Travelers insurance valuable when taking trips abroad

Atlanta attorney Andrew Speaker created quite an uproar earlier this year when he traveled from Europe back to the U.S. on a commercial flight after being alerted he had a highly drug-resistant strain of tuberculosis.

An adviser at the Atlanta Centers for Disease Control and Prevention (CDC), reaching Speaker in Rome, told him to either seek medical care there or charter an air ambulance to return to the U.S.

Speaker did neither, opting instead to fly back to North America commercially. He later said he didn't want to be treated in Italy and he couldn't afford the pricey private flight.

Whether Speaker made the correct decision by extricating himself from the unknown of foreign medical care at the risk of exposing fellow air travelers to his contagious disease has been hotly debated.

But the incident raises another question: How could he have avoided having to make that choice in the first place?

It's simple. He could have bought travel insurance before he left home. The right insurance would have paid Speaker's substantial tab -- typically $40,000 to as much as $100,000 -- for a flight home on a specially equipped "flying hospital," tended to by medical professionals who routinely pluck travelers from unexpected medical crises around the globe.

Depending on which provider he chose, Speaker could have been transported to the hospital of his (and his consulting physician's) choice. Though in hindsight travel insurance is a simple answer, it's unlikely Speaker, age 31, ever gave the idea a passing glance as he planned his extensive European travels.

Nor do the majority of us as we hop on and out of airplanes, rental cars, trains and taxis in places we visit. We trust to some divine luck that we'll make it there and back in one healthy piece.

This raises the question of how many other ways business travelers -- all travelers, for that matter -- can, with a little advance planning, protect themselves against the unexpected when they're on the road.

What to do before you leave home:

Review your personal and corporate medical coverage.

With very few exceptions, HMOs do not provide coverage once you leave the U.S. And when you receive medical care in a foreign country, it's highly likely that you'll be required to pay cash for services.

Some corporate credit cards (the American Express Business Card, for example) offer optional medical and dental benefits with no deductibles, age or health restrictions. Some employers provide international insurance coverage for traveling staff as part of their overall corporate insurance program. The time to know the details -- what your coverage includes and how to get help when you need it -- is before disaster strikes.

Educate yourself to potential health risks at your destination.

The U.S. Department of Health and Human Services Centers for Disease Control and Prevention Web site (www.cdc.gov/travel) is loaded with useful information about potential health risks around the world.

Here again, don't wait until the last minute to review the information. Some vaccinations, for example, must be given four to six weeks in advance of travel. At the CDC site you'll also find a list of travel medicine clinics for all 50 states and the District of Columbia.

In the Madison area, the Dean Clinic and UW Health have travel medicine professionals on staff who can advise you on vaccination requirements and potential health risks. They're also available to consult post-trip if you have the misfortune to return home with a mysterious foreign bug.

The U.S. Embassy or Consulate at your foreign destination is another resource when you need medical attention abroad. They will almost always have a list of English-speaking doctors. Look for more information at usembassy.state.gov and be sure to print out the contact information to take with you.

Check insurance policies

If you decide to go the travel insurance route, there are a number of policies that cover medical costs and medical evacuation services, often to the closest "adequate medical facility" (in Andrew Speaker's case, that would have been to a hospital in Rome). It's important to know in advance what is and isn't covered.

To learn more about travel insurance in general, talk to your insurance agent or review and compare travel insurance coverage packages at Insure My Trip, Travel Guard, Travelex and Access America, a few of the biggest players in the industry. Several of these user-friendly sites allow you to obtain quick quotes and purchase coverage online.

For strictly medical evacuation coverage, look into services available from International SOS. The company has its own fleet of state-of-the-art "flying critical care units" and maintains clinics staffed with medical personnel in remote global regions where quality health care is not locally available.

Medjet Assist is considered one of the most comprehensive in the evacuation business. This service will return you to a hospital of your or your doctor's choice if you're injured or become ill 150 miles or more away from your home base. And there's no 'medical necessity' clause, no deductibles, no co-pay and no pre-existing condition exclusions if you're under age 75. As a bonus, they offer discounts to AARP members. Important note: evacuation services do NOT cover the cost of your medical care; they strictly cover evacuation services.

If you become ill on the road

If you need medical attention when you're on the road, there's the hotel doctor-on-call option -- if one is available. Or, if you're languishing in your room in Philadelphia, Washington, D.C., Las Vegas, Dallas, Boston (here, they offer dental services too), Chicago, Houston or Phoenix, contact Inn-House Doctor, a service that has been around since 1991 in these major cities, providing 24-hour-a-day, seven-day-a-week assistance to hotel guests who become ill.

If your major credit card company offers it, use the card's international 911-equivalent, usually available 24/7, to find medical care at your destination. Most services will make doctor referrals and some will continue to monitor your care and progress through frequent contact with your attending physician. They'll also contact family members on your behalf and if necessary, arrange to fly them to your bedside.

A service called World Clinic employs a team of "telemedicine" specialists who can be available by landline phone and satellite data links to World Clinic members, corporations and to "best of class" foreign attending physicians around the clock. Members make their medical records available to World Clinic at the onset and these are referenced on an as-needed basis to facilitate the patient's medical care wherever they travel.

For a less costly way to access doctors at foreign destinations, consider a membership in the International Association for Medical Assistance to Travelers (IAMAT), a nonprofit organization that provides members with referrals to a network of English-speaking physicians, hospitals and clinics in 125 countries around the world. There is no charge for membership, though donations are welcome. Learn more at www.iamat.org.

In our rapidly expanding global economy, business travelers think nothing of flying to China one week, Poland or Peru the next, usually in packed aircraft carrying an unknown collection of potentially nasty germs. Now more than ever, preparedness is key to avoiding a full-blown medical disaster.

Betty Stark is a Madison travel industry consultant and business travel writer with 25 years' experience.