Travel RX - Medical Emergencies Abroad

I recently helped a friend plan the trip of her lifetime - a four day visit to Rome followed by a Mediterranean cruise. Mary and her husband had never traveled to Europe before.  It goes without saying she was quite excited for their adventure.  Sadly, on the same day they arrived in Rome, she fell and badly injured her ankle, winding up in a Roman emergency room. This is not how she had hoped to spend her dream vacation.  Without going into a lot of detail, I give Mary a lot of credit - she toughed it out and obtained a wheelchair to use for her remaining days in Rome and on the cruise, so while her trip wasn't quite what she dreamed of, it was not ruined altogether. As difficult as the situation was, it might have been worse. Would you be prepared if you had a medical emergency while traveling abroad?
 
 
Most health insurers - including Medicare - will not cover any costs outside of the United States.  Before you go abroad, verify what your policy covers, if anything.  In some countries, payment is required up front, often before any treatment is given. If you don't have adequate coverage, you may be on the hook to pay before you are treated.  For a few dollars a day, you can purchase a secondary policy that will cover the cost of  any medical emergencies that your primary medical insurance doesn't cover while you are out of the country.  Insuremytrip.com allows you to compare policies, but both Travelex and Travel Guard are well respected. Keep in mind, some travel medical insurers reimburse the medical facility directly while others reimburse you only after you file a claim. As you may need to pay the provider upfront, always make sure you have a credit card with a high credit limit available while traveling abroad.  Additionally, most policies provide 24 hour hotlines to help you find the best doctors or hospitals in an emergency (American Express' Global Assist provides this service for their cardholders, as well).
 
Another consideration is the possibility of the need for medical evacuation which can cost up to $100,000. Some medical travel policies include transfer to the nearest adequate facility, so if you are in India, for example, they will fly you to Singapore, not New York.  Additionally, it is up to the insurance company to decide whether or not you need to be evacuated. You may want to consider a membership in Medjet Assist ($195/year for travelers under 75) - they will fly you via air ambulance to any medical facility you choose.  The evacuation policy from Medex will make sure you are flown home as soon as you are stabilized either via air ambulance or an upgrade to business class if your condition puts you at a risk for medical complications (such as deep vein thrombosis or blood clots).
 
Finally, before you travel to a foreign country, bookmark your smartphone or laptop with this site from the US State Department with helpful information in case of a medical emergency abroad, including lists of hospitals and doctors abroad, and a list of Med-Evac companies.  In case of any emergency abroad, you can also contact your local embassy or consulate for assistance.