Safety Tips

Travel Insurance

By Elinor Garely

Risk

Adventure seekers should never leave town without travel insurance. There is a high probability that at least one situation will develop where there is a need for a doctor, an ambulance or even emergency evacuation; without travel insurance the financial impact can be extremely expensive. Your regular health insurance policies are not likely to provide coverage for travel outside the USA. The first step is to investigate your existing policy. Ask if the provider will cover all conditions for the full duration of the trip, including expenses incurred due to illness or injury to you, your family members or travel companions. Does the current provider cover the doctor(s), hospital(s) - up-front or reimbursed? Will the insurance cover preexisting conditions, such as diabetes, epilepsy, asthma, are you and yours covered outside the USA?

Even if the insurance does cover health and medical emergencies abroad, it may not cover accidents incurred through voluntary participation, i.e. snowboarding, and sky diving. Be honest with the insurance provider about the high risk sports you are planning. You may pay more to the insurance company because of your vacation plans, but if you get into an accident, you will really need this coverage.

Read the policy

Review the restrictive language of the insurance plan, and determine if items such as stolen cash, personal belongings, sports equipment, documents (passport/visa), are covered. How long does it take to process a claim? Is the policy renewable or can it be altered or, extended from abroad, if the need arises. Will the insurance pay for the return of the remains, if you or your partner dies overseas? If necessary, will the insurance plan fly you and your partner back to your home city, providing a medical team in the air, ambulance service on the ground, and delivery to your designated hospital and medical team?

Third party liability

This coverage protects against legal liability claims asserted against you for injury or damage to others and their property while you are outside the country.

Trip cancellation

Something happens, forcing you to cancel your trip. The cause could be personal illness or an accident to a family member, or any other justifiable reason. Trip cancellation insurance will reimburse the insured for any non-refundable costs of the trip. Again read the fine print regarding acceptable reasons for cancellation. Acts of war and terrorism are new threats to travelers.

Trip interruption

This coverage reimburses the policy holder in the event that a vacation is shortened because of an accident, serious illness or unexpected outbreak due to a riot or civil unrest in the country being visited. Make certain that the travel insurance policy provides sufficient coverage to at least cover the cost of a one way, economy class ticket from where you are to where you want to be.

Baggage loss

This coverage provides reimbursement for the value of baggage in the event it is stolen or lost, to the extent that the full reimbursement has not been made by the carrier.

Limitations and exclusions

Read the travel insurance policy very carefully so that you are fully aware of the limitations and exclusions that may apply to your situation.

Coverage: Individual health insurance plans based in the US

Not designed for extended international travel, these plans require that you keep a permanent US address. Premiums are based on the state in which you reside. Some policies will reimburse the traveler for treatment of an illness that is "life threatening" or for injuries that occur outside the US while others will only cover emergency treatment overseas. When reading the policy statement, clarify the coverage and seek definitions that are understandable. Medicare coverage is confined to the United States.

Trip insurance or Short-term travel insurance

Most plans cover travel for up to 180 days, and are renewable after that period, while others are nonrenewable. These plans may be used to supplement existing health coverage such as major medical. Check with the insurance provider to determine what is/is not covered, and the length of time available. If you have no insurance at all, this may be a cheap way to get some short term coverage, but these policies often have limits on the amount and type of benefits covered. Other features may include trip interruption or cancellation coverage (good if you have prepaid lots of money for airline tickets), baggage loss coverage, and emergency evacuation assistance.

Long term international health insurance without coverage in your home country

This insurance is designed for trips, and does not offer coverage upon return to the home country. These policies are acceptable, unless you get an awful, protracted illness abroad that requires a long course of treatment upon return (e.g. heart disease, cancer, diabetes, HIV). The plans sometimes have a "home country" clause or rider that provides limited treatment upon return to the home country. The amount of coverage in the home country depends on the length of the policy. If you have been gone six months, you may get two weeks of coverage upon your return, during which time, you must obtain a policy in your own country (if you do not have one). Most of the time, these plans drop the customer immediately upon return to the USA. This type of plan is often favored by expats who may fly into the US for surgery.

Companies providing travel insurance include:

Coverage for cruises, driving vacations, terrorism, and supplier default, as well as last-minute getaways

Covers medical, and dental care; access to 24-hour multi-lingual, worldwide medical assistance service for information and referrals to doctors and hospitals; emergency medical evacuation and repatriation through MedAire, as well as International Employee Assistance Program (IEAP) for counseling and crisis intervention

This plan has no age limit, no deductibles and covers an unlimited number of children. It includes hospital confinement, the loss of golfing equipment and lap top; protects household contents against fire while traveling; rental vehicle excess; accidental death from common air carrier; unlimited medical evacuation and repatriation expenses; all leisure amateur sporting activities; maximum length per trip is 182 days for each single trip.

AAA's plus emergency road service will bring you back from anywhere in the world and provides other travel insurance coverage for car related travel in North America, including Mexico.

If a Medjet Assistance member is ever hospitalized more than 150 miles from home, the company will fly the member to the hospital of choice at no charge in a medically equipped and staffed aircraft. Pre-paid annual memberships are available for individuals up to 75 years of age. Add-ons include secure online storage and maintenance of personal medical information, up to the minute trip intelligence, free international cell phone for the first week of travel and up to $50,000 cash advance for medical emergencies.

The plan covers repatriation and medical expenses related to sudden illness or accident, sea and mountain search/ rescue; medical assistance in the course of transportation; long distance medical advice; local medical specialists; repatriation of mortal remains; return ticket for family/companion to accompany injured/ill traveler; assistance to minor children; urgent dispatch of medicine; advance of bail bond (to be reimbursed); interpreter; transmittal of urgent messages; cancellation and curtailment of trip; baggage and personal effects; delayed baggage; personal liability; and winter sports (14 days per policy).

WorldMed Insurance offers medical expense and emergency medical evacuation coverage to individuals traveling outside their home country. For travelers in need of high limit coverage, this company provides InterMedical insurance which includes accident/sickness medical emergency and medical evacuation coverage, plus assistance services for people traveling outside the US and outside their home country. The accidental death and dismemberment (AD&D) can go as high at $500,000. High limit Accident Insurance is a stand alone accident plan with optional coverage for war and terrorism. The available limits range from $500,000 to $20 million, or higher. The plan is offered by the week, month or an on annual basis. This is of special interest to high net worth individuals, those planning high adventure travel, lengthy trips, or travel to unstable parts of the world. It can also be important coverage for a business to offset the loss of a key employee or principal.

For international visitors visiting the US, Visit USA HeathCare Insurance covers accidents/ sickness medical emergency. It is also available to temporary US resident and new immigrants to the US.

Mary Gallagher's Safety Tips

Travel and Live Safely
Personal safety is awareness.

An awareness of everything going on around you whether walking, riding, driving, flying, eating or sleeping.

Here are a few of my suggestions from personal experience to assist you in staying safe.

To start. Try not to look like an American tourist with T-shirts, shorts, bulging fanny packs, Reeboks, and a baseball cap. There are a lot of clothes suitable for travel with a little style that don’t scream tourist.

In foreign countries, shouting back and forth in English to your friends is like waving a flag that says “Hey pickpocket here I am with money and credit cards come and get me!”

Be discreet with your cash or travelers checks while paying in a store, restaurant, or anytime.

Spread money and credit cards around your body. Use a neck purse, leg purse, money belt, special clothes with Velcro closings and secret pockets. Do not carry anything of value in your purse, rear pants pocket, back or fanny pack. Your attention will be distracted or you will be jostled and these will be sliced open and emptied so fast and slick you’ll never know it happened.

I used a neck purse until a big rash broke out on my chest. Now I just keep money tucked in as many places as possible.

To be truthful only once did I remember to photo copy my credit cards and passport. I know this is a good idea but sometimes even the most experienced of us don‘t get everything done. I have a business card inside my suitcase as well as outside luggage tags.

Cash Machines. I never use a cash machine on the street not even in the U.S. Look at crime statistics. How many people are robbed, kidnapped or murdered in front of cash machines? Cash machines are robber/violence magnets. In Washington D.C., the Secretary of Health and Human Services, Donna Shalala, was attacked at a cash machine on a Sunday morning. Better to go into the bank where there will be less of a chance for unsavory characters to watch you. If you are two or more traveling together, have one person stand back from the teller's window and observe who else is watching customer's transactions. When you’re back on the street notice if anyone that was in the bank is following you and take appropriate safety measures.

Jewelry. Do not take what you can’t afford to lose. I like jewelry and wear a ton of it. On trips it is all fake and not even good imitation fakes but cheap fakes. I had a wonderful $10 faux Rolex, bought on the streets of NYC, that someone must have thought was real and ripped off and that was in Virginia! Imagine their surprise at the pawn shop.

Blending in. For European trips, I use older generic black luggage, a gym bag for a carryon, wear only black clothes including lots of leather (spots wipe off, impervious to wind and rain) and if alone don’t speak unless necessary. In Paris, American tourists come up, enunciating slowly in loud voices, asking if I know where the Louvre is. In Spain, what is the time? Must be the burgundy hair.

More on theft. Personally, my biggest problem is just getting up and forgetting my stuff...an inexpensive camera on the Paris metro, a raincoat in the Chicago airport. One earring under a train in Dijon, wet bathing suits and laundered underwear on balconies. If you can, travel off-season or shoulder-season season. Not only is it less crowded and cheaper, thieves are usually on their own holiday or have moved to more seasonally popular spots. Be alert and careful in crowded tourist sites.

Hotels. In Europe, small hotels, especially with guest rooms on the second floor and up are usually safer. The desk clerk knows everyone that comes and goes - guest or otherwise. Most of the staff are family or have been employed there a long time. Physically check out the fire escape options not just the little map on your door. I’ve been in two hotel fires where the halls filled completely with smoke, and another that was electrical in nature with light smoke and everything shut down.

Be aware of the environment outside your room and windows. Years ago on a family trip to Orlando, our adjoining rooms had sliding glass doors to balconies. We were on the second floor but level with a freeway across the parking lot. About 2:00 AM someone fired a gun into one of the rooms - most likely from the freeway. The bullet shattered the glass doors, went over the heads of the sleeping occupants (my sister and son) through the wall into the bathroom and ended up in the tub! With local and state police all over the place, this experience surpassed anything Disney had to offer as far as my son was concerned.

Many pamphlets are available on questions to ask when booking a room. Woman alone should never be on the ground floor. Years ago and still in some places the keys will have huge bright tags with the room number printed in large white letters. If you suspect someone nefarious has gotten your room number, ask to be moved or change hotels. An inconvenience but not much of one when compared to physical harm.

Personal protection. I had a body alarm for a while but worried it would get set off by accident and I’d forget how to shut it down creating a big scene in a concert or cathedral. Mace or pepper sprays, stun guns and similar products require practice, no wind and lots of nerve. Stun guns may not be legal everywhere and it’s hard to find a volunteer to practice on! Some require that the gun be held against the other person or animal for a few seconds to take affect. Understand your physical strength and capabilities in purchasing any protection devices.

I did a short video series “Self protection for women” with a police officer a few years back. What a disaster, I couldn’t fight off a peanut. The biggest part of personal self-defense is attitude (I have a lot of that). Look and act confident, be aware, don’t worry about looking dumb. Scream, kick, bite do anything to avoid the perpetrator getting you into a vehicle, behind a building, in the woods. My personal adage: If I’m going to die you’re going to have to do it here and now not after hours of torture.

Luggage. On trains in Europe, I’ve never lost a piece of luggage even when storing it at the end of the car. It is best to face that direction so you can keep an eye on it at stops. Tie a piece of bright ribbon or yarn on your bags for quick identification. Duct or electricians tape is a good lock. As porters are almost non-existent or invisible pack only what you can carry all at once. Leaving a suitcase at one part of the airport or train station while you schlep the rest to another location is not a good idea.

Carry a small flashlight. Carry one of those sealed $3 eventually disposable ones that seem to last two or three years. When the hall lights of your B & B or hotel are on a timer and you don’t climb stairs too fast or for reading street and address signs in unlighted areas it can’t be beat.

Keep track of where you are. Also, try to avoid bad neighborhoods, especially after dark, no matter how picturesque.

I was strolling around Perpignan, France on my first day there and wandered into a very rough neighborhood as evening came. I kept walking, purposefully (remember with attitude), in the same direction thinking that eventually I would arrive in a better area.

No other women were on the street and men in bars with open doorways started coming out to shout at me. Finally, I came upon a bakery that was closed but the lights were on and I could see people inside working. I repeatedly knocked on the door. When a woman finally came I said “I m lost”. I only speak English but have great acting skills! She quickly unlocked the door and ushered me in. I could tell she was very worried. They called a cab but doubted if one would come into this neighborhood after dark! I had drifted a long way from my hotel.

Unfortunately those nifty historic urban sites are frequently located in transitional neighborhoods.

Strangers. Be cautious in the U.S. or any other country in making friends with strangers. I tell you this as someone who can stand on a corner and engage the light post in conversation. Certain people prey upon unsuspecting sometimes lonely perhaps naive (usually solo) travelers. Trust your sense of judgment. Do not go to anyone’s hotel room, apartment or home or have them visit yours until you’ve met them several times elsewhere. This goes for men and women. So called glamour places like the Riviera, Paris, London and Hollywood draw all types, not always the best.

A few years ago, I had been traveling alone for a long time in France and craved someone to speak English to. The official tourism office thought it was an unusual request but arranged for me to meet two female school teachers who were thrilled to practice their English. We went out for pizza and had a great time. Fairly safe and we all benefited.

Hitchhikers - you or them. I used to feel sorry for those poor nice people standing out on the highway in the burning sun, blowing wind and soaking rain until I worked in crime prevention and my desk was in the detective division of a suburban police department.

Hitchhikers in the U.S. seldom have identification and not because they lost it. I cannot emphasize enough - do not under any circumstances pick up a hitchhiker whether you or they are a man or woman.

It used to be fairly common for foreign and American students to hitch rides all over Europe. Unfortunately, this is not as safe as it used to be and I would highly recommend against it.

Emergency exits. During my work in crime prevention there were many lunch and dinner meetings with police and fire officials. The majority always insisted on sitting next to or very near the emergency exits. Restaurants have many fire hazards. I refuse to eat or drink in the basement of any establishment. On some occasions this has ended my social excursion for the evening but I’d rather be cautious than not here writing this article.

At Second City, a while ago in Chicago, there were no separate entrance and exit areas, therefore at the end of the first show the entire crowd fought their way through the waiting people. If there was an emergency exit I didn’t see it. How this passed any fire codes was beyond me and truly frightening. We were so smashed together that even if my friend and I had decided to give it up, moving our bodies independently of the crowd was impossible.

Purse Snatchers. Time and time again in the states and abroad, I hear of restaurant purse snatching incidents. Typically, the thief enters a busy restaurant and walks around like they are looking for an empty table or a waiting friend. They will even use this explanation to bypass the maitre d. He/she spots a purse(s) hanging over the back of a chair, then scoop it up by the strap. Now the bag is on their bent arm, held close to their bodies, they walk quickly by and out the door. If your feet move your purse, placed under your chair, to a more exposed position, the thief will drop or feign dropping something and again, scoop up your bag. Keep your foot on it. Women should not carry anything in a purse they cannot afford to lose.

Concerned restaurateurs will acknowledge this problem and but not often post signs “mind your purse”. I saw the entire scenario in a few seconds in a crowded restaurant near Victoria Station in London. It happened so fast that in some ways you knew what was going on but in another perhaps it was just a perception.

Traditionally, successful, professional robbers and burglars work at high speed. Anything that slows them up increases the possibility of being caught and they try to avoid that complication.

MEDICAL SAFETY

Trip Insurance. This is a big soap box for me. Do not leave the U.S. without medical evacuation insurance. If you think your regular health insurance policy covers it - check and make sure. Even if you’re going to a country with superior medical facilities, like France or Germany, not just a third world destination. If something happens and you need long term treatment you’ll be better off at home no matter how civilized the country.

I had arrived on the Island of Grenada and was staying at the beautiful and superb Spice Island Resort. One hour after dinner, six hours after arrival, tripping over an electrical cord while trying to adjust an air conditioner, I fell on the marble floor in my room. I knew my hip or leg was broken. Eventually pulling myself across the floor to the phone (a plus mark for silk pajamas) I called the desk for help. They called a doctor and an ambulance AKA panel truck. I went into shock.

At the local “hospital” the x ray technician told me to get myself on the table! Later in the orthopedic ward, on a bare mattress set up on four cement blocks, the doctor told me my femur was broken. I was in that facility for about 30 hours. No water, no food, no phone, eventually a weight to hold my leg straight. Sadistic nurses caused more damage then I started with. The hotel manager came and said a plane was coming to pick me up.....it took 12 more hours but at least no one banged on me again.

In Florida, 5 1/2 hours of surgery was needed to implant the titanium rods from my knee to my hip and then across for more strength. My femur had literally blown up.

Believe me, you do not want to be in a foreign hospital, particularly in a third world country. I would have been better off staying at the resort. That is my best advice from this experience. Have evacuation insurance, and do not leave your hotel if you have any reason to suspect it is better than the hospital. At least you can get food and water, sheets and blankets.

This experience brought up another safety point. Have a way of notifying someone in the states or your home periodically that you’re OK. Leave them a copy of your itinerary. Hospitals in underdeveloped countries (and this includes a good portion of the popular Caribbean) do not have bedside phones (or lamps, tables, blankets, AC, call bells for assistance etc.) and frequently your belongings, money and credit cards will disappear. A pay phone somewhere down the hall when your money is gone and your bones are broken is of little value.

Medical and physical therapy people tell horror stories of other injured travelers who were left for long periods of time with no care or medications. I owe a great deal - probably my life and at least ability to walk today to the hotel manager at the Spice Island Resort, Air Jamaica who also assisted in being responsible for me, and Dr. Sami Sehayik, my orthopedic surgeon in Palm Beach Gardens, Florida. The ambassador to the U.S. from Grenada could have cared less.

Medical insurance including the absolutely necessary evacuation runs at most $4 per day. I could care less if I lose my luggage but would not leave this country if I could not afford the evacuation coverage. For seniors, Medicare does not cover you outside of the U.S. and neither does every American Express or other credit cards. You can figure basic evacuation cost at $25,000 and up.

Any travel agent or tour company can give you names of various carriers. Searching travel insurance on the web brings up lots of information.

Traveling by wheel chair. Hopefully like me you are only temporarily disabled. In certain areas the airline and airport people are familiar with wheel chairs needs. My flight from West Palm Beach, Florida had about half the passengers come to the gate in wheel chairs. I was the only one who could not walk onto the plane.

In making reservations for all my traveling while in this situation, I notified the airlines during the original booking, and then again a few days before departure. The words “I cannot walk” seemed fairly explicit right? Not once in five separate flights was anyone prepared.

On most airlines the basic program is: You arrive by whatever means at the airport, someone searches to find a wheel chair to take you to check in, then you are wheeled to the gate, if you cannot walk on to the plane, you are lifted into a transfer chair (tiny narrow wheel chair) and thoroughly, chest, legs, lap, strapped in. You’ll feel like Jack Nicholson in “One Flew over the Cuckoos Nest” and I was totally embarrassed. Then you are wheeled and lifted onto the airplane and again lifted into a seat. Just before this point the flight attendant discovers that for some reason your assigned seat is an inaccessible window...heh.. heh ..now she must re-arrange the seating of several rows of passengers while cursing the gate agents under her breath.

Only Sun Country Airlines provided exemplary service. Concerned enough to wheel me to a McDonald’s because the flight had no food, only peanuts, and then having someone waiting to quickly board the plane and remove me at my destination. On my return two weeks later the same gate agent, at my originating airport, met the plane and came on board to supervise my removal and ask about my trip.

Take pills, drops, glasses and such in your carryon bag. To lessen bulk and weight, I put pills in zip lock bags with labels. Although you will need your pharmacy phone number and it is always helpful to have the prescription number.

Usually you can go into the drugstore anywhere in the U.S., tell them what prescription you’ve forgotten or lost. With an ID and your home pharmacy phone number they can transfer the prescription and you’re on your way. Don’t forget or lose the expensive ones! Sometimes the insurance coverage is a hassle in these situations.

While traveling with a person on peritoneal dialysis, we had all the supplies shipped ahead to the hotel. The hotel provided us with an appropriate “sharps” disposal box. The boxes arrived a few days before we did and they kept them in storage, then delivered the boxes to the room.

Persons on hemo dialysis need to acquire a list of centers in the areas they are traveling to. Then call ahead (months in heavy tourist areas) and make their appointments. We found that many centers were too busy with regular clients to accommodate the visiting patient and had to search further out of the city. As the dialysis procedure is several hours long, it wasn’t too difficult for the rest of the group to schedule activities in the area and then pick the person up again.

It is possible to take a specialized cruise with nurses, doctors and dialysis equipment on board. Unfortunately this is not usually covered by your medical insurance.

Every medical facility has a different process whether it is an emergency room or a dialysis center. Stay alert, people make mistakes, mis-read charts. I cut the bottom of my foot on the fourth of July at home, bleeding profusely went to a nearby emergency room, was sent for x rays and the technician said “I don’t see any cuts on your leg?” Apparently the doctor writing up the orders failed in identifying body parts class 101. And we wonder why the wrong part can get cut off.

Carry a small first aid kit. Antibiotic cream, Band-Aids, tape, gauze pads and the ever necessary elastic bandages. Many items you have with you can be converted. Sanitary pads full or mini size, cut to fit, replace gauze squares and other larger bandages. Foam shoulder pads can be cut to pad a blister or provide lift to the insole of a shoe. Any kind of tape works. Cellophane is a little scratchy. I won’t go so far as recommending pouring whiskey on wounds like in the old Wild West but many disinfectants come in individual foil wrapped packages.


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