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It’s officially Wave Season, the cruise industry’s top period for cruise promotions and deals. From January to March and April, cruise lines are busy drumming up new bookings with incentives and flashy extras. But if you’re planning a cruise, you should first ask yourself if you’re going to buy travel insurance.

As always, it’s a matter of risk. If something goes awry, are you willing to risk your vacation and, more importantly, your finances? It’s always a deeply personal choice, but here are 14 factors to consider.

Remember That Life Happens

The unexpected can happen, and often does — even months before the traveler leaves home.

In spring 2007, Michelle Hart-Henry of Wilmington, Delaware, booked an early 2008 southern Caribbean voyage through Liberty Travel. But fate took a cruel turn. “I found out in December 2007 that I had breast cancer,” Hart-Henry said. “I had hoped that we could still take the trip between my surgery and starting chemotherapy.”

But her doctors said, “No way,” so reluctantly, she cancelled the cruise. Because she’d purchased travel insurance, her doctors filled out paperwork attesting to her health issues. “I was interviewed by a claims investigator, it all went smoothly, and we were paid $7,500 on our claim,” Hart-Henry said.

Cruisers might also need to cancel their vacation precruise if they’ve been let go from work, a child or spouse is ill, the boss suddenly decides it’s a critical work period, a parent is hospitalized or even if the school year is extended due to excess snow days.

There May Be Medical Issues

Allianz Global Assistance reported that 53% of all cruise-related “billing reasons” for claims are because of illness for the insured person, while 14% are for an injury. Another 8% are for the illness of a family member, 4% for the death of a family member and 4% for the illness of a traveling companion, among other reasons.

(Photo by Rawpixel via Unsplash)
About 14% of cruise-related insurance claims are due to injury. (Photo by Rawpixel via Unsplash)

With illness and injury claims, often the insured person is already happily enjoying the cruise, so it’s a bummer. Even well-traveled road warriors aren’t immune. A few years ago, Howard Blount of Plant City, Florida, who runs the Backroad Planet travel website, purchased Travel Guard travel insurance through World Nomads for a Viking River Cruise.

During his first day, he was eyeballing historic windmills at Kinderdijk, in the Netherlands. “Suddenly, [I] saw black spots in my right eye, and a gray veil started rising in my field of vision,” Blount said. The Viking concierge immediately made eye doctor appointments for Blount the following day at the next port of call.

The diagnosis? “The retina in my right eye had detached, torn and would require surgery to repair the injury,” Blount said. He opted for an immediate flight home because retina surgery would limit his ability to fly for weeks afterward. Travel Guard booked business-class flights for Blount and his travel companion so that he could remain in a prone position. He later received reimbursement for his claim.

Accidents, too, can happen anytime, anywhere. “People often take risks during vacation that they might not take back home, whether riding a jet ski, zipping around on a motorized scooter in a city they don’t know well or hiking unfamiliar terrain,” James Page, senior vice president and chief administration officer of AIG Travel told The Points Guy.

Regular Insurance Often Can’t Help

While traveling internationally, “The number one thing people do wrong is to expect that their primary health insurance will now pick up the tab for their treatment or their transport home,” Page said. Contrary to common belief, most private medical insurance plans won’t cover US citizens outside the country.

Also, Original Medicare only covers people traveling outside US borders in “extremely limited” circumstances. While certain Medicare Supplement Plans do have some foreign emergency medical benefits, not all do. Be sure to talk to your Medical Supplemental Plan provider to see if you’re covered, what’s covered, what the limits are and how the bill is paid. Here’s the official Medicare low-down.

“In many Central and South American countries, travelers may not be discharged from the hospital until the bill is paid in full,” Page said. So, you could be stuck in a shared hospital room without air conditioning or a private bathroom, or without the level of care you’d expect to receive in the US. “For people traveling internationally, it’s crucial to know beforehand where to go for any treatment … and how they’re going to pay for that treatment,” Page added.

Medevac Is Another Story

Most airlines won’t accept seriously ill passengers, those carrying bulky medical equipment or those requiring a full medical team. “Even a bargain cruise or a weekend jaunt to a Caribbean island may turn costly if the traveler suffers a serious accident or illness requiring medical treatment or emergency medical evacuation,” stressed Page. “A medical emergency abroad can be devastating, both financially and emotionally.”

Only certain travel insurance policies include medical evacuation (aka “medevac”) coverage. Check those out, but if you opt for a less robust travel insurance plan, you can also buy a separate medevac program membership. Being flown back to the US from a far-flung overseas spot in a private, medically-equipped aircraft with a professional medical team onboard, “could run between $70,000 and $180,000,” according to Mike Hallman, president and CEO of Medjet, a medical transport membership company. “Domestic transports, which we cover as well, can cost upwards of $30,000.”

Without proof of medevac coverage, foreign providers will also want that money upfront. Hallman also says that, while regular travel insurance typically will get you to an acceptable overseas hospital and even to a higher-level care facility if “medically necessary,” medical evacuation coverage means you can fly home to your own hospital, doctors and family — without claim forms, cost caps on transports or surprise bills.

The tandem approach — buying both travel insurance plus a separate medevac transport membership — is a good option, Hallman said. “We always recommend travel insurance, as it covers trip interruption, which is important, as well as medical coverage for the hospital and treatment costs,” said Hallman. “We pick up where they leave off.”

You Can’t Predict the Weather

“Cruising is a great way to explore multiple destinations in one trip, but it’s certainly important to keep in mind the unexpected delays, interruptions or cancellations that could impact a cruise vacation during hurricane season,” said Daniel Durazo, director of communications and marketing for Allianz Global Assistance USA.

(Photo via Shutterstock)
(Photo via Shutterstock)

During last year’s Atlantic hurricane season (June 1 to Nov. 30) Allianz paid 6,238 claims from customers whose travel plans in the Caribbean, Gulf of Mexico and southeastern US were impacted by the storms. Durazo advocates purchasing insurance as early as possible, because, “Once a storm or hurricane is named, it’s too late to buy travel insurance to cover it.”

Of course, cruise lines will move ships away from a weather threat. But when the port line-up is adjusted, or the cruise shortened, they might only offer the guest an onboard credit, onboard gift or future cruise credit, rather than any refund. It depends on circumstances for that specific voyage.

Consider the Domino Effect

Even if the cruise line does provide a full or partial refund or cruise credit for an itinerary change or some other interruption, travelers could have to swallow the cost of other travel elements not purchased through the line. That could include nonrefundable flights, prepaid resort or hotel nights, nonrefundable tour fees and more.

Travel insurance can cover those, plus help with flight delays or cancellations, baggage loss or theft. So, if a winter storm causes you to miss your flight to where the ship is boarding, “Travel insurance could help you get to the next port to join the cruise, so you don’t miss your entire trip,” Page said.

In fact, 13% of “billing reasons” for claims to Allianz are for common carrier delays (such as airlines), while weather and natural disaster related claims account for about 3%.

Don’t Expect the Government to Pay

While cruise ships have medical facilities, they’re usually not equipped to treat serious illness. So, guests might be required to get off the ship to seek treatment and, if admitted to a foreign hospital, the ship will eventually sail away without them as it continues its itinerary. It’s not entirely uncommon for people to find themselves stranded overseas without travel insurance.

But don’t expect Uncle Sam to step in and help foot the bill.

The US Department of State, Bureau of Consular Affairs, is clear about the importance of buying travel insurance on its cruise passenger page. On another site page, it also states: “The US government does not provide medical insurance for US citizens overseas. We do not pay medical bills. You should purchase insurance before you travel.”

If you need to be treated for a medical emergency off-ship, the US government won’t pay your medical bills. (Photo via Shutterstock)

Compare Plans and Be Thorough

Search insurer websites and compare travel insurance plans to find what’s best for your personal needs, because one size doesn’t fit all. Alternatively, hop on a travel insurance aggregator or plan comparison site such as InsureMyTrip.com, TravelInsurance.com and others; these offer multiple insurance products and have good information and time-saving resources.

Look for Cruise-Specific Benefits

Stan Sandberg, co-founder of TravelInsurance.com, also points out that, “Many plans now offer benefits that will specifically appeal to cruise travelers, such as Missed Connection, Missed Port-of-Call and Cruise Disablement coverage.”

Missed Connection coverage, for example, reimburses the traveler for a set dollar amount to rebook travel to catch up with their cruise at the next port. Missed Port of Call coverage pays a benefit if the cruise ship misses a scheduled port of call due to weather, a natural disaster or mechanical breakdown. Cruise Disablement coverage pays a benefit if the traveler is confined on a ship for more than five hours without power, food, water or restrooms.

If your ship gets stuck for a reason like bad weather, Cruise Disablement coverage may cover it. (Photo via Shutterstock)

See What Your Credit Card Covers

Some premium credit cards offer trip and transit protections comparable to what you might get from a travel insurance plan. The Chase Sapphire Reserve, for example, offers trip delay reimbursement, trip cancellation insurance and even emergency medical coverage and medical evacuation coverage, among other benefits. And yes, cruise lines are considered common carriers just like airlines.

If you think you’re going to rely on a credit card like the Sapphire Reserve or The Platinum Card® from American Express (among others) for travel insurance, just be sure to carefully recheck your card’s benefits and limits against regular travel insurance. And remember, you must pay for at least part — and sometimes all — of the trip with that credit card to take advantage of its protections.

Find out if your credit card protection includes travel accident insurance or covers pre-existing medical conditions, as well as when it will pay you back. Other questions to ask: What are the coverage limits? Will you have to pay for a foreign hospital bill upfront and then seek reimbursement later?

Be Wary of Cruise Line Coverage

Cruise lines often ask consumers booking a cruise to buy the line’s own protection at the time of purchase. But if specifics about the coverage are lacking, always ask the line for details in advance, review coverage perks and limits, and then compare those to one or two travel insurance, or your credit card’s insurance benefits.

Also keep in mind that, “Many cruise companies will only offer a travel voucher or credit for future use in the event of a covered cancellation,” according to Sandberg. Also, financial default may not be included in a cruise line’s protection, but it’s typically covered with plans from travel insurance companies.

Another factor? “Cruise line insurance seems to have become better and has more widespread coverage than in the past, but it typically won’t cover air or pre- and post-travel [arrangements] unless those elements are purchased through them. This is when private insurance coverage becomes so very important,” said Debra Kerper, a Cruise Planners travel advisor from Carrollton, Texas, who books travel and sells private insurance. She always recommends that clients do their own research, too.

Ask About Pre-Existing Conditions

When you travel, it’s important to be fully covered — which means having comprehensive medical coverage that includes any pre-existing conditions. Otherwise, if you head into a doctor’s office overseas, have any tests completed, or visit an urgent care center or ER, you might find you’re not covered.

Here, timing is extremely important. TravelInsurance.com’s site says those seeking either pre-existing conditions or Cancel for Any Reason (CFAR) coverage should book within seven to 21 days of the first trip payment, as “the availability of these benefits is tied to purchasing the insurance within that time sensitive window.” That timing could also vary by insurer within that window; we found one plan with a two-week maximum window for pre-existing conditions.

(Photo by Rawpixel via Unsplash)
If you have a pre-existing condition, make sure your covered. (Photo by Rawpixel via Unsplash)

Don’t Underestimate the Assistance

“If someone is injured or becomes severely ill during a trip, especially in a foreign country, it may be very difficult to access help without a travel insurance plan and the support of trained professionals,” Page said.

He added that providers often offer, “24/7 assistance with locating clinics and pharmacies; getting to a doctor or hospital; having lost or depleted prescriptions refilled; assisting with up-front payments to the hospital or with filing for reimbursement; arranging flight changes so the insured can get home” and so on.

These trained personnel can also arrange for an air ambulance, a nurse escort, oxygen, a lie-flat seat due to the traveler’s medical condition and for a spouse to accompany them as a nonmedical escort.

Find Your Personal Tipping Point

Allianz’s cruise-related claims fall into these buckets: trip cancellation (53%); medical expenses while traveling (22%); trip interruption (13%) and trip delays (12%).

So what’s the tipping point between buying and skipping travel insurance? Page said travelers should not only consider their total nonrefundable trip costs but also availability of appropriate medical facilities at destinations visited, types of activities they’ll participate in and their own health status including any pre-existing medical conditions.

Durazo emphasized that, “the right travel protection policy will also make sure you’re in a facility up to US health standards or, if not, arrange to be moved to one.” Buying any type of insurance or not is a personal decision, as no two travelers have the same needs. Do your homework, compare plans and always assess the risks.

“I became ill while visiting Johannesburg after a safari and had to have a doctor see me in my hotel,” said Karen Gordon, executive vice president of operations for the Gordon Group, a Florida-based luxury travel planning group affiliated with the Signature Travel Network. She missed three trip days and took unexpected flights back to the US, but her, “insurance covered the days missed, the air and the doctor bill, totaling more than $14,000.”

Additionally, one of her group’s cruise clients somewhat reluctantly bought travel insurance, but then needed emergency gallbladder surgery during an Oceania Cruises’ call in Ho Chi Minh City, Vietnam. Gordon said her client was very relieved: “It paid him back every cent.”

Feature image by eugenesergeev / Getty Images.

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