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Does your health insurance cover international emergencies? Half of Americans don't know - Survey

Here's the scoop on why you need travel insurance and which credit cards are the best for health coverage.
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Written by Toni Husbands, Staff Writer on
Reviewed by Marc Wojno

Americans are dusting off passports and planning foreign travel at a rate surpassing pre-pandemic levels. A recent survey conducted by the International Medical Group confirmed that this trend is up 11% among those who've already traveled outside the US.  

As Americans pack their suitcases for overseas travel, many are often unprepared when it comes to having proper health coverage should a medical emergency occur. According to a survey published in May by travel insurer InsureMyTrip, nearly half of the survey respondents (1,329 Americans ages 18 and older) said they didn't know if their health care policy would cover a medical emergencies incurred in a foreign country. 

Being unprepared can be costly.

Sonja Bell, a resident of Dallas, Texas, was visiting Bratislava in the central European country of Slovakia in 2012 when she started feeling ill. On her way to the hotel, she stopped at a small clinic. "When we arrived, I was told I was so dehydrated that they would be keeping me overnight," Bell told ZDNet. She was ultimately diagnosed with pneumonia and bronchitis. The experience produced another surprise as the doctor returned with her health insurance cards. "She said that I would have to pay, upfront, about $2,000 until my insurance made a payment," Bell added. "If I was due a refund, they would send it to me."

Medical emergencies may not be at the top of your mind when dreaming of overseas adventures, but accidents happen. "While people are more aware of the need for travel insurance, there's still a lot of confusion around what would and wouldn't be covered by their own health insurance," said Suzanne Morrow, Senior Vice President of InsureMyTrip.

"When you file the expense, it may be shocking to find out how little your health insurance will [pay] towards it," Morrow added.

Chandrea Brown, a data analytics professional in the health care industry, is embarking on an extended excursion that will begin in Rome later this year. Over the next few months, she intends to explore additional Italian cities and then make her way to Lisbon, Portugal. Asked whether she knew if her current health care policy would cover medical issues abroad, she told ZDNet, "I don't know yet, but that's one of the points I want to check."   

Don't fly blind when it comes to health insurance coverage overseas. Before embarking on an international voyage, take the time to evaluate your health care options. Reach out to your health insurance provider, and research how your credit cards can help cover your expenses in an emergency.

What questions should international travelers ask their health insurance providers about before traveling?

Travelers should contact their health care providers to ask:

  • Does emergency medical coverage extend to their specific destination?
  • What deductibles, co-insurance, or co-payments would be required in a medical emergency during the trip?
  • How are urgent vs. emergency care issues covered?

(Older adults with Medicare should be aware that foreign medical expenses aren't covered and that supplemental plans must be purchased separately.)

What's the difference between travel insurance and travel reward programs?

"Credit card travel rewards typically offer trip interruption benefits that kick in before travel occurs. Travelers should first understand what benefits are available through their credit card providers. Then, purchase a travel policy that covers everything else," Morrow told ZDNet.

Using sites such as InsureMyTrip can help would-be vacationers compare travel insurance rates and coverage to determine the best fit for their budget.

ZDNet has compared five of the best international travel rewards credit cards, which offer anything from generous bonus point offers to $0 foreign transaction fees on purchases. The following credit cards (drawn in part from the list mentioned above) additionally offer travel-related programs that can assist with unexpected events that arise before and during international trips.

Card Highlights
Intro BonusEarn 60,000 bonus points after you spend $4,000 on purchases in the first 3 months from account opening. That's $750 when you redeem through Chase Ultimate Rewards®.
APR17.49% - 24.49% Variable
Recommended CreditExcellent/Good
Reward Rates
  • 5x on travel purchased through Chase Ultimate Rewards®
  • 3x on dining.
  • 2x on all other travel purchases, plus more.
Annual Fee$95
Intro Purchase APRN/A
Additional Details
Rewards & Redemption Details

The Chase Sapphire Preferred Card offers standard travel protection benefits for any travel expenses paid for with the credit card.

Travel benefits include:

  • Trip cancelation and trip interruption insurance
  • Travel and emergency assistance
  • Accidental death and dismemberment coverage up to $10,000
Card Highlights
Intro BonusEarn 60,000 Membership Rewards® Points after you spend $4,000 on eligible purchases with your new Card within the first 6 months of Card Membership.
APR18.24%-25.24% Variable
Recommended CreditExcellent/Good
Reward Rates
  • Earn 4X Membership Rewards® Points at Restaurants, plus takeout and delivery in the U.S.
  • Earn 4X Membership Rewards® Points at U.S. supermarkets (on up to $25,000 per calendar year in purchases, then 1X).
  • Earn 3X Membership Rewards® points on flights booked directly with airlines or on amextravel.com.
Annual Fee$250
Intro Purchase APRN/A
Rewards & Redemption Details

This card grants access to the American Express® Global Assist Hotline, which offers emergency medical coordination and referrals 24/7. This service can help international travelers navigate emergency services when dealing with the unexpected, but card members are responsible for costs incurred by third-party service providers.

Travel benefits include:

  • Access to the Global Assist Hotline
  • Emergency Medical Transportation Assistance
  • Medical Prescription Replacement Assistance 
Terms apply to American Express benefits and offers. Enrollment may be required for select American Express benefits and offers. Visit americanexpress.com to learn more.
Card Highlights
Intro BonusReceive 50,000 online bonus points - a $500 value - after you make at least $3,000 in purchases in the first 90 days of account opening
APR18.24% - 25.24% Variable APR on purchases and balance transfers
Recommended CreditExcellent/Good
Reward Rates
  • Earn unlimited 2 points for every $1 spent on travel and dining purchases
  • Unlimited 1.5 points per $1 spent on all other purchases
Annual Fee$95
Intro Purchase APRN/A
Additional Details
Rewards & Redemption Details

The Bank of America Premium Rewards Card requires a $95 annual fee, but it's worth it for the travel protections it provides for card members.

Travel benefits include:

  • Emergency evacuation and transportation coverage for you or any family members injured or sick while traveling
  • Travel and emergency assistance services to help coordinate medical, legal, or transportation services
  • Trip delay or cancelation protection up to $2,500 for travel that is canceled or cut short due to illness or other covered reasons

Read more: The Best Bank of America Credit Cards

This Capital One credit card provides a separate accident travel insurance policy. The policy is managed through the card network, and it can be accessed through the card member's online account.

Travel benefits include:

  • Travel accident insurance covers the cardholder, spouse, and immediate family members, including children, in the case of death or permanent injury
  • Trip cancelation or interruption insurance reimburses trip expenses for qualifying reasons that include accidental injuries or non-preexisting illnesses
Card Highlights
Intro BonusEarn 100,000 Membership Rewards® points after you spend $6,000 on purchases on your new Card in your first 6 months of Card Membership.
APRSee Pay Over Time APR
Recommended CreditExcellent/Good
Reward Rates
  • Earn 5X Membership Rewards® Points for flights booked directly with airlines or with American Express Travel up to $500,000 on these purchases per calendar year.
  • Earn 5X Membership Rewards® Points on prepaid hotels booked with American Express Travel.
Annual Fee$695
Intro Purchase APRN/A
Rewards & Redemption Details

At $695, the American Express Platinum Card has a higher annual fee than every other card on this list. Avid international travelers may still find it valuable, however, given the premium travel insurance perks it provides.

Travel benefits include:

  • Expenses due to trip cancelation, delay, and interruption can be covered (if they are approved) by up to $10,000 in a 12-month period per the insurance agreement
  • Premium Global Assist can coordinate help during medical emergencies, and emergency medical transport can be provided at no additional cost (provided the service is approved and provided by the hotline)
  • American Express Travel Insurance has policies that will cover emergency medical and dental expenses worldwide (except in places economically sanctioned by US law)
Terms apply to American Express benefits and offers. Enrollment may be required for select American Express benefits and offers. Visit americanexpress.com to learn more.

How much can medical evacuations cost?

These services can cost up to $10,000 or more depending on the travel destination. "Essentially, you are getting a private jet with medical attention. It can get expensive pretty quickly," Morrow warned.

Medical evacuations are rarely covered by domestic health insurance policies. Travel insurance policies, however, typically cover medical transport to the nearest medically-equivalent hospital that can offer lifesaving services. 

Are pandemic exclusion clauses still included in travel insurance?

Travel insurance companies have largely removed pandemic exclusion clauses from their policies. "Companies that had pandemic exclusions are taking that wording out," Morrow said. "Insurance companies are now treating Covid like any other unforeseen illness." 

If you haven't contracted the virus before booking the trip, it will now be considered a covered illness. "I don't know any company that still has kept in the pandemic exclusion," she added. 

How much does travel insurance cost?

Travel insurance prices can vary based on the age of the travelers and the overall cost of the trip. "It tends to be anywhere from 5% to 10% of the trip cost if you're getting the package plan," Morrow said. 

An insurance package plan will likely include trip cancelation or trip delay insurance. Post-departure benefits -- health insurance coverage in foreign countries, medical evacuation coverage, etc. -- will cost even less than non-package plans, and they can be an effective way to save money.

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