Travel Insurance: The Devil in the Detail

When the excellent Where’s Sharon? wrote this helpful guest post about travelling pregnant, there was one very important thing she didn’t highlight: pregnancy travel insurance may not really exist. I’ve checked.

Now, I don’t say this to discourage you from travelling whilst pregnant. We’ve done it, and had some great times. I hiked around Australia’s highest peak wearing snow shoes during my most recent first trimester and spent hours holding a toddler on my lap whilst travelling by LARC at nearly 30 weeks to name two – but I did so knowing that in the unlikely event of some unexpected misfortune, I could get the care our baby and I needed without incurring a bill we couldn’t afford to pay. Mind you, it meant restricting my potential destinations to stay close to places I was already insured.

I’m missing something, I thought the first time around, after reading through the fine print of literally dozens of “pregnancy-friendly” travel insurance policies, so I picked up the phone to enlist the help of a professional insurance broker, but she, too, turned up the same result.

What are the traps to look out for?

  • Many policies will only cover the second trimester – the first and (almost all of) the last trimesters of pregnancy may be completely excluded.
  • Almost all policies will exclude pregnancies conceived with even the most basic types of assistance – say a couple of hormone pills to induce ovulation, or an unmedicated IUI – despite the fact you might have a normal, healthy, singleton pregnancy now. That’s right – last I checked, it was easier to get cover for naturally-conceived twins than your bog-standard clomid singleton. This makes no actuarial sense that I can fathom. (Some policies do cover for lower-tech assistance, and exclude only IVF babies – again, regardless of the health of the pregnancy or the number of babies you’re carrying. I have not seen a travel insurance policy which covers pregnancies conceived via IVF, no matter how normal or low-risk.)
  • It’s a lot harder to get cover for multiple pregnancies of any style of conception – though not impossible, and there may be an extra charge. We can all see why – it’s just something to look into if you have more than one in there.
  • Of course, if you have any pre-existing pregnancy complications, you can expect travel insurance companies to run a mile. This isn’t exactly news, though, and most people would forgive them for that one. The same naturally applies to routine care.
  • The biggest and most important surprise was that all policies I saw specifically excluded pretty much every pregnancy-related complication I could think of, from morning sickness to premature rupture of membranes, no matter how the pregnancy was conceived or how normal things looked before departure. True story. And I can think of quite a lot of pregnancy complications.

On and off, since then, I’ve wondered what on earth these policies did which entitled them to market themselves towards pregnant travellers. I mean really, with those exclusions, why would they bother to list a thirty-something week cutoff? They actually seemed to be saying that they wouldn’t entirely exclude me from cover on the basis that I was pregnant (unless I was extremely pregnant or pregnant via assisted conception). That is, they would have provided the same cover for missed connections or lost luggage whether or not I had a bun in the oven – as long as the bun was naturally-conceived, less than nearly-cooked and nothing happened with said bun. And if I was in Thailand (say) and I picked up a tummy bug and ended up in hospital on a drip for a couple of days getting rehydrated, they would have paid just as if I’d suffered the same fate nulligravida – again, with a few qualifications.

But if, on the other hand, I’d got diarrhoea so badly that it had induced premature contractions requiring bedrest and tocolytics – as happened to my cousin at about 25 weeks – I wouldn’t have got much more from my pregnancy-friendly insurance policy than a kind note wishing me best of luck. Hope I didn’t blow my budget on “tax-free” “sapphires”. (These days, my cousin’s child is a lively toddler, so all’s well that ends well.)

Now, hopefully you are in a better market than we were – insurance policies vary over time, and across geographical regions. But for heaven’s sake, don’t just assume based on the glossy brochure’s tick next to “pregnancy” like I nearly did. Read. Ask questions. Make sure you’ll be cared for if the unexpected happens. Or seek your adventures within your usual medical insurance zone.

Other Reasons We’ve Found To Be Careful With Travel Insurance:

Very young babies and grandparents

Age cutoffs may exist. My nearly-ninety-year-old (now 90+yo) grandparents successfully found a policy to cover their trip to Papua New Guinea a few years ago, but they had to shop hard. Anyone over sixty-five should double check. Usually, newborns are covered well before you’ve had a chance to complete the passport application procedure, but make sure.

One-way trips or indefinite travels

Your basic travel insurance policy is designed to provide emergency medical care and – for serious/ongoing problems – repatriation back to your point of origin. One-way policies are sometimes available, but must be purchased as one-way. Neither a return nor a one-way policy will cover you once you hit “home” soil.

Simply put, if you packed up your whole life (including your medical insurance policies) before you hit the road, you might end up in trouble. When we made our long trip home from the UK in 2004/2005, our private health insurance stopped with A’s last paycheque. If something nasty had happened, we would have had the choice of an insured medi-vac back to the UK, where we like to hope they would have admitted us on a tourist visa and honoured the reciprocal agreement between Australia’s medicare and the UK’s NHS leaving the uninjured one of us to crash on a friend’s couch with whatever possessions we’d squeezed in to our backpacks, or a dip into our emergency savings to self-fund a medi-vac back home, where our cover under the Australian system awaited us. At the cost of some medi-vacs, this would have been a tough choice, but at least we knew we could handle it one way or the other. (No one-way policies were available at the time.)

In hindsight, since we basically spent the last seven months of our trip in China, we might have been better off treating ourselves as residents with a comprehensive local medical insurance policy in Beijing – depending on waiting periods and other fine print.

I’m glad, though, we didn’t buy our policy from our country of eventual destination, like Sabah from London, only to find out we weren’t actually insured at all because we didn’t start out there.

Look out also for policies which can only be extended up to a maximum limit – perhaps six or twelve months.

Update: Flashpacker Family has a discussion on good policies available through companies in Australia/New Zealand for nomads and long term travellers.

Adventurous activities

These can be a tricky one, with some policies defining “adventurous” as everything down to “making sand castles at a surf beach” or “remote” as “more than one hour’s walk from a landline”. We will certainly be double-checking our policies when we take our next ski trip.

Volunteer work, of any kind

Earlier this year, I rung an insurance company to purchase a policy which advertised itself as covering volunteer work. On the phone, the operator told me they could certainly provide cover, unless I was volunteering to do manual labour.

“Nope,” I confidently proclaimed. “I’ll be assisting with tutorials, facilitating workshops, and demonstrating procedures on anaesthetised animal patients.”

“Sorry, that would count as manual labour,” said the woman, “because you’ll be using your hands.”

It’s lucky she pointed that out so I could use their policy to amuse folks by letting them know that IT professionals, portrait photographers, English Literature academics, and insurance salespeople are actually “manual labourers”, rather than as an actual insurance product I would purchase or recommend.

Me assisting local staff spread the joy of rabies eradication during the festival of Holi - in Sikkim.

Me helping the SARAH staff spread the joy of rabies eradication during the festival of Holi after purchasing an honestly-marketed travel insurance policy – supported by Vets Beyond Borders.

(Shameless plug for a good cause: find out more about the work of SARAH and Vets Beyond Borders.)

Splitting up during the trip

Your family or group policy may require you to depart, arrive back, and stay together during the trip. If you’re planning to split up – especially if someone’s heading out early or staying on for a few extra days after everyone else comes home – be sure to check you’re buying a policy which will remain valid. This is true even if you’re planning to purchase a group policy covering the earliest family member’s departure all the way through to the last person’s arrival home.

If you travel more than a few times a year, especially if you often split up, your best bet might be an annual multi-trip policy. These rarely require all adults to travel together at all times.

Special Needs and Chronic/Pre-existing Conditions

I barely need to add a note here – people with these are probably way ahead of me on this one. Most policies will exclude special needs and pre-existing conditions entirely, although with careful shopping (and some extra cash) you might be able to purchase a policy which provides limited coverage.

All this said

Typical insurance policies come with an emergency assistance hotline, which is valuable in itself, even if you’re not specifically covered for whatever has befallen you. A friend of ours had to return home unexpectedly due to a family tragedy. Her insurance policy didn’t cover the cost of her new ticket at all, but the emergency assistance people helped her find and purchase it, which not only saved her money, but time and stress as well.

The bottom line is don’t live in fear, but do travel prepared. I would love you to add any pointers on travel insurance I’ve missed. I’d hate to learn them the hard way.

I’d like to thank the team at Expat Insurance Singapore for helping me hunt through travel insurance policies to avoid any pitfalls. They’re not giving me anything to mention them, they’ve just gone the extra mile to make absolutely certain the trip we’re planning is covered – and alerted me to several mistakes before I made them.

This post appeared first on Journeys of the Fabulist.