In February, a tourist from Florida named Sandra slipped on a city street in Denpasar, Bali and bumped into a parked motorbike, which fell onto her leg. "It was a freak accident," she told me from her hospital bed in Bali. "There were no others involved, I just slipped on gravel, lost my balance and fell over. The bike fell on my calf and crushed my leg." She was initially taking a break from her hometown as her first trip abroad with her young child. A bold step—especially as a single mother—Sandra escaped the winter blahs by learning about a new culture on a continent she had never been to before.
As a result of the accident, Sandra fractured her tibia in three places and broke her fibula in half. She is in a hospital in Bali for three weeks, though her recovery time is three months. And while Sandra bought travel health insurance, the company denied her claim due to an oversight on the part of the travel insurance agent. She had to pay over $10,000 for an emergency surgery with the generosity and help of friends and strangers through a crowdfunding site.
Regular travel insurance covers flight cancellation, trip delays, lost luggage, flight accidents and medical emergencies. Meanwhile, travel health insurance offers more medical services like emergency medical and evacuation costs, including dental emergencies, ambulance services, hospital fees and—this is morbid but—shipping your body back home if you die on your trip.
Most of us think we don't have to buy travel health insurance, especially if we're young and healthy. But the reality is that our regular health insurance plans don't cover everything you think they might (most plans across the board only cover emergency services—not hospitalization and surgery—if you're out of the service area). The warped world of travel health insurance is a competitive, profit-driven industry with loopholes, grey areas and confusing jargon that obscures what's actually covered.
The insurance agency Sandra opted for used Sanra's travel agent's mistake as a loophole to get out of paying for her high-priced surgery. "The agent is supposed to be the expert and he basically sold me insurance that I cannot use," she told me. "The insurance company is using his ignorance of the rules to avoid paying out on my policy."
Sandra says she still isn't sure if she has the grounds to sue at this point, though she is working with a lawyer trying to help her with her case. "I am filing a complaint with the health insurance company, depending on how they answer will determine whether we pursue litigation," she says.
Aside from the large corporate health care companies, there are alternatives. Phil Sylvester, a travel safety spokesman at World Nomads, which sells travel health insurance package deals, says one of the main problems with travel health insurance policies is their legibility, specifically their often ambiguous 'fine print' policies.
"We want you to understand the limits of your coverage and we try our hardest to explain those limits up-front," Sylvester says. "No one likes unpleasant surprises, and we hope to help you avoid them. Despite this, many people simply do not read anything about the coverage, which is frustrating, but we will always try harder."
The most common mistake he has seen with customers is that people fail to read and understand "the part of the policy that explains how reckless or illegal behavior is not covered," he says. For example, if you're pool-hopping in Beverly Hills backyards and break a leg while hopping a fence, it's still considered trespassing, so your hospital care would not be covered.
Other times, it comes down to what you forget to tell them about pre-existing conditions. "Travel insurance is for 'unforeseen circumstances,' but a flare-up of an old injury or a new bout of an illness is not unforeseen and probably won't be covered, unless you declare it up front and we can make special arrangements or exclude the condition," he says. Sometimes it's not the smaller font but instead the kind of medical jargon or marketing language used.
Because it seems like there's an aversion to reading clunky and dense policy, travel health insurance comparison site Insure My Trip lets customers review health care policies from companies like Allianz and Travelex directly on their website (a Yelp-like shortcut). If a company gets less than a four star average, they're booted off the site.
"Oftentimes, a traveler will purchase a well-advertised, low-priced travel insurance plan offered by a cruise line or tour company, but it could be missing some key benefits," says Insure My Trip's CEO, Jim Grace. "For example, it may not include medical coverage or it may only provide travel vouchers and not cash reimbursement."
The site offered a survey where customers were asked: "Does your domestic health insurance provider cover you when traveling out of the country?" A spokesperson told me that their findings revealed the surprising number of folks (26 percent) who were unsure, proving further that people are taking a cursory glance at the presented terms.
Since there are caveats in coverage, travel health insurance can act as supplemental while abroad. For example, a sample comprehensive travel insurance plan for a two week vacation in Aruba for a couple in their 50s costs $200, including a $50,000 medical limit, $250,000 for medical evacuation and trip cancellation coverage. However, for travel medical insurance which only covers emergencies, it costs $80 for the same trip.
It's a good deal for a two week vacation, but that's not how everyone travels. Some like to travel like Sandra, who aimed to be in Bali for three months. At the time of our interview in late February, Sandra was still in the hospital in Bali and her broken foot was healing post-surgery after having a titanium plate screwed into her tibia. Looking back on her situation, Sandra has many regrets. She wishes she'd bought travel health insurance well in advance instead of last minute, so she could fully read and understand the policy.
But honestly, who is responsible enough to prioritize this? It's adulting to a whole new level. There's enough that goes into planning for a trip like this as it is.
Today, her biggest issue with travel health insurance is that it isn't customizable. "I am traveling for an extended period of time and can only get coverage for eight weeks unless I want to spend thousands of dollars, which would make traveling the way I do impossible," she said. "Luckily, I have a lot of care, support and people surrounding me who want to help. And I can afford it considering how much money I just hemorrhaged for the surgery and hospitalization."