Plane tickets, check. Passport, check. Medical evacuation insurance? It's probably not something most people think about when packing for a vacation.
But Louise Robbins says she'd probably be bankrupt without it. The University of Wisconsin library educator and her husband, Robby, were in southwest China last summer when Robby slipped and fell backward on a hotel walkway made of the region's famed red marble.
Their regular health insurance covered many expenses, but not flying him home on a jet specially equipped for transporting critically ill patients and medical equipment. The cost exceeded $100,000.
"We would have been lost" if not for the medical evacuation insurance, said Louise Robbins, whose husband later died.
With summer vacation season approaching, experts say there are several ways international travelers can protect themselves against medical emergencies — from registering in advance with the State Department, which can help locate doctors abroad and arrange emergency medical flights, to buying supplemental insurance or stand-alone medical evacuation policies.
Thousands of American travelers each year are flown home with medical assistance because of health emergencies. Car accidents and heart attacks are among the most common reasons.
"Americans have the concept that when they travel, their health insurance travels with them," said Dan McGinnity, vice president for North America for Travel Guard, which sells travel insurance.
But most regular health insurance plans don't cover costly evacuations. Finding that out after an emergency can be catastrophic.
A 21-year-old California woman died last year after her insurance company initially said its emergency coverage wouldn't pay to fly her home from China when she developed a blood disorder, according to her family's lawsuit. The suit, claiming wrongful death and breach of contract, says the company relented too late. Anthem Blue Cross, the insurer, disputes the claims.
Travelers should check their policies to see what kind of expenses are covered, said Susan Pisano of America's Health Insurance Plans, a trade association. Most will pay for emergency care outside the United States — but for leisure travelers that often doesn't include medical evacuation.
"Just make sure you know very clearly" what your policy says, she advised.
The federal Centers for Disease Control and Prevention recommends considering supplemental health insurance, including medical evacuation, if your existing policy is lacking.
According to the U.S. Travel Insurance Association, another trade group, Americans increasingly have been buying travel insurance; more than $1 billion was spent in 2008. Most covered things like unexpected trip cancellations — disruptions caused by the erupting Iceland volcano have prompted a flurry of recent business. But growth also has been strong in policies covering medical emergencies and evacuation, the group says.
Short-term policies typically cost about 4 to 8 percent of the total per-person trip price. At Stevens Point, Wis.-based Travel Guard, coverage for a $2,000 trip would be about $120.
The travel insurance trade group has a list of member companies on its website, where it also offers tips. The State Department's website also has a link to medical evacuation companies.