Parlez-vous health plan?

Travel: Your medical insurance may or may not extend to illnesses and injuries suffered abroad.


Amy Rossmark has a backup plan in case her wallet disappears during her trip to France this month.

She's prepared for the temperamental weather. She has her map marked with good areas and bad areas of Paris. But if Rossmark, 30, of Columbia, gets sick, really sick, she might not have any safety net at all.

Health plans may not cover doctor visits or hospital stays abroad, and travel experts fear too many travelers don't know about the missing coverage until they have the bill in hand. Some plans won't cover health-care costs for people traveling within the United States.

"Most people are traveling for a short time, and they just roll the dice and plan for everything to go fine for a week or so," said Nick Stat, manager of Round the World Travel in Baltimore.

And most of the time, tourists come back just fine. A majority of overseas ailments result from unusual foods or drinking water and can be handled with over-the-counter medicines, travel experts said, but extra coverage can't hurt.

Rossmark said she just assumed her BlueCross BlueShield plan covered her during her travels. But that's not always true, said Debbie McKerrow, a manager at Carefirst BlueCross Blue-Shield, which handles policies in Maryland, northern Virginia and Washington.

"When people are traveling and they have concerns, we get them in touch with a program called BlueCard WorldWide," she said. "But even there, some countries, you show the card and you're fine. Some hospitals have agreed to accept it and some don't."

Even those going for a short break should be prepared, said Evelyn Hannon, editor of Journeywoman, an online travel magazine for women (www.journeywoman .com).

"Hopefully, people are thinking about it, but I wonder if they really do," she said. "Even going across the border from Canada to the U.S. for one day, if you land in a hospital without insurance, can you afford it?"

Pregnant woman and older travelers particularly need to read the fine print of their insurance coverage -- and specifically ask about their conditions when buying travel insurance, she said. Finding the right kind of insurance is also important; it won't do any good to get extra coverage that does not include personal watercraft accidents if using the watercraft is a major part of the vacation, Hannon said.

Those traveling to developing countries may want to bring their own needles, she warned, because sterilization isn't always automatic.

Although Hannon said it cannot hurt to be too careful, many fears go unfounded.

"I had a friend who had a miscarriage in Tunisia and thought she would have to have a blood transfusion," she said. "Everyone here was very worried, but she said she felt her hospital care there was better than a lot of what's here in North America."

That wasn't the case for Valerie Fudge. During a trip to England in 1990, she hurt her foot while riding a bicycle. Because she was working in London with a student work permit, she was covered under the country's health plan.

"When I went to the clinic, she examined my foot, but didn't take any X-rays," said Fudge, 28. "She didn't think I had broken anything, but she just thought I should wear a metatarsal support."

But Fudge, then an undergraduate student at Virginia's James Madison University, had indeed broken a bone, and when it wasn't corrected, it healed improperly, causing a great deal of pain. Two years after her trip, she had an operation to correct the break.

"A doctor here didn't catch the break either, even when he looked at the X-rays. So I don't know what's worse, not to have taken X-rays in the first place, or to take them and not catch the break," she said.

Although students tend to take longer trips because they have longer summer vacations, only about a third even inquire about health insurance, said Shannon MacDowell, a reservation agent at Council Travel, a national student travel agency based in Boston.

"It's mostly only the older ones who ask [about health insurance]," said MacDowell, 23, who described "older" as ages 25 to 35. She said getting sick wasn't something she considered during her own travels to Scotland, Kenya or Barbados.

"In Kenya I did get sick, but it was just more or less weird food sickness," she said. "I just took Sudafed or some over-the-counter medication and I was fine."

The agency encourages students to purchase an International Student I.D. card, which has emergency insurance for hospital costs. Those wanting to purchase coverage for doctor's visits or trip cancellation insurance must buy additional coverage from another company, MacDowell said.

Hannon, of Journeywoman, the online magazine, said often the worst thing about getting sick while traveling is not knowing a reputable doctor or hospital.

She pointed to a new online service for women that connects female travelers with overseas residents in times of emergency (

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