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 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.
Just came across this!! Very interesting. I’m glad I didn’t read it before I travelled pregnant!
I must admit, I didn’t ring the insurance companies or go to big lengths to ensure I was covered. Most times I travelled pregnant were actually first trimester, a time when they can’t do much anyway and I wasn’t worried about being able to afford a check up , scan, etc in SE Asia. In fact, I nearly went and had scans just for the sake of it while i was away as they were so cheap lol. If we have a third child, we have considered having it in Malaysia. It seems cheaper without insurance than what we have paid via the private system in Australia with insurance and then my husband could take far longer off work 🙂
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Yes, the first trimester tends to defy medical intervention in most respects – as long as you’ve confirmed that the pregnancy is growing in the right place. (An old friend of mine went to Canada a few years back not even realising she was pregnant. The pregnancy ended in emergency surgery, blood transfusions, etc because it turned out to be ectopic and suddenly ruptured. She didn’t have a huge bill because it ruptured on the flight home! I think she would have preferred the huge bill to that excitement, though.)
I think the Australian private system can look expensive in hindsight if everything goes well (in which case you essentially paid for a lot of hand holding), but I’d hate to pay out of pocket for NICU in any place if stuff goes wrong. A lot of expats in Singapore arrive pregnant and uninsured and some of them choose to deliver in Malaysia for the affordability, but every now and again you hear of someone who got slapped with an astronomical bill (usually NICU). Of course, most people get away with it because mostly things go to plan (we would have risked it from here), and at least those with high bills are usually well enough off that life can go on, even if they are a hundred thousand dollars or more poorer!
If we never took risks we would all be too scared to get pregnant in the first place, of course, it’s just worth knowing where you stand so you can make the choice you’ll be happy with no matter what happens, and be properly prepared for contingencies (or in some cases just shop around for a decent insurance policy).
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I did read (somewhere) more recently that you can even get travel insurance policies in the USA which cover for premature birth – if you’re prepared to shop around. So apparently it’s not impossible everywhere, but Singapore and Australia are both terrible travel insurance markets.
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This is a GREAT article. So helpful and informative. I’m not planning on having kids or traveling so traveling while preggers is not in my near future. But I will bookmark this and share it with my friends who do travel.
I just love your blog. Well written with humorous quips along the way. SO glad I’m a follower. It’s one of my favorites!
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I’m amazed you managed to read it, since you’re not a traveller, let alone a pregnant one. I consider that a very high compliment in itself!
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Yes, its quite scary how little insurance can cover at times. I shopped and shopped for travel insurance that would cover my perfectly healthy but technically “high risk” pregnancy. After coming up empty I especially decided that I would risk it, and got permission and the blessing from my doctor. But both times I traveled on that 2nd trimester sweet spot, had lots of discussion with doctor, and was very careful with food and water.
Another good point, always bring a note from your doctor clearing you to fly. In India on a domestic flight at 6 months pregnant, I was denied boarding until I showed the note which thankfully I had with me.
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Yes, pregnancy shouldn’t be prohibitive, but you do have to know what you’re covered for and how you’ll handle if it something happens.
I’ve heard a couple of stories now about people being hassled over boarding when they’re well, well within the usual cutoffs so I suppose it pays to always take a note if you’re showing!
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That was a great post. I fell pregnant accidentally while abroad and was blissfully unaware of the potential dangers, and then I had a baby in the US with health insurance pregnancy cover….good cover and after it was all done and dusted with a natural birth they still managed to sting us for extra $$$
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Yes, it can add up quickly and you don’t want any exclusions to come as a surprise! The US was one of the places we chose not to go, based purely on the insurance issue. A shame, because A had a several-week-long business trip to New York during my second trimester (with P, our eldest). The medical facilities there would have been top class if by chance I’d needed them, but after reading the fine print of the travel insurance policies on offer I didn’t think we could afford it! We decided Malaysia was a better bet. (Although we never made it in the end, for various reasons.)
I’m glad your pregnancies went safely. Of course the majority do, but it’s good to have a contingency plan in case.
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I think if I’d known about all the things in the super fine print then I would of gone back home to have Alex- lets put it this way, a return flight and accom. in a nice hotel for a coupe of weeks would of been cheaper than having Alex in the US and sadly I’m not alone. Once you talk about it, a lot of women have similar stories. Malaysia would of been wonderful, you know the service would if been great :]
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Eek, that does sound expensive for a fully-insured natural birth. Sounds like we weren’t wrong to avoid the trip!
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