to buy primary medical insurance as opposed to something that is what we would call a supplemental policy.

 

A major problem with many US Travel policies is that they focus on the Trip Cancellation benefits (which seems to be the focus of many travelers) while offering very little medical coverage. A good example is a multi-trip policy from TravelGuard that gives you lots of trip cancellation benfits but only cover $10,000 of medical expenses. As you are probably aware, $10,000 does not even cover a single day in many hospitals!

 

Hank

[CruisinGerman]

We have the Spanish version of Travel Guard, platinum (platino) coverage, annual policy.

 

Check it out on http://www.insurancebookers.es (you can click on English and read the policy in English).

 

It has unlimited medical coverage, and what is unusual is that it also has unlimited cancellation and interruption coverage.

 

The policy cost us 250 euros per year total for two people.

 

There must be a catch someplace -- never had to use it, thank god, so haven't caught the catch yet.

 

Most of the European insurance companies aren't as nasty about denying claims as the U.S. companies tend to be.

 

As permanent international health insurance, we have http://www.dkv-globality.com (yougenio, TOP coverage). One of my family members needed elective surgery. Went to Cedars-Sinai in Los Angeles and was given a private suite in the hospital. What kind of insurance company gives you that, nowadays? Check out the policy, it is very broadly written without many exclusions.

 

HTH's international expatriate insurance coverage has improved because it is now unlimited yearly and lifetime maximum on their permanent policy. Our DKV policy has always been unlimited coverage.

 

The health insurance policies we can purchase here in Europe tend to be more competitive and more complete, because they are competing against the free system. Interestingly, if you want to purchase one of these policies to include elective coverage in the U.S.A., the premiums double.

 

Let's hope we never have to use any of this insurance for really dire emergencies or serious illness.

 

Kind regards,

 

Gunther and Uta

[Hlitner]

The type policy (unlimited) you mention does not appear to be available on this side of the ocean. In fact we looked at the Spanish version of Travel Guard and it specifically excluded North America (Canada and US) and I did not figure out whether this meant you get no coverage in North America.. This makes me wonder (am thinking out loud) whether it has something to do with the National Health Insurance enjoyed by all the Western European countries. We do not enjoy this type of health care coverage and our seniors who are on the Federal Medicare Program do not get any health care benefits outside the US. I am wondering if your policies are based on the fact that your national policies are effective in other European countries.

 

Of course there is the other issue of whether one can enforce a policy. If I buy a European policy and file a claim...and they refuse to pay....then what do I do? Travel to Europe and spend a few months (or years) fighting through the legal system in the country that sold me the policy? In the US, insurance is very fragmented and regulated by each state using their own specific laws. This is why some trip insurance policies sold in the US are not permitted to be sold to residents of certain states (because their specific state did not license the policy). It is enough to drive mere mortals to drink (just what I am doing now).

Hank

[donaldsc]

Having spent a working lifetime in the health insurance industry we find some of the discussions on this board (and elsewhere) very interesting. So here are a few thoughts to ponder. When you book a trip you plan on spending X amount of money on that trip and are prepared for this expense. Your trip liability is essentially the cost of the trip which is a known amount that you can afford (or you would not have booked the trip). A good trip cancellation policy is quite expensive and for those who do a lot of travel can be very expensive. For example, on an upcoming cruise our cost for a typical trip policy would be in excess of $1200....and that is just for a single trip. Many of us choose to self-insure trip cancellation since losing that money leaves us in the same financial situation that would have existed if we had taken the trip. So although it hurts to lose that money it is not catastrophic.

 

Medical is a whole different story. Your potential liability for medical issues is essentially unlimited. Yet folks will worry about insuring a $5000 trip (where there maximum loss is $5000) but not give as much thought to good medical coverage (where your liability could easily be in the hundreds of thousands of dollars). Many of the commonly sold trip cancellation policies have lousy medical insurance but folks do not seem to care. A couple can purchase an annual trip medical policy for as little as $150 (from companies like American Express) or you can buy a $250,000 policy from companies (like HTH) for about $350 a year (per couple).

 

We think travelers need to give a lot more consideration to their medical coverage and not be nearly as concerned about trip cancellation. Just one person's humble opinion :)

 

Hank

 

I agree w you completely. We carry a yearly travel medical / evacuation insurance policy and self insure for everything else. It always amazes me when people worry about minor costs such as trip delay or luggage loss but don't worry about the potential big hit.

 

On a recent trip, my wife had a medical problem in Australia and was in hospital for 3 days. Our policy covered everything less the deductible without any problems.

 

DON

[CruisinGerman]

Hank,

 

The Spanish Travel Guard policy has two versions. You can click to purchase coverage "Europe" or "Worldwide INCLUDING U.S.A." The second version, which costs double (but still only 250 euros per year for two persons) obviously does not exclude North America. That is a travel insurance policy.

 

The permanent international health insurance policies we can purchase in Europe are really quite interesting and generous if you compare them to U.S. policies. Firstly, because of their nature as international policies, they are valid worldwide and not just in your home country, and include evacuation and repatriation insurance. All of these policies include emergency coverage in the U.S. (i.e. if you're on a trip and you suddenly take ill or have an accident). If you want elective coverage in the U.S. (being able to have your private suite at Cedars Sinai, for example), the premiums are double and sometimes more than double, because of the "peculiar" pricing system in the United States versus the rest of the world. Secondly, because they are competing with the "free" system, they have to be extremely generous, flexible, policies, or nobody would buy them. That is probably the main reason why claims processing in Europe tends not to be as nasty as in the United States. The insurers know very well that private health insurance is a luxury in Europe, not a basic necessity as in the United States, so this product is generally treated as a luxury should be treated. The practice of denying a claim because the insurance company finds out that you were treated for a similar condition 6 years ago but didn't disclose this on your application doesn't work very well in Europe, first, because private insurance is treated as a luxury product and, second, because Personal Data Protection Laws are much stricter in Europe than in the United States, it becomes virtually impossible, if not illegal, for an insurer to be able to obtain this type of third party, protected, information. So medical insurance becomes much more of an honor system here in Europe than in the United States, because databases such as the "Medical Information Bureau (MIB)" do not exist and would be considered to be illegal.

 

Each European country has an insurance regulator very similar to the insurance regulation departments of each one of the U.S. states and territories. As you know, Europeans tend to dominate the world's insurance underwriting and reinsurance system (see companies such as Munich Re, Zurich, Swiss Re, Lloyds, Allianz, etc.) so there really should be very few fears about the stability of a European policy. Insurance underwriting is probably one of the few areas in which Europe exceeds the United States. Anyway, the most popular travel insurance purchased in the United States appears to be Travel Guard, which is AIG, and look what happened to them, and they're still going.

 

This thread is interesting and I hope it keeps on .......

 

Kind regards from Madrid,

 

Gunther and Uta

[Keith1010]

Hank all that you say makes a lot of sense to me.

 

In the end, I've found that the trip cancellation portion of the cruise comes down to how much risk someone is willing to take and some of that depends on your personal financial situation. To me it's not a lot different than a deductible on your home or automobile. Just as we might choose to have a higher deductible on some of these items because we are willing to take some additional risk we sometimes do not insure the trip cancellation portion of our cruise or we insure it for less than what we paid to lower the premium. We understand the implications up front of this strategy as we understand the implications when we raise or lower our home insurance on a home or automobile.

 

On the medical side we try to make sure we have sufficient coverage based on a cruise specific basis as we also make sure we have sufficient coverage for medical the rest of the year for our own regular medical policy. For example, I usually get a plan that provides me with more medical coverage on a cruise say where I am in Asia versus say one going to Alaska or NYC to Montreal.

 

To me the important thing is to think through each persons situation and what the implications are for taking or not taking coverage and how much to take factoring in cost and risk. And I always believe the devil is in the details and that people should thoroughly read in writing what is covered and what is not covered and to carefully compare policies to find what works best for them.

 

Keith

[Hlitner]

Gunther and Uta (not sure which of you is posting here),

 

We have lots of issues with those Spainish policies (and we have not even given it our usual due diligence). I will cite on two issues. 1. The Policy is only available to people who live in Spain or who have lived in Spain for at least 6 months of the past year. So it is not an option for us. 2. This policy uses very broad language to exclude any pre-existing condition. In fact, the language is so broad I am not sure they could get a similar policy licensed in most of the State of my country. To put it in simple terms the polcy says they will not pay claims related to any condition you were aware of prior to the trip. This clause can be a real problem. For example, say you have a stroke (CVA in medical terms) when you are on a trip. Now lets assume you have a history of high blood pressure *hypertension") which has been treated for thirty years and under control. The insurer can simply say, your hypertension (of which you are aware) led to the stroke...hence you are not covered.

 

I should mention that the annual multi-trip HTH Policy offered in the US does cover pre-existing conditions. In fact many other Trip policies sold in the US also cover pre-exisiting conditions (some of these policies require they be purchased within a day of booking a trip). After spending more then thirty years in the health insurance industry I could write a book about how insurers take advantage of pre-existing clauses.

 

Hank

 

P.S. I was just glancing (again) at that Spanish Policy and found an interesting exclusion"

 

"21. Any claim resulting from you being under the influence of or in connection with the use of alcohol or drugs unless prescribed by a doctor.'

 

This means that if you stop at a pub for lunch and have a pint...and then you trip over anything and break your neck....they can deny any coverage because you had that pint. :)

[BosoxI]

Having spent a working lifetime in the health insurance industry we find some of the discussions on this board (and elsewhere) very interesting. So here are a few thoughts to ponder. When you book a trip you plan on spending X amount of money on that trip and are prepared for this expense. Your trip liability is essentially the cost of the trip which is a known amount that you can afford (or you would not have booked the trip). A good trip cancellation policy is quite expensive and for those who do a lot of travel can be very expensive. For example, on an upcoming cruise our cost for a typical trip policy would be in excess of $1200....and that is just for a single trip. Many of us choose to self-insure trip cancellation since losing that money leaves us in the same financial situation that would have existed if we had taken the trip. So although it hurts to lose that money it is not catastrophic.

 

Medical is a whole different story. Your potential liability for medical issues is essentially unlimited. Yet folks will worry about insuring a $5000 trip (where there maximum loss is $5000) but not give as much thought to good medical coverage (where your liability could easily be in the hundreds of thousands of dollars). Many of the commonly sold trip cancellation policies have lousy medical insurance but folks do not seem to care. A couple can purchase an annual trip medical policy for as little as $150 (from companies like American Express) or you can buy a $250,000 policy from companies (like HTH) for about $350 a year (per couple).

 

We think travelers need to give a lot more consideration to their medical coverage and not be nearly as concerned about trip cancellation. Just one person's humble opinion :)

 

Hank

 

Thanks, Hank, for some very interesting insights. We are content to kiss off the cost of the cruise, and our medical insurance will cover the cost of care on a cruise (eventually, I'm sure), but what do you think of having a policy to cover transport home? I have seen one offered at a very reasonable rate for a year's coverage. I once met a guy onboard using a cane. He said he had broken his leg in Mexico on a previous cruise and the cost of getting home would have been , I think, $20,000. He lucked out, he claimed, because as a Navy vet somehow the DOD carried him home. I'm not a retired vet, so I'm curious about the insurance. Thanks.

PS How much is the trip on which the insurance would have cost $1200?

[6rugrats]

. I once met a guy onboard using a cane. He said he had broken his leg in Mexico on a previous cruise and the cost of getting home would have been , I think, $20,000. He lucked out, he claimed, because as a Navy vet somehow the DOD carried him home

 

I don't think this is true. Why would the DOD pay to get him home after he injured himself on vacation?

[Hlitner]

Thanks, Hank, for some very interesting insights. We are content to kiss off the cost of the cruise, and our medical insurance will cover the cost of care on a cruise (eventually, I'm sure), but what do you think of having a policy to cover transport home? I have seen one offered at a very reasonable rate for a year's coverage. I once met a guy onboard using a cane. He said he had broken his leg in Mexico on a previous cruise and the cost of getting home would have been , I think, $20,000. He lucked out, he claimed, because as a Navy vet somehow the DOD carried him home. I'm not a retired vet, so I'm curious about the insurance. Thanks.

PS How much is the trip on which the insurance would have cost $1200?

 

When it comes to fellow Americans we tend to categorize folks into a few classes. Those of us who are fortunate to have health insurance that covers us outside the US (many Blue Cross/Blue Shield programs have this coverage) and those with policies that do not extend coverage outside the US (Medicare, many private plans). And of course there are those with no health insurance that live every day with a financial gun to their head. We do think that even if you have coverage that extends outside the US...it is wise to have emergency trip evacuation insurance. This kind of insurance is quite cheap and many of the policies will cover at least $100,000 in expenses. We have long liked the simply policy sold by American Express (I think you need to have an AMEX card) which only costs about $149 a year (total per couple) and provides some secondary medical coverage plus trip evacuation. Our one problem with this policy is that it only covers the first 45 days of any trip...and we do take much longer trips. Hence, we recently purchased a policy from HTH because it covers the first 70 days of a trip and also provided $500,000 of trip evacuation coverage.

 

Personally, we are not big believers in Trip Cancellation insurance because we do an awful lot of travel and these policies are very expensive. In our case we choose to self-insure the risk of cancelling a trip, but be very conservative when it comes to medical coverage since medical issues involve unlimited liability to the traveler. We figure that over the years we have saved in excess of $100,000 by not purchasing trip cancellation insurance. Even if we have to cancel a trip (and lose the cost of that trip) we would now be far ahead of the game.

 

By the way, regarding the Navy Vet story we assume that person was a "retired" Navy Vet. As a miliary retiree he would have been eligible for "space available" transportation and assume they had space :)

Hank

[klfrodo]

I don't think this is true. Why would the DOD pay to get him home after he injured himself on vacation?

 

It's very possible that if the person in question is a retired vet, he has the benefit of flying "standby" on any military flight going in his direction. When I was active duty, we could do this on MAC flights. Retired military have the same benefits.

[critterchick]

Thanks, Hank, for some very interesting insights. We are content to kiss off the cost of the cruise, and our medical insurance will cover the cost of care on a cruise (eventually, I'm sure), but what do you think of having a policy to cover transport home? I have seen one offered at a very reasonable rate for a year's coverage. I once met a guy onboard using a cane. He said he had broken his leg in Mexico on a previous cruise and the cost of getting home would have been , I think, $20,000. He lucked out, he claimed, because as a Navy vet somehow the DOD carried him home. I'm not a retired vet, so I'm curious about the insurance. Thanks.

PS How much is the trip on which the insurance would have cost $1200?

 

Perhaps he was on enough pain meds on the trip home that his recall is fuzzy:p. My DH is retired Navy, too. We have checked with Tricare (military retirees' insurance company/administrator) and they have told us that they provide for transportation home in the event of illness or injury overseas. But I don't think that it's via military transport. I certainly hope we never have to find out!

 

Trip insurance is always an interesting dilemma for me. Between Tricare and BC/BS we have worldwide medical coverate which, as Hank says, is the largest potential expense. We generally don't purchase additional coverage. But once in awhile we do take an expensive trip and, although not purchasing insurance all these years has resulted in a hypothetical "kitty" of a few thousand dollars, I still am tempted to buy the insurance on the big ones for the cancellation coverage.

 

We are more likely to cancel a trip for a non-covered reason than for our own illness, so when we do get insurance, we've done it through the cruiselines (once you add that coverage to the independent policies, the price becomes comparable or more, given our ages, 58/60). Sometimes I think we're just flushing the money down the toilet. I would love to find an annual policy with that feature...

[Keith1010]

Hank, question.

 

In addition to insurmytrip.com are there any internet sites that you would recommend for cruise critic members looking for more information on medical insurance. I realize they can also go to each of the individual travel insurance sites but was wondering if you had any other recommendations?

 

Keith

[cruiseco]

Hank, question.

 

In addition to insurmytrip.com are there any internet sites that you would recommend for cruise critic members looking for more information on medical insurance. I realize they can also go to each of the individual travel insurance sites but was wondering if you had any other recommendations?

 

Keith

 

TravelInsuranceCenter.com does have one of those "European-Style" annual policies available to residents of any country. Max trip length is 42 days, only good during international travel, and max age is 74. But it has the high medical limit ($2,000,000) and at least a reasonable trip cancellation benefit ($4500). US resident pays $205, $355/couple, $455/family

 

http://www.travelinsurancecenter.com/eng/information/cm_home.cfm?line=gbg_ts_an

[Hlitner]

Hank, question.

 

In addition to insurmytrip.com are there any internet sites that you would recommend for cruise critic members looking for more information on medical insurance. I realize they can also go to each of the individual travel insurance sites but was wondering if you had any other recommendations?

 

Keith

 

Like many on CC we do sometimes look at insuremytrip.com. Another interesting site is http://www.travelinsurancereview.net/ which has a lot of info. But it is interesting that neither of these sites mention such basic insurance as offered by AMEX. In fact, when we recently called AMEX to cancel their annual policy (replaced with HTH) we learned of another travel medical insurance policy they offer on a per trip basis which is good for 60 day trips and costs less then $70 (since we have not read the specific policy info we cannot comment on this policy). We suspect there are some other good options which are not mentioned on any of the popular web sites and will continue monitoring this board hoping to learn of new and better things.

 

Hank

[Keith1010]

Thanks, Hank.

 

Keith

[BosoxI]

I don't think this is true. Why would the DOD pay to get him home after he injured himself on vacation?

 

I agree, that's why I said "he claimed" OtOH why would he lie?

[CruisinGerman]

Personally I think the squaremouth website has more complete information than insuremytrip.

 

Just my personal opinion though.

 

Kind regards,

 

Gunther and Uta

[Hlitner]

TravelInsuranceCenter.com does have one of those "European-Style" annual policies available to residents of any country. Max trip length is 42 days, only good during international travel, and max age is 74. But it has the high medical limit ($2,000,000) and at least a reasonable trip cancellation benefit ($4500). US resident pays $205, $355/couple, $455/family

 

http://www.travelinsurancecenter.com/eng/information/cm_home.cfm?line=gbg_ts_an

 

Your post got my attention but still have not had the time go work my way through all the fine print. But since this policy is only governed by the laws of Guernsey, which is where you have to take any dispute, we probably would not purchase this product in the US. In fact we are not sure they are even licensed to sell this policy in any state. Its tough enough dealing with properly licensed US policies..but at least you always have the ability to take unresolved issues to the appropriate state insurance commission. But with a policy from Guernsey...who knows? As a general rule we always suggest that Americans only buy insurance policies licensed to be sold in their home state.

 

Hank

[cruiseco]

Your post got my attention but still have not had the time go work my way through all the fine print. But since this policy is only governed by the laws of Guernsey, which is where you have to take any dispute, we probably would not purchase this product in the US. In fact we are not sure they are even licensed to sell this policy in any state. Its tough enough dealing with properly licensed US policies..but at least you always have the ability to take unresolved issues to the appropriate state insurance commission. But with a policy from Guernsey...who knows? As a general rule we always suggest that Americans only buy insurance policies licensed to be sold in their home state.

 

Hank

 

In order for TravelInsuranceCenter.com to be able to legally sell this plan the insurer and plan would have to be approved and registered in their state (NE) and TravelInsuranceCenter would have to be appointed by the insurer as an authorized agent. Since agents all over the country sell this plan they're probably registered and approved by the insurance departments of every state.

 

So as long as everyone is indeed playing by the rules you would have at least some protection. A complaint could be filed through the appropriate state department of insurance and the insurer would have to respond to the complaint or risk being barred from offering their products. But they can't force an insurer to pay your claim -- that would have to be done by a judge or jury. They can exert some pressure though. The protection you may not have is the ability to file legal action locally as the plan documents have a clause requiring legal action to be filed in Copenhagen (at least for the version I downloaded for CA residents). It would have to be a pretty big claim to justify that sort of expense.

[Hlitner]

That GBG annual policy really has an interesting pedigree. It is underwritten by a Texas based life insurance company who is licensed in many states (including mine). But the actual company who provides the insurance (and service) is based in Guernsey...and now cruiseco finds that legal action must be filed in Copenhagen. A very interesting structure...to say the least. Sure would not want to get in a legal hassle with these folks... :)

 

Hank

[mescat4]

@ Hank

checked amex website- appears they don't cover pre-existing conditions.

Is that correct?

Enjoyed cruising with you on the P-dam last Spring

 

Ev