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If you get sick while traveling in a foreign country.

If you get sick while traveling in a foreign country

When you're traveling, even a minor ailment can make you want to exchange-- immediately--a view of the Mediterranean for one of your own medicine cabinet. Serious illness can be frightening indeed.

That's why the wise tourist packs preparations for mishaps in with the guidebooks and socks. Are you insured for illness or accident abroad? How will you find a doctor? How easily can you get home? It's best to know the answers before you go.

Getting insurance before you leave

Having adequate medical insurance is essential. Even in countries with socialized medicine, tourists are most often ineligible for the no-cost health care given citizens. There are exceptions: in the United Kingdom, the National Health Service treats you for free, short of overnight hospitalization; in Denmark, emergency health care is given gratis--provided you didn't enter the country to seek treatment.

Typically, though, you'll be charged, often at rates approaching American levels.

Most insurance plans such as Blue Cross cover emergency care abroad. So do most plans provided by health maintenance organizations like Kaiser. Policies differ, however; examine the fine print closely. (One program that does not cover treatment abroad is Medicare.)

But few foreign hospitals recognize American health insurance. You must pay in cash, often in advance, then ask your insurer for reimbursement. Pack claim forms, as insurers will want them filled out by your attending physician-- preferably in English and itemized.

Several companies in the U.S. sell supplementary policies covering medical costs abroad as well as events such as trip cancellation; one 14-day package costs $60 per person, $140 per family. Travel agencies and insurance brokers have details.

Finding a doctor in a hurry

When time is of the essence--after an auto accident or suspected coronary--it helps to know many European countries now have a single emergency number for ambulance service. The numbers are listed in two of the books we recommend on page 74--but remember that even in countries where many doctors do speak English, ambulance dispatchers usually don't. You may need to get a person who speaks the language to make the call.

If time permits, you can consult the physician at your hotel or--as many travelers prefer--one included on the list of doctors supplied by American consulates or embassies.

Consular officials can also arrange for money to be wired to you from home; in extreme cases they can make emergency loans. But they won't take responsibility for medical bills. You can find consulate and embassy addresses and phone numbers in Key Officers of Foreign Service Posts (List ID-KOFS), available for $4.25 at government printing office bookstores or from the Superintendent of Documents, Government Printing Office, Washington, D.C. 20402.

If for some reason you can't reach a consulate, you can call the State Department's Overseas Citizens' Emergency Center, (202) 632-5225 or 634-3600.

Another list of English-speaking physicians is available through the International Association for Medical Assistance to Travellers. Now in its 25th year, nonprofit IAMAT lists 3,000 screened physicians and hospitals in 140 countries. Each has agreed to treat IAMAT members for a flat fee of $20 per office visit. Membership is by donation: write to IAMAT, 736 Center St., Lewiston, New York 14092, or call (716) 754-4883.

Like IAMAT, Intermedic provides its members with a list of English-speaking physicians in 200 foreign cities. Each doctor will treat Intermedic members for an office visit fee of $30 to $40. A one-year individual membership costs $6, a family membership $10. Write to Intermedic, 777 Third Ave., New York 10017, or call (212) 486-8900.

If you must cut short your trip, you may lose money

On charter flights, any change in plans can cause you to forfeit your return ticket.

If you have an excursion fare on a scheduled airline, you can usually get a refund for the original ticket but you'll likely have to pay a higher fare for the rescheduled return. Many of the travel policies mentioned earlier insure against such possibilities. Most tour-package organizers also offer such insurance.

Still-ailing passengers who want to return home face further obstacles. They may need to present their airline with a signed release from doctor or hospital. And the trip can be expensive: a stretcher-borne traveler may have to pay eight economy fares. Passage on air ambulances or aboard U.S. military planes (available in dire emergencies) is even more costly; air ambulance service from Europe to the West Coast might run around $40,000.

Travel assistance organizations . . . for as low as $3 per person per day

The last few years have brought a flock of new companies that arrange emergency medical care (along with legal and other services) for their clients.

Coverage begins the moment you become injured or ill, though in practice in most severe emergencies, the assistance company isn't called until the victim has reached a hospital. Once you've notified the company's local office or its 24-hour-a-day regional center, its doctors then determine if you're being treated at a suitable facility. If not, they'll move you to a better one.

The assistance company will advance money to pay hospital bills; it may fly your dependents home or bring a family member to you. In some cases it will evacuate you to the States. (That decision generally rests with the assistance company. If you're getting adequate care abroad, you'll probably remain there.)

The company pays transportation and associated costs; many packages now include limited medical insurance. Similar programs are also available through credit card and traveler's check companies, automobile clubs, and as part of broader travel insurance coverage.

You'll want to compare each company's benefits and arrange coverage well before your trip begins.

Access America, 622 Third Ave., Box 807, New York 10163; (800) 851-2800. Coverage begins at $4.25 a day.

Assist-Card, Suite 703, 347 Fifth Ave., New York 10016; (800) 221-4564. Coverage costs about $4 a day.

Global Assistance Network, 999 Summer St., Stamford, Conn. 06905; (203) 964-9137. Coverage starts at $15 for 14 days.

Health Care Abroad, 923 Investment Building, 1511 K St. N.W., Washington, D.C. 20005; (800) 336-3310. Cost is $3 a day per person, minimum $30.

International SOS Assistance, Box 11568, Philadelphia 19116; (800) 523-8930. Fee begins at $15 for oneto seven days.

NEAR--Nationwide/Worldwide Emergency Ambulance Return, Suite 210, 1900 N. MacArthur Blvd., Oklahoma City, Okla. 73127; (800) 654-6700. A 15-day membership costs $45.

Travel Assistance International, Suite 300, 1333 F St. N.W., Washington, D.C. 20004; (800) 821-2828. One-year membership costs $35, including coverage for one to eight days.

TravMed, Brooks--Shettle Co., Box 10623, Baltimore, Md. 21204; (800) 732-5309. Coverage: $3 a day. Travelers with special medical conditions may want to register with Medic Alert, Box 1009, Turlock, Calif. 95381; (800) 468-1020 in California, (800) 344-3226 outside. A $20 life membership includes a bracelet or necklace identifying allergies or other conditions and a wallet card with medical information and a toll-free number for the Medic Alert central office.

Boning up on heath care abroad

The Traveler's Medical Manual, by Angelo T. Scotti, M.D. (Berkley, New York, 1985; $4.95), gives a partial listing of IAMAT-approved Medical centers and discusses travel-related illnesses.

A similar discussion is found in Traveling Well, by W. Scott Harkonen (Dodd, Mead, New York, 1984; $11.95), along with telephone numbers for consulates.

Peter Manston's Manston's Travel Key Europe (Travel Keys, Sacramento, 1985; $9.95) lists emergency numbers throughout Europe.

More detailed than any of these is Traveling Healthy, by Sheilah M. Hillman and Robert S. Hillman (Penguin Books, New York, 1980), which has extensive descriptions of doctors, hospitals, and emergency services in 23 countries. Though out of print--and by now partly out of date--it's still worth searching for at a library or used book store.
COPYRIGHT 1986 Sunset Publishing Corp.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1986 Gale, Cengage Learning. All rights reserved.

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Date:Feb 1, 1986
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