Will Travel Medical Insurance Become Mandatory?

With Americans being told that health insurance will become mandatory, will visitors also be required to have travel medical insurance?

It would seem only logical to make the same requirement apply to visitors to protect hospitals and doctors from foreigners getting medical services, then skipping out without paying.  First of all, understand that if health insurance ever becomes mandatory for US citizens—which is still a long shot—it will be years before that happens, and it is not likely to become mandatory for visitors to America in the foreseeable future.

That’s from a legalistic point of view.  From a practical one, anyone who travels to the US without supplementary health insurance specifically designed to cover emergency hospital and doctor services is either witless, negligent, or extremely rich. That stands for travellers to most other countries, too.

There are, however, some exceptions, and you need to be aware of them. Cuba recently announced it will require mandatory health insurance from “approved” vendors beginning May 1, 2010.  (See my earlier post on this issue here.)

For most countries in Europe, the rest of the Americas, and most of Asia and Africa, or places where Americans and Canadians do not require visas, travel insurance is not mandatory—but again, if you don’t have it, you are at exceedingly high risk.

If you are moving to Europe as a student or worker or some classification other than a tourist, you may need a visa and very likely proof of some acceptable form of health insurance. Right now, most provincial health coverage available to Canadians would not meet those requirements as out-of-country reimbursement levels are far too low. In any case, if you move out of your province for more than half a year, you lose that coverage anyway.

Foreign travel options in American private insurance plans might offer some coverage if you are a short-term tourist. But these would not be valid if you are leaving the country for long periods. So you might need to get student or expatriate insurance.

Europeans take the need for supplementary insurance outside of the European Union for granted. It’s routine for them to get it. Many tour firms make it mandatory. They don’t want to be stuck with one of their clients racking up huge medical bills in a foreign country—and perhaps holding up the travel plans of other co-travellers.

Similarly, most cruise ship companies booking in Europe will require passengers to buy their in-house travel insurance (which is quite expensive) or have proof of other insurance that meets certain high coverage levels. Usually you are better off finding your own insurance independent of the cruise companies: it’s cheaper and better. Cruise companies booking out of US or Canadian ports usually do not impose those same requirements, although they will try to sell you their in-house insurance. Don’t bite.

Most countries going after tourist dollars—and which aren’t?—must weigh the advantages of requiring insurance on the one hand against the disadvantage of making travel to their country more expensive. Right now most would rather have the tourists. But if enough countries, such as Cuba, find that imposing mandatory insurance requirements doesn’t make much of a dent in their tourism numbers, you can expect to see a rapid shift toward international implementation.

So from now on, if you’re travelling anywhere, make sure you know what the travel insurance rules are in the countries you are planning to visit.  And if you need insurance, start your shopping with travel insurance specialists at home. It will likely be cheaper, and the coverage will be tailored to your own domestic needs and existing insurance.

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