The last time I traveled overseas, I called my health insurance provider to make sure I was covered. They said I had coverage for emergencies, and that sounded fine to me—I wasn’t planning to get a mammogram in Amsterdam.

Luckily, I didn’t need to tap into health insurance during my trip. Because it turns out, there were a lot of follow-up questions I should have asked to make sure I didn’t need additional coverage.

Travel medical and evacuation insurance can cover the costs your existing plan doesn’t cover, explains Katie Tu, a content specialist at QuoteWizard. Think costs like:

  • Help in locating medical care
  • Language translation assistance
  • Doctor and hospital visits 
  • Transportation back to the U.S., including medical evacuation
  • Travel expenses for a loved one to be by your side
  • Help with medical billing

More than half Americans don’t know whether their health insurance works outside the U.S., according to a survey from InsureMyTrip. I didn’t know, until I called. 

Half of Americans don’t know whether their health insurance works outside the U.S.

Even if you have insurance that covers you outside the U.S., you could still be surprised by unexpected costs. Ask these questions to make sure you’re prepared:

  • What constitutes an emergency?
  • What documentation do you need before seeking care? Do I need preauthorizations or second opinions?
  • Do you cover emergency transportation to a U.S. hospital?
  • What locations are covered?
  • Is there a list of providers I can visit at my destination?
  • What activities are considered dangerous and require additional coverage? Think skiing, diving, or mountain biking. “The cost of being helicoptered off a mountain is astronomical,” says Brad Emery, founder of travel club Aimviva.
  • How do I file a claim? Do I have to pay for my medical costs and get reimbursed? 

You might want to look into additional health insurance for your trip if:

1. You’re traveling outside the United States

Within the U.S., your existing health insurance should provide coverage. If you’re worried about higher out-of-network costs at your U.S. destination, check your policy or call your provider.

“The average healthcare company will not cover your medical fees for an illness abroad.”
Justin Tysdal
Seven Corners

But overseas, you may not be covered at all. Justin Tysdal, CEO of travel insurance provider Seven Corners, says, “The average healthcare company will not cover your medical fees for an illness abroad.”

And don’t assume you’ll be covered by the country you visit. “Many people think if they are traveling to a country with a nationalized health care system, healthcare services will be cheaper or at no cost,” says Kendra Guild, smarTours director of product and operations. But that may not be the case for noncitizens, she says. 

And costs can be high. Nick Brennan, the founder and CEO of www.myuksimcard.com, says, “As a tourist in a foreign country, if you fall ill or have an accident, a visit to the ER can be very expensive. For example, if you needed to visit the ER in the United Kingdom, you’d be up for about $1,500 per day.”

2. You have a pre-existing condition

Some plans won’t cover medical costs related to pre-existing conditions. For others, you might need to pay an additional premium. 

P.K. Rao, president of the travel medical firm INF Visitor Care, says, “Diabetes and blood pressure are the root cause for many issues for travelers aged 60-plus, from urinary tract infections to complications like acute renal failure. If you have any chronic issues, getting a plan with pre-existing coverage is a must.”

3. You’re taking a cruise

“Many cruise passengers don’t realize that when traveling outside the U.S., they’re not covered by their medical insurance policy or Medicare,” says David Yeskel, the travel journalist behind The Cruise Guru.

4. You’re covered by Medicare

Medicare doesn’t cover healthcare outside of the United States, except in limited cases. “Some Medicare supplemental plans offer foreign travel protection,” says Travis Price, licensed insurance agent. “Plans vary, so it is essential to call and ask for the information in writing.”

5. You want coverage for an emergency evacuation

It’s not something you want to think about, but if you’re seriously ill or injured and you need transportation back to the U.S., you’ll want coverage.

“An air ambulance back to the U.S. can cost $15,000 to 25,000 from the Caribbean, $40,000 to 75,000 from South America, $65,000 to 90,000 from parts of Europe and $165,000 to 225,000 from Australia,” says Daniel Durazo, director of communications at Allianz Global Assistance USA.

6. You’re not paying for your trip with a credit card that covers you

Some credit cards offer travel insurance that covers health issues as well as missed connections, delayed baggage, lost passports and other problems that can crop up during trips. Two caveats—make sure you pay for the full amount of the trip with that credit card, and read the policy to see what’s included. 

7. Your travel is considered dangerous

Phil Sylvester, a travel safety expert at World Nomads, says, “You should buy travel insurance for active vacations where you’re going to be participating in adventure sports and for travel to countries where medical facilities may be inadequate.”

How much does travel health insurance cost? 

Prices vary—your age, pre-existing conditions, destination, and length of trip all get factored in. Julie Loffredi of InsureMyTrip offers these examples:

For a $5,000 two-week vacation to Aruba, a comprehensive travel insurance plan (covering trip cancellation, trip interruption, emergency medical coverage, emergency medical evacuation, emergency assistance, and baggage protection) will cost a couple in their 50s around $200. 

Travel medical insurance, which doesn’t include trip cancellation, would cost around $80 for the same trip.

For more information about overseas health coverage, visit the U.S. Department of State.