Tuesday 23 April 2019

A medical emergency could cost more than your holiday

Louise McBride

Louise McBride

THE recent Spanish train crash, in which 79 people died after a train derailed near the famous pilgrimage city of Santiago de Compostela, shows just how quickly disaster can strike. So, too, did last week's coach crash in southern Italy, which saw 38 people killed when a tour bus plunged off a flyover and into a ravine.

Tragedies like this are the last thing we expect when we head off on holidays – yet they can happen. Aside from the personal trauma experienced if you or a relative are injured (or worse) in a foreign accident or disaster, the financial headache can be debilitating. If you don't have insurance, you could have to cough up hundreds of thousands of euro to cover the hospital bills that arise from a medical emergency abroad.


If you're seriously injured while travelling in the US, for example, your hospital bills could reach almost half a million euro, according to Ciaran Mulligan, managing director of Blue Insurances.

Mulligan, who has more than 20 years' experience in the insurance industry, cited a case where an Irish man was paralysed from the neck down after diving into a pool while holidaying in Las Vegas. "The medical bills in this case came to almost €450,000," said Mulligan.

In another case cited by Mulligan, an Irish holidaymaker was injured in a motorcycle accident in the US. The medical bills came to €100,000, including a €60,000 bill to have him flown back to Ireland by air ambulance.

A stint in a European hospital could set you back tens of thousands of euro. "A week in a hospital in Europe could easily cost from €5,000 to €10,000," said Dermot Goode, of healthinsurancesavings.ie. "If you're in hospital for a few weeks, you could be talking around €25,000."


So what can you do to avoid ending up in a financial nightmare if a medical emergency strikes while you're abroad?

If you are holidaying in Europe, get a European Health Insurance card through your local health office before you travel. With this card, you are entitled to free emergency care in a public hospital if you become ill or injured while travelling in the European Economic Area (that is, the EU plus Iceland, Liechtenstein, Norway and Switzerland).

Don't rely solely on this card, however. It does not usually cover the full cost of hospital treatment, and it won't cover you for repatriation or any additional accommodation or travel costs which arise after you become injured or ill. A good travel insurance policy, however, should cover those additional costs. Similarly, the card won't cover you for care outside the EEA or in a private hospital or clinic – but your travel insurer may foot the bill for these costs.

If holidaying in Spain, you could run into trouble using your European Health Insurance Card in some hospitals. Last month, the European Commission launched an action against the Spanish government after foreign holidaymakers who needed urgent medical care were turned away or asked to pay cash.

"Some hospitals in Spain are refusing to accept European Health Insurance cards and are demanding that patients pay upfront for the bill," said Goode. "If you find yourself in such a situation, stand your ground and get on to your travel insurer as soon as possible. Your travel insurer will know how to deal with the hospital."


If you have private health insurance, you will usually be covered for between €50,000 and €100,000 of expenses that arise from a medical emergency abroad, depending on your plan.

If you have travel insurance and private health insurance, your private health insurer will typically cover the first chunk of the hospital bill; with your travel insurer picking up the tab for the balance.

If you don't have private health insurance, your travel insurer will usually cover you for the full emergency bill – but your policy will be slightly more expensive than it would be if you had private health insurance.

Insurers will typically cover between €3.5m and €10m of emergency medical expenses, according to John Geraghty, chief executive with the online insurance brokers LABrokers.ie.

"Emergency medical expenses cover the cost of medical, surgical or hospital treatment," said Geraghty. "If you are involved in an accident, contact your insurer as soon as is reasonably possible as failure to do so could invalidate a claim."


Relying solely on your private health insurance to cover you for mishaps abroad is a mistake, according to Goode.

"Unlike travel insurance, private health insurance won't cover loss of luggage, theft, cancelled flights and so on," said Goode.

It's important to understand the restrictions of the cover for emergency medical treatment offered by your insurer.

"Normally, the emergency medical cover offered by a private health insurer only kicks in if you're injured when on a temporary stay abroad," said Goode. "Each insurer has its own definition of 'temporary stay'. With some, it could mean being abroad for no more than 31 days at any time. So if you're abroad for six weeks, and you're in an accident beyond the 31-day limit, insurers could refuse to cover medical bills.

"We've seen people caught out by this. I believe there are hundreds, maybe thousands, of family dependents who are travelling or studying abroad where the parents think their children are covered – but they aren't."

Most travel insurance policies also limit the number of days that you are covered for when on individual trips abroad.

So if you're studying or backpacking abroad, or you have children doing so, check if you will lose cover after being abroad for a certain length of time. If your health or travel insurance policy restricts your cover to a month – but you or a family dependent plans to travel for longer, ask your insurer if you can extend the cover for the entire duration of the trip.

If it won't extend your cover, consider buying a backpacker or long-stay travel policy – these policies usually cover trips of up to a year or more.

Even if your insurance covers you for the length of your trip, your insurer could refuse to cough up if you're not admitted to a hospital overnight.

"If you're in hospital for a day, emergency medical cover does not usually apply as you must be admitted overnight for the cover to kick in," said Goode. "You also need to be careful to phone your insurer before you choose a hospital so your insurer can approve the treatment. If you just walk into the nearest private hospital, you may not be covered."


If you have to be flown home for medical care after being injured abroad, the repatriation bill could run into tens or hundreds of thousands of euro.

Earlier this year, VHI Healthcare said the average repatriation costs for an air ambulance was €150,000 from Australia and New Zealand, between €59,000 and €65,000 from the US and €9,000 from France. If you don't have insurance, you'll have to foot the bill yourself.

Most travel insurers and private health insurers cover repatriation costs but you should check if this cover is included in your policy – as well as any limit to the costs for which you are covered.

Your insurer will only cover you for repatriation if it's done on medical grounds. "If you simply don't like the hospital abroad and hop on a plane home, you won't be covered," said Goode. "You have to be declared fit for flying – otherwise, your travel insurance will be null and void."


If you're travelling to a politically unstable country, check if your insurer covers that destination. Some insurers don't cover Algeria, Israel, Lebanon and Libya, for example.

If you have a pre-existing medical condition, you may not be covered if you need medical care if this condition flares up while you're abroad.

"The largest pitfall for people taking out travel insurance is where they do not disclose a pre-existing medical condition," said Geraghty.

"Many people don't realise this condition also extends to anyone travelling with them. An insurer will have a list of accepted medical conditions so it's always safer to phone first to have the condition noted on the policy."

Better safe than sorry.

Sunday Independent

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