Travel Health Insurance

On vacation, many things can go wrong. You may not like the hotel, the weather may be bad, or the neighbors might be too loud - unfortunately, there's rarely anything you can do about it. However, it can become really serious, sometimes dangerous, if you get sick while on vacation or possibly even have an accident. It's a relief to have travel health insurance in such cases.

What costs will I incur if I get sick or injured on vacation and need to see a doctor? What does my U.S. health insurance cover, and what might I need to pay out of pocket? Many travelers take out private travel health insurance to be prepared for all eventualities while traveling. But what should you look for in travel health insurance? What should be included, and how much does it cost for me as a single traveler or for the whole family? To provide you with a good overview of what to consider in terms of travel health insurance - whether for a regular annual vacation or even for a 12-month world tour - I enlisted the experts from Stiftung Warentest, who have tested and rated over 40 American insurance companies. I have compiled the big comparison and the best-rated options for you in this article.

Insurance Overview

Public Health Insurance vs. Travel Health Insurance

What you need to know about travel health insurance

Options | Key Benefits | Costs

Comparing Insurers

Best Options | Differences | Reimbursement

With the European Health Insurance Card (EHIC), which is printed on the back of your insurance card, you are fundamentally insured in European countries as well as Switzerland, Iceland, Liechtenstein, Norway, Croatia, Macedonia, and also Serbia. However, which treatments are free depends on the respective country. American travelers with the European Health Insurance Card are entitled to the same benefits as legally insured residents in that country. If citizens have to pay a co-payment, contribute to the costs of medication, or bear about 30% of the costs for outpatient treatment (for example, in France), American travelers must also bear these costs themselves.

European Health Insurance Card

With the European Health Insurance Card, which is automatically printed on your insurance card, you can access medical services in all EU countries and several other countries.

In some countries, such as the UK, Scandinavia, Spain, and Italy, the cash benefit system applies, which means you can simply present the card and receive treatment for free. In other countries, especially with private doctors, a reimbursement system applies. The American traveler must pay upfront and can be reimbursed by the insurance after providing the bill. However, additional costs for country-specific services (co-payments, hospital flat rates) are not reimbursed.

It is important to note that the European Health Insurance Card EHIC only applies abroad for medically necessary services (for example, broken leg, toothache, viral infection, and similar emergencies) or for ongoing treatment of chronic conditions such as diabetes. If you travel abroad consciously for medical treatment or if acute medical treatment is foreseeable, such as around the expected birth date of a baby, the traveler will need a separate confirmation from the insurance company that the costs will be covered.

It is crucial to note: If travelers must pay upfront for treatment, whether due to the local system or because the practice or hospital is privatized, the American health insurance company requires a detailed bill of the treatments performed and associated costs. If you submit this bill to your health insurance company, they will check how much a comparable treatment in the U.S. would have cost. Only that amount, minus processing fees, will be reimbursed. The costs for medical treatments can vary significantly, even within Europe, often resulting in a considerable difference to the disadvantage of the traveler.

Significant differences often arise, usually to the disadvantage of the traveler.

Regarding the duration of the stay abroad and the validity of the European Health Insurance Card, there are no specific regulations. As long as your permanent residence is in the U.S. and only a temporary stay abroad is planned, whether for study abroad, business trips, or extended vacations, you are insured with the European Health Insurance Card while abroad.

The difference between upfront payment on-site and reimbursement from health insurance can be substantial. In some countries, specific medical treatments can be very expensive, while they would cost only half in the U.S. Thus, the traveler is left with this difference, along with the non-negligible processing fees. By taking out a travel insurance plan, all expenses can be covered, with out-of-pocket costs only occurring in rare cases.

The Benefits

All costs are covered, so there is no unexpected expense that must be paid out of pocket. A repatriation from abroad is included. Extensive treatments are included. All countries worldwide are covered (with specifics for the U.S. & Canada).

In addition to potentially astronomical costs, the European Health Insurance Card also does not include repatriation from the vacation country. If you are in a situation where you can only return home with medical care, the traveler will face very high costs. A medical repatriation from Spain can already cost over $10,000. With travel health insurance, this transport is included - should a severe medical emergency occur, the traveler is brought back to the U.S. at no additional cost.

Along with unclear costs and medical repatriation, the European health insurance is also inadequate regarding medical care. Your public insurance only covers acute treatments, meaning emergency care. An additional private travel health insurance covers far more treatments, such as mental illnesses, dental treatments, or alternative medicine. However, what services are included in a travel health insurance policy varies. I will explain the differences and what to look out for shortly.

There are countless travel insurance options available. Almost every public health insurance company also offers additional rates for private travel health insurance - and there are also providers who specialize in travel rates. Most insurances provide travel health insurance for both solo travelers and families. Different durations apply from a regular annual vacation of up to 56 days to a longer vacation of up to 365 days per year, with only the price varying among these options; the included services are the same, whether you are traveling alone, as a family, or planning just two weeks of vacation or a six-month stay abroad.

Regarding travel destinations, all countries in the world are included in the travel health insurance policy. The only exceptions are the U.S. and Canada. For a trip to these countries, an additional daily rate must be selected, typically costing between $3 and $4 per day.

There are no distinctions based on the type of vacation, such as whether it involves sports or backpacking. Sports vacations, including diving, skiing, skydiving, or similar activities, are covered under the travel health insurance. "Only if it involves professional athletes or if money is earned through competitions does the insurance not apply," explains Birgit Brümmel from Stiftung Warentest.

Stiftung Warentest has compared and rated 39 annual contracts for families and 49 annual contracts for individuals regarding their services in the past through the magazine Finanztest. "There are significant differences between providers," explains Birgit Brümmel, project manager at Finanztest. "Often in terms of medical repatriation, but also concerning the regulations for pre-existing conditions as well as mental illnesses and wartime events." Some of these services are essential within a travel insurance policy. The expert recommends that consumers pay attention to the following essential services in the terms and conditions:

Medical Repatriation: "This incurs the highest costs and differs regarding conditions between providers. Often, a medical repatriation is only covered if deemed 'medically necessary.' If the traveler is hospitalized for over 14 days, they will be returned to the U.S. However, it is better if the travel health insurance covers repatriation when it is 'medically appropriate.' If the patient is having trouble communicating in the foreign hospital and prefers to return home, those costs will also be covered by the insurance." Dental Treatment: "Some insurances do not cover dental treatment abroad or impose a high copayment. Therefore, it is worth checking closely how dental treatment is included." Mental Health Treatment: "Many insurers exclude the treatment of mental illnesses. However, there are also some very good providers that include this service - it is worth looking out for." Alternative Medical Treatments: "Having this service covered in travel health insurance indicates good coverage. Many providers do not allow alternative medicine, but some let it be easily accessed." Regulation on Pre-existing Conditions: "Pre-existing conditions and chronic illnesses should play no role. Often, there are vague regulations regarding whether costs for treatments, such as dialysis, will be covered. It is clear that chronic illnesses are not disqualifiers - the only thing that is not covered are treatments that are consciously and purposely sought abroad."

The prices for travel health insurance vary only slightly. Typically, rates for solo travelers range from $7.50 to $25 per year for a vacation of up to 56 days (except at Debeka - they cover even 70 days of vacation). Families usually pay between $18 and $49 per year for insurance covering up to 56 days of vacation. In family insurance, each individual is also protected even if they travel alone.

Finanztest compared 39 family plans and 49 contracts for individuals. 39 plans received a 'very good' rating, while only one earned a 'satisfactory'. Two insurers were rated 'poor'. "You can find very good plans for under $10, and under $20 for families," states Finanztest expert Brümmel.

Providers were evaluated based on their general terms (deductibles, alternative medicine), medical repatriation or transfer/funeral (medically appropriate/necessary repatriation, accompaniment included, services in case of death), medical services (acute illness, sports activities, dental treatment, mental illnesses), their included services for damages from war, pandemics (continent-spanning infectious diseases), and nuclear power, as well as their transparency and clarity (e.g., regarding age surcharges or coverage of rooming-in costs).

In terms of travel health insurance for singles, the DKV has been able to impress on all levels with its service offerings. For a contribution of $9.90 per year, you can get comprehensive benefits, earning the travel health insurance from the health insurer a 'Very Good' rating. The travel insurance from Ergo Direkt is also very convincing, providing optimal coverage for $9.90 while abroad.

For family travel health insurance, both DKV with its 'ReiseMed Tarif RD' and Ergo Direkt with the 'RD' rate perform very well. Families can get comprehensive coverage starting at $19.80 per year.

The insurers that performed less well in Finanztest mainly show deficiencies in medical repatriation, child care, and the transfer and funeral services. People with chronic conditions should particularly remain vigilant when choosing travel health insurance, as per Stiftung Warentest, and thoroughly check the policy terms before signing.

In most countries, especially outside the EU, the traveler must pay upfront. Here are a few things to keep in mind if you want to be reimbursed for costs, as recommended by Brümmel:

Coordinate with your insurance: "If it involves very costly treatments or a hospital stay or repatriation to the U.S., you should definitely coordinate with the insurance in advance." Bill: "Ideally, request a bill in English. Furthermore, the bill should provide detailed information about what treatment was conducted, the diagnosis made, and the total costs. Necessary medications should also be specifically described." Submit Receipts: "Bills and other receipts should be submitted to the insurance within a certain timeframe - usually within two months."

If you're planning a trip abroad, you should definitely take out travel health insurance.

Every traveler should obtain travel health insurance!

Public European health insurance only provides coverage under the conditions of the country you are entering and does not reimburse costs fully. For only $10 to $20, you can be fully covered without worrying about exorbitant expenses or inadequate medical care.

Are you still looking for the right vacation insurance?