Travel insurance is usually a good bet, but not for everyone

A.M. Costa Rica/Shahrazad Encinias Vela This popular waterfall at Montezuma also has been the scene of accidents befelling tourists.

Medical evacuation flights costing tens of thousands of dollars, emergency surgeries and unplanned doctor visits are all reasons any vacationer or expat should have some sort of medical coverage before living or traveling abroad in Costa Rica. But for both short- and long-term stays out of country many people are left either unprepared before leaving home or confused by the complicated landscape of international medical coverage.

When Elissa Merritt, a vacationer from Minnesota, prepared for her birthday trip to Costa Rica Feb. 8 with her husband, one of the last things on her mind was how to pay for astronomic hospital bills in a foreign country. That is until she drove her all-terrain-vehicle over the edge of a cliff near Jacó two days after her arrival.

What resulted was not only a dangerous battle for the preservation of her health but an international medical insurance nightmare for her and her husband, Ron Merritt, as they struggled to cope with a $25,000 hospital bill and thousands of dollars more for a medical evacuation to the United States.

An example of a medical travel insurance plan in Costa Rica, through the Instituto Nacional de Seguros, costs $84 and would cover a vacationer for two weeks and up to $20,000 for a sudden illness or accident-caused medical expense. That same plan can be extended to 26 weeks for $272 and other travel insurance plans, such as those offered by one of the 23 companies brokered through Squaremouth, can provide coverage for up to three years. Certain extreme sports and dangerous activities are not covered under certain plans.

Merritt said he and his wife were able to take a medical evacuation flight and make it back to the United States. Merritt said the medical evacuation flight was pre-approved by his insurance company and he expects their provider to cover the medical costs incurred as well.

The couple were medical evacuated back to Minnesota Monday. They had been in Florida for about a week while Mrs. Merritt underwent medical procedures. She will have six months to a year of rehabilitation.

Mrs. Merritt is alive but still undergoing extensive treatment for the three broken limbs and blood clots. Chad Swenson was not so lucky.

Swenson was rafting with his wife in Costa Rica in October 2010 when a tree branch struck him in the head. He was duck taped to one of the rafts as a makeshift stretcher and walked out of the jungle. It was 15 hours before he was seen by a medical specialist. Furthermore the couple was left without medical coverage costs, and Swenson was stuck in the country until members of the Texas community where he is from near Houston and an anonymous donor paid the more than $30,000 evacuation flight to bring him home.

The 36-year-old Swenson died in August in the hospital after a series of surgeries, medical procedures and blood transfusions, according to a Web site page created to help pay for his evacuation and medical treatment. Mrs. Merritt has a benefit Web page as well to accept donations to help with the medical costs. An adequate travel insurance policy would not have prevented the accidents both Swenson and Mrs. Merritt suffered, but it would have been one less preoccupation.

For people who travel frequently or will be living out of their home country for long periods a travel insurance policy may not be adequate. Most travel plans, such as those offered through Squaremouth, are tailored for medical costs as a result of emergency situations.

Moreover, Sarah Byrne, marketing manager for the company said only residents of one country embarking on a trip to another country can qualify for the travel insurance. She said medical claims could be denied if it is discovered that a person is not actually traveling to Costa Rica and was living instead as a perpetual tourist here prior to when he or she obtained the travel insurance.

This leaves many expats in Costa Rica in a strange limbo when it comes to health coverage. An expat must have legal residency before he or she can affiliate with the Caja Costarricense de Seguro Social and its medical services.

With luck, a tourist injured in an accident here might receive treatment at a Caja hospital. A perpetual tourist, one who lives in Costa Rica and renews a tourist visa every 90 days, probably could receive emergency Caja care, too, but regular medical expense would have to come out of the pocket.

U.S. Medicare does not assist outside of the United States, and expats from countries such as Canada with national policies are not covered in foreign places, said Carlos Perez from Global Insurance Net.

Perez works as an insurance broker providing worldwide coverage through one of the dozen or so companies specializing in global policies. He said he has many customers in Costa Rica. Some are retirees. Others are working as missionaries or own a tourism-type business and don’t want to be caught off-guard in a coverage gap while traveling back and forth between different countries. He said the plans will provide for treatment in any country and can cover entire families and evacuation expenses.
There also are plans that specifically offer just evacuation insurance.

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