International Health Insurance Plans seem to be divided into four types:
1) Individual Health Insurance Plans Based in the U.S.
These are not designed for extended international travel. Basically, you must keep a "permanent" U.S. address since your premium is based on the state you live in, and not tip them off to how long you've actually been out of the country. Some of them will only reimburse for treatment of "life-threatening" illnesses or injuries that occur overseas. Some will cover "emergency" treatment overseas, which may or may not be clearly defined in the policies.2) "Trip Insurance" or "Short-Term Travel Medical Insurance"
It's often difficult to find a plan that will cover you for more than 180 days. Sometimes they are renewable, sometimes not. These plans work better as a supplement to major medical health insurance plans. They are not really designed as primary medical plans. If you're on a tight budget, this can be a cheap way to get some coverage. They often have limits on medical benefits. Other benefits include trip interruption/cancellation coverage (good if you've prepaid a lot of money for air tickets), baggage loss coverage (good if you have expensive gear), and emergency medical evacuation (always good to have).3) Long-term International Health Insurance without Coverage in Your Home Country
Designed for trips, but do not offer much coverage (if any) once you've returned to your home country. These aren't too bad, unless you contract some awful, protracted illness abroad that requires a longer course of treatment once you return (e.g., heart disease, cancer, diabetes, or HIV, which is a whole other kettle of fish, often excluded from coverage). These plans sometimes have "home country" clauses or riders that provide limited treatment upon return to your home country (e.g. if you return home and then leave again). The amount of coverage in your home country depends on how long you took the policy for. For instance, if you've been gone six months, you may get two weeks of coverage upon your return, during which time you must shop like mad for a policy in your own country. Basically, these plans drop you like a hot potato once you return to the U.S. These may be favored by expats who may want to fly into the U.S. for surgery.4) Long-term International Health Insurance with Coverage in Your Home Country
I only found two plans that do this. One is offered by International Medical Group (SIRIUS International, a Swedish company with offices in Europe and Singapore), and the other is Premier One, a plan offered by International Health Insurance, a Danish company. The first one, IMG, keeps your policy going upon your return to your home country for the duration of the policy. A PPO network can be used (or not) in the US, which accepts co-pays. The second one, IHI, is renewable indefinately, but is not affiliated with a PPO network. The advantage is that hospital pre-certifications are not required. Both plans include air ambulance benefits.
"Travel health insurance is prohibitively expensive for long (more than a month or so) trips. Keep coverage in your home country for catastrophic illness and self-insure for any treatment you need while travelling; such treatment is available locally and is usually cheap; if you need major treatment you will probably want to come home)." <Edward Hasbrouck>
"My experience was the same, and I suggest you keep your existing policy, or obtain a new one, but raise the deductible into the $2000 to $6000 range. The treatment in most Third World countries is very basic and inexpensive. Buy medical evacuation insurance to get you back home, unless you can afford $20,000 or more up front." <Marc>
"In Australia, I pay AUS $700 for one year's good travel insurance (that's about $2 a day). Australian domestic insurance is not valid overseas and you are running appreciable risks to travel without some insurance." <Bernd Wechner>
"If you are evacuated to your home, you must still pay for your medical care. It's important to make sure that your medical insurance will pay for accidents and illness incurred outside its coverage area. Most do, but lots of hassle could be avoided by: checking with them, getting the phone/address/e-mail necessary to notify them, and try in advance to get the paperwork they would require." <Scott Soper>
"There are different levels of coverage, and different rates based on parts of the world covered, length of trip, participation in high risk sports etc. It is often best to buy coverage from whoever you get your ticket with rather than separately -- don't no why." <Chris Finlayson>
"Considerations when economizing on insurance: (1) Be honest about high-risk sports. You will pay more, but if you need it you will really need it. (2) Look at what you are getting, especially in terms of if you need to fly home through illness, is your partner's return covered too; is your health covered under only restrictive conditions; what level of insurance is there against stolen cash, belongings etc. -- what is the excess. Is replacement of documents (e.g. passport and visas) covered? (3) How long will it take to process a claim? (4) Will you be able to extend/alter/replace/renew this policy from abroad if the need arises? (5) Read the fine print!" <Chris Finlayson>
"Read the fine print. I cannot believe the number of people I meet that do not. Just take a short look at all the exclusions before you start feeling comfortable." <Bernd Wechner>
"Trip cancellation and interruption insurance does not depend on the time duration of the trip, only the cost of your tickets; it will cover the cost of tickets home if you need to come home." <Edward Hasbrouck>
"If you are using an RTW ticket, it is useful to understand clearly if it is good for an early return, and especially if there are frequent flights available on which it can be used." <Larry Cotter>
If you have health insurance with your current employer and you will not be able to obtain a leave-of-absence, you usually have the option of continuing the same coverage under the COBRA plan in the US. COBRA seems to be a term for "continuing insurance", not a specific insurance company. It is available for the first 18 months after you quit working, and covers overseas claims, such as hospitalization, etc., as long as you have the receipts. Normal, independent insurance policies are usually more expensive then than COBRA. Medicare does not provide overseas coverage, but many MediGap policies do. Start the paperwork far in advance, as there can be many delays.
On a grim note: some of these insurances will coordinate and pay for the return of your remains should you die overseas.
For some more tips about travel insurance, have a look at Travel In Uncertain Times
1 Cover Travel Insurance Australia
Suite 205, 147 King Street, Sydney 2000
Tel: 1300 368 344Cover-More Insurance Services
Lvl 3/60 Miller St, North Sydney, NSW Australia 2059
Tel: 13 23 03, fax 02 9202 8003Defence Health
Level 2, 344 St Kilda Rd, Melbourne Victoria 3004
Tel: 800-335-425, fax 03-9291-1050HBF Travel Insurance Australia
125 Murray Street, Perth WA 6000
Tel: 133-423, or 08-9265-6111STA Travel
Student Travel AustralasiaTravel Insurance Cover
PO Box 1435, Crows Nest NSW 1585
Tel: 02-9460-3812, fax 03-9423-6968World Nomads
1306 World Tower, Sydney
Tel: 2 8263 0422Worldcare Travel Insurance
Worldcare House, PO Box 102
Toowong 4066, Queensland
7 3360 0360 (24 hours)
TFG Global Travel Insurance
#216 - 2438 Marine Drive, West Vancouver, BC, V7V 1L2, Canada
800-232-9415, 604-913-1150, fax 604-913-1153
1 Stop Travel Insurance
Crowley House, Bentalls, Basildon, Essex, SS14 3BY
Tel: 0870 152 5840, fax 0870 240 0304British Mountaineering Council
Churchill
Churchill Court, Westmoreland Road, Bromley BR1 1DP
Tel: 0800 085 2436, 020 8313 3030Columbus Direct Travel Insurance
17 Devonshire Square. London EC2M 4SQ, UK
Tel: 0845 330 8518Endsleigh
97-107 Southampton Row, London WC1B 4AG, UK
+44-171-375-0011
Sold through youth-travel specialists, or direct from their office.Essential Travel Ltd
Princess Caroline House. 1, The High Street, Southend-on-Sea, SS1 1JE
Tel: 0870 343 0024, fax: 0871 750 1653Go Walkabout
10 London Road Bexhill-on-Sea East Sussex, TN39 3JU
Tel: 0845 345 0327, +44 1424 223964HealthCare International
84 Brook Street, London W1K 5EH, UK
Tel: +44 (0)20 7529 1618, fax +44 (0)20 7491 8818Insure & Go Travel Insurance
Warners Mill, Silks Way, Braintree, Essex CM7 3GB, UK
Tel: 0870 9013674JS Travel Insurance
14-18 Heddon Street, London W1B 4DA, UK
Tel: 0870 755 6101Navigator Travel Insurance
19 Ralli Courts, West Riverside, Manchester, M3 5FT, UK
Tel: 0870 241 0576 National Rate Call, or 0161 973 6435, fax 0161 973 6418Round the World Insurance
61 Western Road, Hove, East Sussex, BN3 1JD, UK
Tel: 0870 429 4225. Overseas 00 44 1273 718 025. Fax 0870 429 4226Travel Insurance Direct
Rowan House, 226 Unthank Road, Norwich, Norfolk, NR2 2AH, UK
Tel: +44 (0) 1603 464123; Fax: +44 (0) 1603 464124William Russell Limited
Suite 201, The Mayford Centre, Smarts Heath Road, Woking, Surrey GU22 0PP, UK
+44-1483-772-245, fax: +44-1483-747-553Worldwide Travel Insurance Services Ltd
Business Centre, 1-7 Commercial Road, Paddock Wood, Tonbridge, Kent TN12 6YT, UK
+44-1892-833-338, fax: +44-1892-837-744
Allianz Global Assistance
P.O. Box 71533, Richmond, VA 23286-4684
866-884-3556, 800-346-9265, 804-673-1469
AIG Assist, American International Group
New York, NY
800-382-6986American Automobile Association (AAA)
"AAA's PLUS emergency road service will bring you back from anywhere in the world and provides other travel insurance coverage for car related travel in North America, including Mexico for about $30 more a year than regular emergency road service, which makes it a no brainer. free maps, no-fee travelers checks, and they issue international drivers licenses too." <Scott Soper>ASA, Inc.
International Health Insurance
PO Box 93100, Phoenix, AZ 85070-3100
888-272-8288Associated Insurance Plans International
1301 S. Wolf Rd. Ste. 403, Prospect Heights, IL 60070
800-452-5772Betins
PO Box 110998, Tacoma WA 98411-0998
Toll free 866-552-8834. Phone 253-238-6374. Fax 253-238-6382CSA Travel Insurance
PO Box 939057 San Diego, CA 92193-9057
800-234-0375, 800-873-9855, fax 800-336-6409Carefree Travel Insurance
The Berekeley Group, PO Box 247, Providence, RI, 02901-0247
800-323-3149, 800-645-2424, 516-294-0220DAN - Divers Alert Network
6 West Colony Place, Durham, NC 27705
800-446-2671, 919-684-2948 x333, fax 919-490-6630Diver Security Insurance
800-288-4810eGlobal Health Insurers
5489 S. Westwood Ave, Springfield, Missouri 65810
417-882-1413, fax 417-459-4623Europ Assistance USA
1825 K Street NW, Suite 1000, Washington, DC 20006
800-777-8710, 800-821-2828, 202-331-1609, 202-347-7113, fax 202-331-1528UnitedHealthcare Global TravMed
8501 LaSalle Road, Ste. 200, Towson, MD 21286
PO Box 5375, 19056, Baltimore, MD 21284
800-732-5309, 800-937-1387, 410-453-6300, fax 410-453-6301Geico Overseas Insurance
For expats.Tokio Marine HCC Medical Insurance Servise / MultiNational Underwriters
107 S. Pennsylvania St, Suite 500, Indianapolis, IN 46204
800-605-2282, 317-262-2132, fax 317-262-2140Highway to Health
P.O. Box 8181, Radnor, PA 19087-8181
888-243-2358, 610-293-2062, fax 610-293-3529Insurance Consultants International
17101 Kuykendahl Rd. Suite 130, Houston, TX 77068
800-576-2674, 281-587-9884Insurance Services of America
International Travel and Visitors Health Insurance
PO Box 1617, Chandler, AZ 85244-1617
800-647-4589, 480-821-9052, fax 480-821-9297International Association for Medical Assistance to Travellers (IAMAT)
International Medical Group
2960 N. Meridian St, Indianapolis, IN 46208
866-368-3724, 800-628-4664, 317-655-4500, fax 317-655-4505Petersen International Underwriters
23929 Valencia Boulevard, Suite 215, Valencia, CA 91355
800-345-8816, 661-254-0006, fax 661-254-0604Quote Wright
329 Long Hill St, PO Box 280764, East Hartford, CT 06128-0764
800-821-4940, 860-289-3602, fax 860-282-6158Seven Corners
303 Congressional Blvd, Carmel, IN 46032
800-335-0611, 317-575-2652STA
Student Travel Australasia
For students, teachers, and youths. Offices worldwide.
In the US: 800-781-4040, 800-777-0112, 212-661-1414.TFG Global Travel Insurance
#216 - 2438 Marine Drive, West Vancouver, BC, V7V 1L2, Canada
800-232-9415, 604-913-1150, fax 604-913-1153Travel Assistance International
P.O. Box 668, Millersville, MD 21108
9200 Keystone Crossing Ste. 300, Indianapolis, IN 46240
800-821-2828Travel Care International
PO Box 846, Eagle River, WI 54521
800-524-7633, 715-479-8881Travel Guard / Chartis
1145 Clark St, Stevens Point, WI 54481-2980
800-826-4919, 800-826-1300, 888-409-7750, 800-826-5850, 715-345-0505, fax 800-955-8785Travel Insured International (Travel Pak)
52-S Oakland Ave, PO Box 280568, East Hartford, CT 06128-0568
800-243-3174, 860-528-7663.Travel Insurance Services / USI Affinity
2950 Camino Diablo, Walnut Creek, CA 94597-3991
800-937-1387, 925-932-1387, fax 925-932-0442Travelex Insurance Services
PO Box 641070, Omaha, NE 68164-7070
888-457-4602, fax Number: 800-867-9531Travellers Emergency Network (TEN)
800-275-4836TravelSafe Insurance
P.O. Box 7050, 40 Commerce Dr, Wyomissing, PA 19610
(888) 885-7233, fax (610) 678-1238Wallach & Co, Health Care Abroad/Health Care Global
107 W Federal St, PO Box 480, Middleburg, VA 22117-0480
800-237-6615, 703-687-3166, 540-687-3166, 540-281-9500, fax 540-687-3172
[I would greatly appreciate hearing about your experiences with insurance companies, such as reputation, reliability, and pricing - Marc]For a list of Air Ambulance/Med-Evac Companies, visit the US State Departments: Medical Information for Americans Traveling Abroad.