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Thread: Insurance????

  1. #1
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    Insurance????

    Really boring question but I just wanted to get peoples opinions on the issue of insurance.

    Bit of background me and my girlfriend are leaving in the near future for our pan america ride, starting in Vancouver, Canada. My girlfriend is Canadian, I m British but a Permanent Resident of Canada.

    Can anyone recommend a company that would provide insurance? Or is there anyone rides out of their country without insurance?

    Thanks alot

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    Quote Originally Posted by rockytom View Post
    insurance.
    Health insurance?
    Bike insurance?
    Personal liability insurance?
    Trip insurance?
    Life insurance?

    Me:

    Yes, no, yes, no, yes.

    You are about to leave the civilized world, and once you cross the border on your way south you'll be entering a country that does not provide medical coverage to its citizens. Here's a travel tip - go to any small US town, buy a newspaper, and in the fine print in the back of the local paper, read the legal notices in fine print. There will almost certainly be a section on personal bankruptcies. Those notices will often list the major creditors who have driven the individuals into bankruptcy, and on many of them you'll notice that it's the local hospital or doctor's clinic that is the major creditor of the financially ruined individual. That's because you're entering a country that would rather see its own citizens go broke, or die of preventable diseases, than organize itself to provide comprehensive medical coverage for them. Now, imagine how much this country cares whether you, as a foreigner visiting, has the ability pay for medical coverage (hint - the answer is, not at all).

    So, I'd advise health insurance, at a minimum, unless you have no financial assets you want to protect. Otherwise we're happy to drain every last cent you own in case of accident.

    Welcome to the Third World!
    Last edited by BengeBoy; 10-01-09 at 12:12 PM.

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    (You only need "life insurance" if you have dependents who can't support themselves without your salary.)

    Health insurance could be difficult to use in some countries. You should be clear on what your health insurance covers out of the country. Note that, in some countries, you may have to pay for the health care you receive up-front and get reimbursed by your insurance company later.
    Last edited by njkayaker; 10-01-09 at 12:36 PM.

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    Canadian and recently toured in the US. We bought health insurance through CAA (AAA in America); I'm pretty sure you don't need to be a member to buy it, and you can get it on the spot at any of their travel centres. For a two month trip I think it cost something like $120 total for the two of us; we paid a bit more to get zero deductible, because we figured relatively minor injuries would be most likely.

    We did in fact each have a nasty yet minor injury during the tour that ended up healing fine on their own but could have required medical attention had they been a little worse. I'm glad we had the insurance, because we knew that we could seek help if we needed it.

    I would not recommend riding in the US without health insurance. There is an elevated risk of serious injury on a long bike tour and you do not want to have to deal with the nightmare of being uninsured and in need of care in that country. A hospital stay could bankrupt you.

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    Welcome to the Third World!
    Yadda yadda yadda

    For health insurance, just use the ever dwindeling emergency rooms. Free health care - no questions asked.

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    Quote Originally Posted by dipy911 View Post
    For health insurance, just use the ever dwindeling emergency rooms. Free health care - no questions asked.
    An aggressive small-town hospital will bill you.

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    We've picked up a health insurance policy through IMG for our Pan American journey. The stipulations are that you have to be out of the USA for at least 6 months every year and you canīt pick it up until the day you leave the country. That worked OK for us since I still had our insurance from my work until October and then we had the option for COBRA until January. By then, we were in Mexico and could get the IMG coverage.

    IMG has a lot of options for coverage. We decided to get the $5000 deductible and only use it as a true emergency insurance. Everything else, we cover ourselves. Teh good news is that health care in Latin America isnīt nearly as expensive as in the USA:
    WE DID IT! Our little family of four cycled 17,300 miles from Alaska to Argentina! The trip of a lifetime for sure. www.familyonbikes.org

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    mev
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    My guess is a "health insurance" answer might depend on nationality, i.e. options for getting insurance coverage outside your country will be slightly different for a country like Canada or Netherlands with a national insurance plan than one like the US without one.

    With that said, as a US citizen I've made certain I continued health insurance when traveling overseas. I've had health insurance via my employer and my longest trips overseas were done under a leave of absence from that employer - so I just continued the insurance including paying extra premiums.

    As far as travel insurance goes - on my last long trip across Russia, I did buy a policy because of two reasons (a) it was required for later travels through China I was doing with a group and (b) I wasn't as confident in my insurer's ability to address claims originating overseas. Typically that insurance covers either health issues overseas or evacuation to your home country... so I'd expect if I got anything very expensive they'd choose to evacuate. I haven't had travel insurance on other overseas trips and probably wouldn't get it normally.

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    Quote Originally Posted by rockytom View Post
    Really boring question but I just wanted to get peoples opinions on the issue of insurance.

    Bit of background me and my girlfriend are leaving in the near future for our pan america ride, starting in Vancouver, Canada. My girlfriend is Canadian, I m British but a Permanent Resident of Canada.

    Can anyone recommend a company that would provide insurance? Or is there anyone rides out of their country without insurance?

    Thanks alot
    You want health insurance at a minimum, there are reciprocal agreements between Provinces, I am from Ontario and if travelling in BC I know that OHIP will cover me to the maximum that OHIP pays, which could be different from BC procedure rates, but I doubt that the out of pocket would be much. Even on something serious. However the US has no government health Insurance, so there are not reciprocal agreements in place. Some work plans will cover you out of country, some enhanced credit cards, will also offer out of country medical insurance. CAA is an option, not sure about membership requirements.

    The US president wants to create a government insurance plan, but I am sure that whatever they end up with will be overly expensive, overly complicated and underwhelming it what is actually covered.

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    For Americans, I can also tentatively recommend IMG. I bought a plan that INCLUDED the USA with a $2,000 deductible. I wanted the USA included because I'm from the states and I wanted to be insured if I got injured and needed to return for medical care. Many travel insurances wouldn't cover you the moment you land back at home. So for Americans, that means that you'd also consider paying for local insurance, in addition to travel medical insurance.

    So I bought IMG in January and took off to Asia for a year. About half way through, I was in a taxi that flipped over in India. I broke my collar bone. First I went to a small medical clinic (it was free). Then I flew to Delhi ($260, which IMG just refunded to me four months later - sweet!). I went to a government hospital (free). Then I went to a private hospital (I paid the $14 out of pocket). Then I flew back to the USA because I needed surgery. IMG didn't refund that flight, but covered the $30,000 medical bill. It's been a positive experience. I got to choose a very good doctor and now I'm the proud owner of a large piece of metal and six screws. The only thing that IMG wasn't good for was physical therapy. They only covered $50 a visit. So I had to shell out about $100 per visit of my own money.

    A popular travel medical insurance that doesn't cover the USA is worldnomads.com

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    I'd expect if I got anything very expensive they'd choose to evacuate.
    That's likely not true. An insurance company would likely want to keep their costs down. I know of at least one company that will only evacuate you to the nearest "quality" medical care. They choose the city and hospital. While it's generally ok (big cities like Bangalore) they will likely refuse to evacuate you to the United States because their bill would be much higher if you go there. For more complicated procedures you might end up in Europe but more likely Bangkok or Santiago, etc

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    Quote Originally Posted by norcalhiker View Post
    Then I flew back to the USA because I needed surgery. IMG didn't refund that flight, but covered the $30,000 medical bill.
    Couldn't you get the collarbone repaired in India? Surely they have a few million qualified surgeons there. I bet it would have been much less than 30,000 USD there.

    What did IMG charge for this coverage?

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    Quote Originally Posted by mev View Post
    address claims originating overseas. Typically that insurance covers either health issues overseas or evacuation to your home country... so I'd expect if I got anything very expensive they'd choose to evacuate. I haven't had travel insurance on other overseas trips and probably wouldn't get it normally.
    Two things you need to remember, health care in foreign countries, even poorer countries, can be very good. Expect larger cities to have as good care as you can get in the US, especially hospitals connected to Universities. Also expect that such treatment can be much cheaper then in the US, so an insurance company may very well have you treated where you are.

    Case in point, you require surgery, your in India

    Option 1, you have the surgery in India where it costs $1,000, plus a 14 day hospital stay at $100 per night, and once the doctor clears you for travel it will cost the insurance company $200 to rebook your existing flight. Total cost $2,600.

    Option 2, the insurance company pays $15,000 to emergency fly you to the US, where the same surgery costs $100,000 and the hospital stay $1,500 per night. Total cost: $136,000.

    If you were the insurer, which option would you pick?

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    Quote Originally Posted by dipy911 View Post
    Yadda yadda yadda

    For health insurance, just use the ever dwindeling emergency rooms. Free health care - no questions asked.
    Hospital ER health care is not free. In fact, it's the most expensive route to go for health care.

    Hospitals do bill you. Half their employees perform billing, accounting and customer service. There are hundreds of bill collection agencies in the US that will hound you to collect that money. Obviously you have not visited an ER yourself recently.

    The only way it would be free is if you own no real property, no motor vehicle, and have no employment where your wages can be garnished. If you're homeless, sleeping in a cardboard box or under a bridge, then it is effectively free health care.

    Although ERs aren't free, there are free health clinics in many large cities where you can get limited health care services.

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    Quote Originally Posted by Wogsterca View Post
    you have the surgery in India where it costs $1,000, plus a 14 day hospital stay at $100 per night, and once the doctor clears you for travel it will cost the insurance company $200 to rebook your existing flight. Total cost $2,600
    If you have a $2000 deductible (or more), then it sounds like you're better off skipping the travel insurance policy completely and taking your chances.

    How many times can your taxi rollover in one lifetime?

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    Option 1, you have the surgery in India where it costs $1,000, plus a 14 day hospital stay at $100 per night, and once the doctor clears you for travel it will cost the insurance company $200 to rebook your existing flight. Total cost $2,600.

    Option 2, the insurance company pays $15,000 to emergency fly you to the US, where the same surgery costs $100,000 and the hospital stay $1,500 per night. Total cost: $136,000
    Are those theoretical figures or something based in fact?

    I could definitely have gotten surgery in India. And that was my initial plan. So I went to the "best" government run hospital in New Delhi, than the "best" private "expensive" hospital. The government hospital would have been OK if I had no better options. The private hospital was OK, but by no means as good as the treatment I received in the USA. The doctor, a UK trained senior specialist, misdiagnosed my problem. The hospital was "mostly clean". The surgery was going to be $2500 if I was ok convalescing in a room with 6 other people, or $3500 if I wanted my own room.

    In the end I'm very glad that I came back to the states. It would have been a miserable experience to be alone in a hotel room the day after surgery. Heck it was a miserable few days even being back at home surrounded by family. Then I required months of physical therapy which would have been impossible to obtain while traveling (though I could have spent three months in New Delhi).

    In the future, if I get injured again, I'd get medical treatment on the spot if I needed it. But not if I could avoid it. I wouldn't choose New Delhi for medical care, but I'd be happy to be treated in Bangkok. In six months I saw (as in actually saw, not saw the aftermath) fifteen motor vehicle accidents. Mostly motorcycles. One was a fatality. I was in two accidents, both in India within four days of each other.

    If you have a $2000 deductible (or more), then it sounds like you're better off skipping the travel insurance policy completely and taking your chances.
    I buy insurance to cover worst case scenarios. A $2000 deductible is cheap when medical bills can quickly reach the hundreds of thousands or millions of dollars.

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    Quote Originally Posted by Wogsterca View Post
    Two things you need to remember, health care in foreign countries, even poorer countries, can be very good. Expect larger cities to have as good care as you can get in the US, especially hospitals connected to Universities. Also expect that such treatment can be much cheaper then in the US, so an insurance company may very well have you treated where you are.

    Case in point, you require surgery, your in India

    Option 1, you have the surgery in India where it costs $1,000, plus a 14 day hospital stay at $100 per night, and once the doctor clears you for travel it will cost the insurance company $200 to rebook your existing flight. Total cost $2,600.

    Option 2, the insurance company pays $15,000 to emergency fly you to the US, where the same surgery costs $100,000 and the hospital stay $1,500 per night. Total cost: $136,000.

    If you were the insurer, which option would you pick?
    We're making different assumptions in Option 2. The assumption I made reading the fine print was:

    Option 2, the insurance company pays $15,000 to emergency fly you to the US. Once you land in the US, the clause in the insurance policy kicks in that says, "This policy doesn't cover any costs paid in the US". Cost paid by insurance company $15,000. Cost paid by me $121,000.

    With the numbers given, Option 1 is cheaper in either scenario. However, my original comment was a case where my Option 2 assumptions were lower cost (to the insurance company) than the costs of Option 1.

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    Quote Originally Posted by BengeBoy View Post
    You are about to leave the civilized world, and once you cross the border on your way south you'll be entering a country that does not provide medical coverage to its citizens. Here's a travel tip - go to any small US town, buy a newspaper, and in the fine print in the back of the local paper, read the legal notices in fine print. There will almost certainly be a section on personal bankruptcies. Those notices will often list the major creditors who have driven the individuals into bankruptcy, and on many of them you'll notice that it's the local hospital or doctor's clinic that is the major creditor of the financially ruined individual. That's because you're entering a country that would rather see its own citizens go broke, or die of preventable diseases, than organize itself to provide comprehensive medical coverage for them. Now, imagine how much this country cares whether you, as a foreigner visiting, has the ability pay for medical coverage (hint - the answer is, not at all).

    So, I'd advise health insurance, at a minimum, unless you have no financial assets you want to protect. Otherwise we're happy to drain every last cent you own in case of accident.

    Welcome to the Third World!
    BengeBoy is entitled to his opinion of the US, but it is not a universally held one. Moreover, his attempt to turn a simple question into an incendiary political debate is unnecessary in a civil and helpful bike touring forum such as this.

    When traveling in the US, you would be wise to have some type of health insurance. If you need emergency treatment in the US, you will be treated at any hospital emergency room without regard to your ability to pay. It is true you may be billed for the service, but you will receive any emergency treatment you need on the spot.

    The situation in the US with regard to health insurance is no different than auto insurance if I were driving a car in Canada. I would be expected to provide my own insurance.

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    To me the bottom line is that regardless of the health care system of the country that you visit, common decency should dictate that you make some kind of arrangement that covers health care (unless your country or province has some kind of effective reciprocal agreement). It should not be up to the country you visit to provide you free health care, nor should you effectively stiff them on the bill. Someone has to pay -somewhere.

    I know that most of us cycling folk are in reasonably good health, but emergencies and accidents do arise for anybody of any age at any fitness level (e.g. a car hitting you will not discriminate based on those factors). To not be able to handle medical issues without placing an expensive burden on others isn't acceptable IMHO. And if you can't afford some kind of reasonable coverage, I think serious thought should be given to whether you can afford to go in the first place.

    I might also be wrong, but my understanding of the US is that in any emergency you will (or should) be treated by any hospital -though you will be at least attempted to be billed afterward (unless you are indigent or provide false details, etc). Of course you can skip town, but then someone other than you has to pay the health providers. Who? However, if the health provider then believes you are not in a position to pay (e.g. do not have insurance or adequate insurance) as soon as you are stabilized, you'll most likely be out. If you have any serious disease (e.g. cancer) and are not very wealthy, subject to a charity, or do not have reasonable health care insurance -generally don't expect any treatment unless you're in the terminal stages and collapse. Again, they'll take you in, but as soon as you are stable (or pass away), you're going to be out. Health care is a business based model -not a human service -in the USA. Obviously pros and cons to this approach.



    Quote Originally Posted by xyzzy834 View Post
    BengeBoy is entitled to his opinion of the US, but it is not a universally held one. Moreover, his attempt to turn a simple question into an incendiary political debate is unnecessary in a civil and helpful bike touring forum such as this.

    When traveling in the US, you would be wise to have some type of health insurance. If you need emergency treatment in the US, you will be treated at any hospital emergency room without regard to your ability to pay. It is true you may be billed for the service, but you will receive any emergency treatment you need on the spot.

    The situation in the US with regard to health insurance is no different than auto insurance if I were driving a car in Canada. I would be expected to provide my own insurance.

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    Quote Originally Posted by dipy911 View Post
    Yadda yadda yadda

    For health insurance, just use the ever dwindeling emergency rooms. Free health care - no questions asked.
    That's not cool, this is the reason that when I want to go to the emergency room for a real emergency I have to wait in line for 3 hours and it costs me $8000 for 8 stitches in my hand.

    Thanks for throwing that advice out there......jerk

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    Quote Originally Posted by norcalhiker View Post
    Are those theoretical figures or something based in fact?

    I could definitely have gotten surgery in India. And that was my initial plan. So I went to the "best" government run hospital in New Delhi, than the "best" private "expensive" hospital. The government hospital would have been OK if I had no better options. The private hospital was OK, but by no means as good as the treatment I received in the USA. The doctor, a UK trained senior specialist, misdiagnosed my problem. The hospital was "mostly clean". The surgery was going to be $2500 if I was ok convalescing in a room with 6 other people, or $3500 if I wanted my own room.

    In the end I'm very glad that I came back to the states. It would have been a miserable experience to be alone in a hotel room the day after surgery. Heck it was a miserable few days even being back at home surrounded by family. Then I required months of physical therapy which would have been impossible to obtain while traveling (though I could have spent three months in New Delhi).

    In the future, if I get injured again, I'd get medical treatment on the spot if I needed it. But not if I could avoid it. I wouldn't choose New Delhi for medical care, but I'd be happy to be treated in Bangkok. In six months I saw (as in actually saw, not saw the aftermath) fifteen motor vehicle accidents. Mostly motorcycles. One was a fatality. I was in two accidents, both in India within four days of each other.



    I buy insurance to cover worst case scenarios. A $2000 deductible is cheap when medical bills can quickly reach the hundreds of thousands or millions of dollars.
    The figures are theoretical. We all know that the US has the gold standard in health care, and Americans pay for that privilege. There are many places that are extremely good, Canada is one, most of Western Europe including the UK is also pretty good, although many, including Canada have two tariff levels, one that is covered by domestic health insurance and another, higher rate for foreign travellers. Some places though where you would expect it to be horrible, isn't, my wife was treated in Bolivia for something, I forget what now, and found the care pretty good.

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    norcalhiker - good to hear IMG was good for you. We've never had to use it, and haven't heard from anyone who has, so we had no idea if they were good or not! We send in our premiums every year and go from there. I also agree on paying for the coverage in the USA. If we need to return home, I want to be covered!
    WE DID IT! Our little family of four cycled 17,300 miles from Alaska to Argentina! The trip of a lifetime for sure. www.familyonbikes.org

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    Quote Originally Posted by xyzzy834 View Post
    BengeBoy is entitled to his opinion of the US, but it is not a universally held one. Moreover, his attempt to turn a simple question into an incendiary political debate is unnecessary in a civil and helpful bike touring forum such as this.
    I'm happy I'm still entitled to an opinion; I wish I also were entitled to comprehensive medical coverage.

    Sorry, I really did not mean to turn this into P&R. Just troubled by some situations close to my own experience; it really is sad to see people who go sick or become impoverished because of their health situation.

    Excuse me while I go write another check to my health care provider...

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    We don't need to go into the relative merits of health care in different nations to answer the OPs question.

    Theft of a bike and gear will probably be covered under your renters or homeowners insurance as will Personal Liability. If you have car insurance this may also provide some coverage if have an accident while bicycling.

    So before you leave check with your insurance companies about what the will cover while you're in the US.

    As for health insurance the OP and his girlfriend are both covered under the Canadian system. The fact that he is a UK citizen isn't relevant because he's not resident in the UK he isn't covered under the NHS. The Canadian system might pay for some US health care costs up to the rate that's charged in Canada, but over that they won't. So its important to buy supplementary insurance to cover the excess charges and things like if you have to be flown home on a plane to a Canadian hospital. Take your Canadian health card with you and be prepared for lots of paper work if you do fall ill.

    The European Union has this well sorted out. If you are a resident and travel within the EU you just take your EHIC (European Health Insurance Card) with you and this gives access to health care in whatever country you're visiting just as if you lived there. In the UK there'd be no out of pocket charge, in France you'd pay the small co-pays just like a French citizen etc.......

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    Quote Originally Posted by nun View Post
    We don't need to go into the relative merits of health care in different nations to answer the OPs question.

    Theft of a bike and gear will probably be covered under your renters or homeowners insurance as will Personal Liability. If you have car insurance this may also provide some coverage if have an accident while bicycling.

    So before you leave check with your insurance companies about what the will cover while you're in the US.

    As for health insurance the OP and his girlfriend are both covered under the Canadian system. The fact that he is a UK citizen isn't relevant because he's not resident in the UK he isn't covered under the NHS. The Canadian system might pay for some US health care costs up to the rate that's charged in Canada, but over that they won't. So its important to buy supplementary insurance to cover the excess charges and things like if you have to be flown home on a plane to a Canadian hospital. Take your Canadian health card with you and be prepared for lots of paper work if you do fall ill.

    The European Union has this well sorted out. If you are a resident and travel within the EU you just take your EHIC (European Health Insurance Card) with you and this gives access to health care in whatever country you're visiting just as if you lived there. In the UK there'd be no out of pocket charge, in France you'd pay the small co-pays just like a French citizen etc.......
    The Canadian system is a funny one, and this is actually important, while all provinces have something, the plan is administered by the Province, there are agreements in place that if your ill or injured in Quebec, but your from Saskatchewan, then the Saskatchewan plan pays, according to it's rate chart. So if a specific treatment is $200 in Quebec, but Saskatchewan's plan pays only $175, you're responsible for the difference. Now you can buy supplemental insurance that would cover the difference, it's usually not expensive, in that the differences are usually quite small. Now if you needed an expensive treatment, like orthopaedic surgery for a broken collarbone, it could get large enough to be something that you might want coverage for.

    Whether the plan pays for out of country or not, some will, some will not, and you may need to pay up front and be reimbursed later. Best is to call the provincial health plan and ask them. Typically if travelling in the US, you want coverage, because the cost of even a relatively minor treatment could be enough to zap the finances you have available for your trip. If you budget $100 a day for your 14 day tour, and fall ill, an overnight at a hospital can kill your whole trip budget. I've used the CAA insurance, and it worked well the time we needed to use it. A couple of other places to check, if your employer covers out of country travel, some do, some only cover travel on company business, some cover nothing. The company that provides your employers coverage may also have plans available for travel you can buy.

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