It is only under extremely limited conditions that Medicare will pay for healthcare expenses in foreign countries—usually in situations in which a hospital in a foreign country is the closest one for a person in the U.S. (https://www.medicare.gov/coverage/travel-outside-the-u.s.).

Some Medigap Plans (Plans C, D, F, G, M, N) do have limited foreign travel emergency care, as follows:

When you travel outside the U.S., most plans cover emergency health care, with a lifetime limit of $50,000. Plans may:

• Cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.
• Pay 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.

If you have plans E, H, I, and J that are no longer sold, they still cover foreign travel emergency care.

Note that there is a lifetime limit of coverage, it covers only the first 60 days of a trip, only 80% of the charges are covered after a $250 deductible is paid, and that there is no coverage for evacuation and other costs that might be associated with a health emergency. You are also of course on your own to find the necessary medical care.

Medicare Advantage plans generally don’t offer foreign emergency care, but some plans may have such a supplemental benefit.

There is a January, 2023, Medicare webpage that describes the above in some detail, that you can read by clicking here.

It is true that some Medigap Plans will reimburse international healthcare expenses. One of our members had to go to a hospital for respiratory distress in The Netherlands, and once home, he was reimbursed for 80% of the charge, after a deductible of $250 was applied by his Medigap F plan. 

Note that the concern about healthcare coverage and travel is mainly about international travel. Those with Medigap plans should be well-covered in the U.S. (at least as well-covered as anyone else; healthcare in many rural areas is problematical). Those with Medicare Advantage plans may be out-of-network in many circumstances. One can get travel insurance for domestic trips, but the greatest need tends to be for international trips that are more expensive and many times in places with sub-optimal healthcare infrastructure.

Sid Stein offers two thoughts on international travel:

One thought I had was that our retirees should consider a trip to the Emory Travel Clinic (https://www.emoryhealthcare.org/centers-programs/travelwell/index.html) a couple of months before they travel to see if they need special vaccinations and/or medicines to carry if they are traveling far out of the first world.

I also think our retirees need to take special care when traveling outside the United States with respect to the risks of Covid. Now that Paxlovid has moved to full FDA approval, one no longer needs to have a positive test to get a prescription and I recommend that our retirees carry one package of pills for treatment should they get infected outside of the United States. Most doctors I know will not leave the country without Paxlovid, because it can be very difficult, if not impossible, to get outside of the United States. Our retirees are in the age group most likely to get hospitalized if they are not treated. Most, but not all, primary care physicians will prescribe it for travel, and the supply of the drug in the U.S. is quite plentiful. Primary care physicians will know which version to prescribe for their patients based on kidney function and they know what potentially conflicting drugs their patients are taking which may require special consideration (statins, and a few anticoagulants and heart drugs). An FDA checklist for paxlovid and various drug interactions, published on May 25, 2023, can be read by clicking here.

This newsletter will focus on insurance for international travel because the need for domestic travel insurance will likely not substantially change before and after retirement. It is also likely that many faculty will do more leisure international travel in retirement. The focus will be on emergency medical care during international travel because that is the type of insurance that is most needed by those travelers who are covered by Medicare. However, because so many travel insurance plans include some coverage for emergency medical care, it seemed most helpful to include information about the various available plans.

Foreign travel by our members can generally be put into two categories: organized tours or cruises offered by some type of tour organization and trips by members that they have planned or that are a result of travel to meetings, conferences, or leisure. The important difference is that tours offered by organizations will frequently have, or make available, travel insurance, whereas that is usually not the case with individual trips.

Organized Tours and Cruises

Travel insurance considerations for travel internationally on tours and cruises.

Foreign Travel on your Own

What travel insurance do you need when you travel internationally on your own?

Insurance for Extended International Trips

Some factors to consider if you are planning to take an international trip of several months.

Travel Assistance

In examining various travel insurance policies, the travel assistance offered can be an important consideration.

Travel Insurance Brokerage Websites

There are websites that allow you to get instant quotes for travel insurance from a variety of different companies. These can be useful, but you need to understand how they operate and what you might miss.

Travel Insurance for Organized Tours and Cruises

If you want to purchase travel insurance for an organized tour or cruise, you don't have to use the insurance offered by the tour or cruise company. What factors should you consider?

Summary

A brief summary of some of the important points made in this newsletter.

Glossary

It is important to understand some of the terms used for travel insurance so you understand the parameters of any purchased coverage.

Organized Trips and Cruises

Many of our members do some or all of their international travels in tours organized by companies. Most of these companies will offer travel insurance as an add-on cost. Those insurance policies generally include both trip cancellation and interruption coverage as well as medical coverage. One member referenced a trip they took with Odysseys Unlimited; they purchased travel insurance and were satisfied with its offered coverage. Another member usually travels as part of a group travel (generally Tauck or Viking) and purchases the tour company's insurance. (When traveling independently, he purchases TravelGuard Insurance—see below.) Recently, this member had reason to use his travel insurance, and his experience is instructive. His trip was with Tauck, and on the third day aboard his ship, both he and his wife developed Covid. He informed the ship director, and that evening a sheet of paper was shoved under his door informing him that he and his wife would be put off the ship in the morning. It had phone numbers for the Tauck rep in the US and their Medical Rep in Europe. They had to find their own accommodations in the small town where they were dropped off (which turned out to be difficult) and remained there to quarantine. The US Tauck rep told them that their costs would be covered and found another flight home for them as they had to miss their originally scheduled flight. It was impossible to get even mild medications without a doctor’s prescription, but the medical contractor for Tauck did not even call until they were getting ready to leave for their flight home. After his return home, he submitted his charges to Tauck and five months later was reimbursed. Even with these issues, he felt that the process worked better than it would have with TravelGuard where he would have had to explain and document all the details. 

My wife and I have taken a number of trips with Road Scholar. The Road Scholar Assurance Plan is included for every traveler and “provides 24-hour assistance in the event of an emergency during your program and insurance for emergency medical evacuation. The plan includes travel insurance benefits underwritten by Arch Insurance Company and assistance services provided by LiveTravel Assist.” For international travel, the plan may be seen by clicking here. The coverage for emergency medical care and medical evacuation is equal to that of many separate travel insurance plans. We will sometimes arrive early in the arrival city or remain a few days after in the departure city. The Assurance Plan will cover those extra days as long as the total is not more than 14 days. Road Scholar also offers, for an additional fee, a trip insurance plan that covers cancellation, etc. and also has coverage for COVID-19 isolation or quarantine costs. For international trips, the extra trip insurance is generally around 12-15% of the trip cost. 

In summary, it is important to understand especially what emergency medical coverage you have on your trip and when that coverage begins and ends. Although the need for it is rare, emergency medical evacuation would be extremely costly if you had to pay for it yourself. I think it is relatively rare for any type of emergency medical care to be included as part of a tour price, as it would be included in the additional trip insurance policies. Whether you purchase trip insurance to cover the cost of cancellation, or an early return, is likely a function of your tolerance for losing the cost of your trip. As detailed below, it is possible to purchase trip insurance separate from the policies that are offered by the tour or cruise companies.

Foreign Travel on Your Own

For travel on your own, emergency medical coverage, along with medical evacuation, is probably the most important consideration. You also need to purchase any medical plan in advance of your trip, as you will not be able to purchase it once you have left the U.S. 

Below are companies that have been mentioned by members, and their comments on their coverage. Note that most of these policies offer both emergency healthcare as well as other types of trip coverage. Also most of these companies offer policies that can provide coverage on organized trips and cruises.

Allianz

• I have been traveling to Europe and the Middle East for many years. I traveled with Allianz foreign travel insurance coverage from May 12, 2022 to September 8, 2022 with my wife. It included insurance for: travel delay, baggage loss, baggage delay, emergency transportation ($250,000), emergency medical care ($50,000), dental emergency coverage ($750), epidemic coverage, and travel accident coverage ($10,000). We paid $1084.00 for both of us.” The contract may be seen by clicking here. “Also don’t forget to get vacation permission to purchase medicines you will need to take along.

• Rather than buy single trip insurance, we buy Allianz insurance, which covers trips for whole year for the 2 of us for ~$1,000. We have had a claim (delayed trip owing to relative’s medical emergency) that was dealt with promptly. There is a limit to how many days it will cover per trip.

• For any of these "big" trips, we usually buy travel insurance to cover airplane/ground transportation issues, knowing that these agencies also cover medical emergencies. We have primarily used Travel Guard but recently purchased an annual policy from Allianz. A recent claim with the latter was initially rejected but paid upon appeal with an Allianz agent. The trip involved a flight to Australia, followed by a flight to a resort, where two nights were paid for that were nonrefundable. A change by the airline in the scheduled flight to Australia necessitated a change in the flight to the resort. However, the flight to the resort was twice cancelled, meaning that we lost both nights in the resort. The cost of the two resort nights was finally reimbursed by our policy.

AIG Travel Guard

• For travel my wife and I purchase an annual policy from AIG. The premium is reasonable and it covers emergency medical care, medical evacuation and lots more plus the usual trip cancellation costs.

• If traveling on our own, I buy Travel Guard, and get their maximum coverage plan, because we have had good experience with them. Others on our group trips who use them have had good results as well.

• We usually buy travel insurance to cover airplane/ground transportation issues, knowing that these agencies also cover medical emergencies. We have primarily used Travel Guard.

Medjet

Note that Medjet primarily offers medical evacuation services, and does not have healthcare benefits. For those 74 and older, a doctor’s examination is required and there are limits to the service.

• Even before retirement, sometimes I purchased Medjet insurance. I never used it (didn’t have any claims) but felt safe because of what they provide if needed.

• My wife and I use MedJet insurance for foreign travel. The premium varies according to your age.

• I used to purchase Medjet, but after 75 it goes up to $800 a year, and you need a doctor's letter. I think they offer short term coverage. My Amex Platinum card costs less than medjet for over 75, and they say they evacuate you, even for Covid, if you're in a hospital. However, this turned out not to be true for friends with COVID in Mexico in April 2023. Amex said you can get paxlovid in Mexico and gave them the name of a private clinic. There is no paxlovid in Mexico except for Mexican citizens in a public hospital. Private procurement of paxlovid costs $1000 US. I'm re-evaluating my AMEX platinum card because of this. I would take paxlovid with me if travelling to countries where vax rates are low and COVID still roams. 

Geo Blue

• We do purchase supplemental health insurance when traveling outside the country. We have used GeoBlue which I find to be reasonably priced with options for the desired deductible and whether one has other health insurance such as Aetna. We have never needed it so I cannot speak to experience.

• We have heard that many policies require an initial outlay then the reimbursement with receipts. My brother (retired) who travels internationally many times a year suggested we look into Geo Blue and says he has used this when abroad with good results.

Generali

• My wife and I flew Atlanta to Istanbul on April 28, returning May 13, in 2023. Direct flight on Turkish Airlines. We took out general trip insurance (including medical coverage) + auto coverage for a rental car in Anatolia through Generali. Coverage and basic policy information may be seen by clicking here. We also flew Atlanta to Istanbul in May of 2022 and used Generali. No claims were required for either trip. Note: I have traveled internationally 4 times since 2018 (twice to Italy, twice to Turkey, each trip approx. 2 weeks). I developed a sinus infection during each trip. This year, I contacted my PCP in advance, and asked about the advisability of getting a 10-day supply of an antibiotic before traveling, to be used only if needed during the trip. After a flight back to Istanbul from Kayseri on May 9, I felt the familiar symptoms of a sinus infection coming on, and I started taking doxycycline. Symptoms did not significantly worsen (as they had on each previous trip). 

Atlas Travel Insurance

• I have often added personal travel insurance, as I combined work trips with personal travel (usually family visits). I have used Atlas insurance (world travel), which has a good reputation, but have never had to call on them. One important thing to remember that they and most foreign travel insurance companies have a limit of 30 days in a country (even when they allow for longer trip coverage).

Dan Dive Insurance

DAN (Divers Alert Network) Insurance is an example of specialty insurance that covers dive accidents as well as more general travel and medical issues. Two of our members are long time divers!

• I purchase dive insurance from Dan Dive when I go diving. They have great coverage and you can opt for coverage for all medical and accident expenses (including car) on a dive trip. 

• My wife and I are continuing our passion for diving and my passion for underwater photography. Given these passions, we have been lucky to be able to travel around the globe seeking particularly special dive sites, including a trip at the beginning of last month back to Papua New Guinea. These trips have included areas in North America (e.g. Mexico), Central America (e.g. Galapagos), and the South Pacific (numerous locations). We have been fortunate in not having to call upon healthcare providers for any serious issues. That said, we do carry specific insurance for diving accidents from DAN (Divers Alert Network) which is based in Durham, NC (I believe on Duke's campus).  

Insurance for Extended International Trips

Insurance for extended international travel that you undertake on your own introduces some complications. "Extended" in this context would refer to trips that would be several months or more in length. The trip costs you would want to insure would be nonrefundable costs and not the costs you would expect to incur on a daily basis during your stay. Some plans have a limit on the length of a trip they would cover; annual plans will frequently have a relatively short maximum for any one trip, such as 45 days.

Emergency healthcare, or healthcare more generally, becomes an important consideration for extended travel. Two articles introduce some of the considerations: one on long-term travel that can be read by clicking here, and one on travel major medical insurance that can be read by clicking here. It is also important to understand that if you are out of the country for an extended period of time, you can't drop or suspend your various Medicare insurance plans.

One factor that can be important for extended travel is how long you are allowed to stay as a tourist in any one country. Each country will have its own regulations. One example that came up in discussion of travel insurance is stays in Germany. If you plan to stay in Germany for more than 90 days within a 180 day period, you have to acquire a residence visa. It turns out that for a residence visa, Germany will not accept any U.S. health insurance, and requires a person to purchase a German health insurance policy. One of our members has conducted research in Germany for several months each year for many years, and obtains health insurance policies through a German broker.

Travel Assistance

The companies mentioned here offer coverage for listed events. The coverage is usually a maximum amount that will be paid for a given event. However, particularly for foreign travel, a person is likely to need assistance in coping with an unforeseen event. That assistance could be particularly important in a medical emergency. Thus most companies will offer some form of travel assistance. The example mentioned above of the experience of one of our members and his wife who got Covid and their experience with their Tauck insurance in instructive in this regard. The extra expenses they incurred were covered, but they had no assistance except for the booking of a return flight. One problem is that coverage listed in policies is quite specific, but assistance is generally a description of what might be available, with no guarantee that it will provide the help that you need in a timely manner.

In the following are examples of the travel assistance offered by companies mentioned above with a focus on emergency medical assistance.

GeoBlue

GeoBlue is a company that offers mainly emergency medical care.

Here is what they claim:

What they offer as a case study may be read by clicking here. That case study, requiring several weeks in an ICU in Dhaka, Bangladesh, followed by an air ambulance to the US, obviously represents an extreme. It also suggests that your choice of insurance plans might depend on the trip you are taking. You would likely have very different needs in visiting relatives in the UK compared to traveling on your own to Bangladesh.

Allianz

Allianz offers a more comprehensive set of trip protection plans. Even their most basic plan includes the following.

With Allianz Global Assistance, you'll never travel alone. Our multilingual assistance team is available 24 hours a day to help you handle all kinds of travel emergencies. We can help you find local medical and legal professionals, arrange to send a message home, help with missed connections and lost/stolen travel documents, and much more.

What should I do if I have a medical emergency while traveling?

If you need help urgently, call your destination’s equivalent of 911. The free Allianz TravelSmart^TM app makes it easy to reach local emergency services with a single tap, wherever you are.

Then, contact 24-hour assistance. Our team of experts can arrange emergency medical transportation, if needed; refer you to pre-screened local medical providers, provide an interpreter, guarantee advance payment for medical care (where accepted), monitor your condition, update relatives back home, and arrange your transportation home. In short, we’ll do everything we can to make sure you’re getting the care you need.

AIG Travel Guard

Travel Guard also offers comprehensive plans. Even their most basic plan includes the following.

All Assistance Services listed below are not insurance benefits and are not provided by the Company. Travel Guard provides assistance through coordination, negotiation, and consultation using an extensive network of worldwide partners. Expenses incurred from third-party vendors for assistance services not part of a filed insurance plan are the responsibility of the traveler.

Travel Medical Assistance

A menu of services available for emergency medical requests including prescription replacement assistance, Physician referrals, medical evacuations, and more.

Generali

The following is information about obtaining emergency services.

Generali policyholders that need emergency help from an available service can call 877-243-4135 toll-free 24 hours a day from within the United States, or call collect to 240-330-1529 from around the world.

Medical Referral

If an emergency occurs during a trip that requires a visit to a doctor, you can call the Emergency Hotline to obtain the names of local qualified doctors who speak their language. If additional medical services are required, the assistance provider is prepared to consult with the attending physician and provide assistance services that they believe is in your best interest.

Atlas Travel Insurance

This is information about emergency travel assistance.

Travel and medical assistance services are available to WorldTrips customers who purchase an Atlas Travel, Atlas Premium, Atlas Group, Atlas MultiTrip, or StudentSecure travel medical insurance plan. These services are available worldwide 365 days a year. Emergency assistance services are available 24/7. 

For access to these services, please call our World Service Center at: 

 Within the United States: (800) 605-2282 (toll-free) 

Outside the United States: +1 (317) 262-2132 (collect calls accepted) 

You will note that some of these emergency services involve making calls to a U.S. call center. It would be of interest to know how that works in practice.

Travel Insurance Brokerage Websites

I am not sure of the proper names for these websites, but there are a number of websites that offer a comparison of many different travel insurance policies and then offer to sell you one of the policies. They may be called "comparison" websites, but the fact that they also sell policies needs to be considered when evaluating any biases that may be present on the sites. These websites can be very useful and contain a lot of information about obtaining travel insurance and the various types of coverage. They all offer instant quotes (as do the individual websites listed in the previous article) and so can provide side-by-side comparisons of policies from different companies. Some of these websites are:

InsureMyTrip.com

TravelInsurance.com

SquareMouth Travel Insurance

CoverTrip

What you need to understand about these websites

These websites offer information (and quotes) from the "best" travel insurance companies and usually promise that you cannot get lower prices on a quoted policy from anywhere else. What can one then conclude about the business models of these websites? If there are no fees associated with purchasing insurance on these sites, then the owners of these websites must be charging the insurance companies a commission for sales of their policies through these websites. Thus the strong presumption is that companies that do not pay commissions will not be listed on the websites. Because there is no transparency about this part of the business model, we do not know if all companies pay the same relative commission, or if there could be preferences given to companies paying higher commissions.

I note that of the companies mentioned by our members in the article above, two of the companies are not listed as providers in any of the four websites listed above, and others do not appear in all of them. The two that are not listed in any of the sites are Dan Dive and Allianz. The absence of Dan Dive is perhaps easier to understand, as it caters to a fairly small group. Allianz is a different situation. Allianz is the world's largest insurance company. My assumption is that it is not listed because it does not pay commissions to third parties for insurance sales. This should be a caution that using these websites will likely NOT give you access to all reasonable policies.

What are the "Best" Travel Insurance Companies?

I assume that most of us would like to choose one of the "best" travel insurance companies and a quick Internet search revealed many websites offering ratings of travel insurance plans. The concern is how the ratings are determined. The problem is illustrated by the member responses above about their insurance policies. Most were satisfied, although they had never made a claim. The ratings I looked at mainly used a close examination of the policy coverage; I did not see any evaluation of issues in obtaining travel services or satisfaction with the claims process. It would seem that caution is needed in relying on most such evaluations.

InsureMyTrip.com

With the above cautions in mind, the website InsureMyTrip.com has a lot to recommend it. It has 21 provider companies, including all of those mentioned by our members, with the exception of Allianz and Dan Dive. It is difficult to determine the entire list of provider companies with some of the other brokerage sites listed above, but in other cases, the numbers seem to be considerably shorter. Various insurance plans are sorted according to the types of travel insurance: evacuation, medical, comprehensive, cancel for any reason, and cruise.  There is also a lot of information about travel insurance in general, as well as the specific types.

One valuable part of the website is that there are customer ratings for each company. The overall ratings for each company seem to be equivalently high. There are 7306 reviews for AIG TravelGuard for example. However, it is possible to look at the reviews for each company sorting out only those in which a claim was filed. Those reviews tend to be much more revealing and useful. The good news about travel insurance is that most of the time it is not needed. One really wants to know how the companies respond when the insurance has been needed. I have looked through some of the reviews, and in some cases the unsatisfied person has not understood the coverage they had.  In other cases, the customer support has seemed to be lacking.

One of the benefits offered by InsureMyTrip.com is “A group of licensed representatives, the Anytime Advocates™, that help you with a claims process, whenever necessary.” This sounds good, but I don't have any information about its actual utility.

Clark Howard has a webpage devoted to InsureMyTrip.com which you can read by clicking here. The article is very positive about InsureMyTrip.com and explains how to navigate through the site. Nowhere is it mentioned what the likely business model of InsureMyTrip.com is, and the various reasons that some companies are not represented on the site.

Travel Insurance for Organized Trips and Cruises

Based on member responses, it seems that most members who go on organized trips or cruises, if they purchase insurance, will purchase it from the tour company. This is certainly the most convenient way to obtain extra insurance, and it would seem reasonable that the insurance coverage would integrate best with the tour. Travel insurance policies can be obtained from other insurance companies, but what would be the reason for purchasing such insurance?

It is difficult enough to try to evaluate the travel insurance companies mentioned above. It is more difficult to evaluate the insurance policies of various tour companies. What is usually done is to evaluate the coverage that is offered. The experience of our member with Tauck and Covid shows that the coverage was fine, but the assistance (and claim process) was subpar.

InsureMyTrip.com has a lengthy discussion of Cruise travel insurance. Their advice: "Typically, to find the best and most robust cruise insurance it's most advisable to look at cruise insurance reviews and then buy travel insurance for your cruise from a third-party source — not from the cruise line itself or from a booking site." It goes without saying that it is to their benefit for you to choose a policy on their website! The entire article can be read by clicking here.

What is certainly important is that you have at a minimum emergency medical coverage and that the coverage you have covers you the entire time that you are out of the U.S.

Summary

There is some confusion among members about Medicare coverage of foreign travel emergency care. As indicated above, there is essentially NONE from Medicare. The Medigap plans that most of our members have do provide some coverage, with a lifetime maximum, a limit of no more than 60 days in one trip, and no evacuation coverage. There is also no emergency care helpline, and that could be an important consideration if you are in a country in which you don’t speak the language or know your way around.

Most members who commented on this topic strongly recommended getting additional coverage for foreign travel, and they do so when they travel.

Most, or all, policies that offer foreign medical emergency coverage have some level of coverage for medical evacuation. Medical evacuation is rarely needed, but when it is needed can be very expensive. One question about any evacuation policy is how restrictive the conditions are for evacuation and how well the evacuation can be done. Medjet offers only evacuation services and a quick read suggests that it is generous in both a decision to evacuate and a choice of places to which one can be evacuated. 

There are some plans that offer mainly emergency medical coverage; comprehensive plans offer additional coverage for trip delays and cancellations. One consideration for any of those plans is what assistance is available in the country you are visiting and how that assistance is obtained. I think it would be reasonable to be concerned if the only option for assistance is to call a support line in the US.

The decision to purchase a more comprehensive plan that would include coverage for trip delay or cancellation, lost baggage, etc. is likely dependent on your financial tolerance for loss of a trip or having to pay additional costs because of delays. An additional factor might be how much assistance you could expect from a company in helping you solve problems due to trip delays or other problems.

Glossary

There are certain terms that are found in many travel insurance policies. Below are excerpts from two articles found online that explain some of the important terms. Links are provided to the complete online articles.

6 key phrases to know before buying travel insurance

From a post on October 2, 2018 by Chris McGinnis on SFGATE

Click here to read the article online

Travel insurance is designed to offer protection against sudden and unforeseen situations and events-- like hurricanes.

This post is sponsored by Allianz Travel.

Travel insurance is a tough subject to write about. That's because no one really wants to read about it until they really need it.

So as record numbers of Americans hit the road and skies this year and wonder whether or not they really need travel insurance, here's some help.

Along with Allianz, I've put together a list of six important travel insurance terms that you should be familiar with before shopping around for the right policy:

"Named storm" or "foreseeable event." At this time of year, the beginning of hurricane season, it's especially important to know what these phrases mean. Travel insurance is designed to offer protection against sudden and unforeseen situations and events. When a hurricane (or any storm) becomes a named storm, it also becomes a "foreseeable event" with known potential to affect travel plans. If you buy travel insurance after a storm is named, your plan won't provide coverage for storm-related claims. This means that it's always smart to purchase travel insurance right after you book your trip (especially to the Caribbean, Mexico or Florida), so you know you're covered. The same scenario applies to other natural disasters, too. For example, the volcanic activity at Kilauea on Hawaii's Big Island became a "known event" on May 3. While you can still buy insurance for a vacation to Kona, the plans will not provide any coverage for volcano-related claims.

"Cancel for any reason" policies. At Allianz, there are 26 covered reasons for having to cancel or interrupt a trip—such as terrorist events, job loss, illness or provider bankruptcy, etc. The reasons vary based on the type of policy you buy. But there's one type of policy that will reimburse you for most or all of your prepaid trip expenses if you cancel for ANY reason, and that's a "cancel for any reason" policy. These policies are more expensive than regular ones and you may have to call to purchase one. Keep in mind, most policies require you to insure 100% of your pre-paid expenses and may only reimburse you up to 80% of the trip cost.

"Repatriation" vs. "evacuation" coverage. These terms refer to emergency medical coverage that travelers buy before big overseas or adventure trips like African safaris or round-the-world cruises. An evacuation plan will generally cover the cost of extracting you from a remote location and getting to the nearest suitable hospital for care. A more expensive repatriation plan goes further by getting you out of harm's way and then transporting you back to your home country for medical care.

"Assistance" vs. "coverage." Travel insurance comes in three primary flavors. One, it can help you deal with travel inconveniences, like lost bags and delayed flights (that's travel assistance). Two, it can protect your travel investment, so you don't lose all your money if you have to cancel a trip for a covered reason (that's coverage). And three, it can help you get care in the event of a covered medical emergency (that's medical coverage).

Emergency Medical "coverage" vs. "transportation." If you become sick or injured on a trip, you'll be faced with two significant costs: 1) emergency transportation to a hospital (that's emergency medical transportation) and 2) medical care or treatment at the hospital (that's emergency medical coverage). Most travelers need to be sure that they have both. For example, travelers who are covered by Medicare in the U.S. are not covered for treatment in other countries, so will need both healthcare coverage and emergency medical assistance.

"Primary" vs. "secondary" car rental coverage. When renting a car and paying for it with a credit card, it's important to know if the card provides primary or secondary coverage—and what the limits of that coverage are. Primary coverage means that the policy will cover you whether or not you are covered by a personal or company auto policy. Secondary coverage kicks in only if you are not covered elsewhere. If you do not own a car, it's a good idea to use a card with primary coverage, or to purchase a policy like Allianz Rental Car Damage Protector for just $9 per day.

Disclosure: This post is sponsored by Allianz Global Assistance. We will periodically publish posts like this one from commercial partners about topics relevant to frequent travel.

The following article is taken from smartertravel.com. You may read the entire article by clicking here.

Dealing with pre-existing conditions:

Whether—and how—travel insurance covers pre-existing medical conditions remains a source of uncertainty among many travelers. This recent question is a case in point:

"My husband and I will fly to Venice on October 6, where we will stay two weeks. I bought our airline tickets last February 8. My husband is diabetic, managing it with medication, and he just had surgery on his carotid artery, after which he is doing well. Can we still purchase trip-cancelation insurance including medical evacuation?"

The short answer is you can buy medical evacuation (medevac) insurance that will cover an evacuation required by your husband's diabetes—as long as you can show it was totally controlled up to the time of departure—but probably not for potential complications following the surgery. It would cover both of you for any other health problems that arise during your trip. Here are the pertinent details.

What Is a "Pre-Existing Condition?"

Most travel insurance, including medevac and trip-cancelation, excludes pre-existing medical conditions as a "covered reason" for paying on a claim. Here's how one insurance company defines that exclusion:

"Pre-Existing Condition" means any injury, sickness or condition for which medical advice, diagnosis, care or treatment was recommended or received within the 180-day period ending on your date of departure. Conditions are not considered pre-existing if the condition for which prescribed drugs or medicine is taken remains controlled without any change in the required prescription.

Another company says it this way:

"An illness or injury that you, a traveling companion or family member were seeking or receiving treatment for or had symptoms of on the day you purchased your plan, or at any time in the 120 days before you purchased it. You, a traveling companion or family member are considered to have an existing medical condition if you, a traveling companion or family member:

• Saw or were advised to see a doctor
• Had symptoms that would cause a prudent person to see a doctor
• Were taking prescribed medication for the condition or the symptoms, unless the condition or symptoms are effectively controlled by the prescription, and the prescription hasn't changed.

Some policies do not even include the allowance for conditions controlled by medication, but many do. The typical exclusion period ranges from 90 days to 180 days. In my reader's case, as I noted, a typical policy would cover her husband's controlled diabetes but not complications from his recent surgery.

Insurance companies are serious about the definition of the "medical advice, diagnosis, care, or treatment" limitation. If you so much as called a doctor about a possible problem, the insurance bean counters could deny a claim.

Waiving Pre-Existing Conditions

The good news about pre-existing conditions is that many travel insurance companies waive that exception if you buy the insurance shortly after making your initial travel arrangements. Here's how one company puts it:

"If your plan includes this coverage, you, a traveling companion or family member can have an existing medical condition and you will still be eligible for all coverage and assistance services, as long as:

• You purchased your plan within 14 days of making your first trip payment or first trip deposit
• You purchased trip cancelation coverage that covers the full cost of all your nonrefundable trip arrangements
• You were a U.S. resident and medically able to travel on the day you purchased the plan, and
• The total cost of your trip is $20,000 per person or less.

Depending on the company, the purchase deadline for buying the insurance ranges from seven to 14 days. As far as I can tell, you don't have to pay anything extra to get pre-existing conditions waived: Just buy the insurance on time.

Buyer's Guide

Pre-existing conditions are apparently the biggest source of problems between insurance companies and travelers. Given how easy it is to have the whole problem waived, it seems to me to be a no-brainer that anyone interested in medevac or trip-cancelation insurance should buy the insurance within the specified seven- or 14-day period after making the first trip payment.

Beyond that, I continue to recommend that travelers check one or more of the travel insurance agencies' comparison sites, enter their trip details and coverage requirements, and select the least expensive policy that meets their needs.

I will reiterate that the articles in this section were taken from online sources, and the first article was sponsored by Allianz. The second article ends with a "Buyer's Guide" that suggests that travelers use one of the listed travel insurance comparison sites and choose from one of those. Ironically, only one of the suggested comparison sites includes Allianz, the sponsor of the first article. I am not sure if there are any truly unbiased travel insurance websites, so caution is always recommended!