A visitor to Longboat Key, near Sarasota, Florida, was recently bitten by a raccoon twice on the leg while showering beach sand off herself and her infant. The Ohio woman kicked the raccoon away, but it came back and bit her a second time before running into the surrounding sea grapes. A trip to the Sarasota emergency room revealed two puncture wounds to her right leg.

You are probably already aware that your U.S.-based health insurance coverage will not likely cover you outside the U.S., but out-of-network medical care is also a problem for travelers who find themselves with a medical emergency.

Every year vacationers find themselves in an emergency medical facility each year for dog bites, stingray stings, and more. The odds that you will visit an emergency room on your trip go up if you are also an adventure traveler. Many travelers have good health insurance coverage back home, but when traveling outside their health coverage network, the medical bill can be higher than they expect.

It’s for this reason that we recommend travelers – even those staying within their home country – get at least $10,000 in medical coverage with emergency medical evacuation benefits that can help you get you back inside your health insurance network for continued treatment. For a relatively minor incident that can be easily treated with an emergency room visit, you’ll have the secondary travel medical coverage you need to cover your out-of-pocket expenses after your primary health insurance covers their out-of-network portion.

Hint: If you need help understanding primary versus secondary medical insurance, please see this page.

As a quick comparison, we ran a travel insurance quote comparison for two travelers ages 38 and 42 traveling in the U.S. and we quickly selected two plans:

* Please note, we did not included trip cancellation in our plan selection.

As you can see, for just a little extra, you can have the secondary coverage you may need even if you already have health insurance. Adventure travelers enjoying activities such as whitewater rafting, or downhill skiing, or rock climbing can usually upgrade their coverage to include those activities. Either way, you’ll avoid a huge medical bill on your vacation.

Once you’ve finalized your itinerary, you’ll want to take proper steps to prevent picking up an illness while traveling.

Now, it’s time to do a little homework.

1. Check in with these websites. The official government websites, such as the Centers for Disease Control and Prevention and the U.S. State Department offer a number of safe travel resources.

• CDC Traveler’s Health Information
• U.S. Department of State Traveler Health Issues

2. Determine which vaccinations are necessary. Remember that diseases that are now considered rare in the U.S. may still be common in other countries, so it’s important use these website resources, select your destination, and read the information provided.

As an example, we selected Australia on the CDC country map and this is a snapshot of the current information:

Required vaccinations also depend on the time of year you plan to visit – monsoon season or dry, for example. In some regions of the world, for example, yellow fever is common.

3. Find a travel medical care clinic. Your primary care doctor can offer a lot of the typical vaccinations, but for vaccinations that are not typical to the U.S., you’ll likely need to seek out a travel medical clinic. Note: travel clinic appointments fill up quickly, and you’ll need to plan extra time after you receive the vaccinations to be sure there are no adverse reactions. So, make your appointment quickly. Your primary care doctor’s office can usually point you to a travel medical facility where you can obtain the necessary vaccinations. If not, try your local health department.

4. Last, understand your health care coverage. If you’re traveling outside the U.S., it’s important to understand that your health care coverage is not likely to be accepted outside the country, nor is Medicare. If your health care does not extend to your travel destination, check our medical care coverage guide for travel insurance companies who do.

A new interactive map from the American Trauma Society shows the availability of medical care across the country.

You can pick a location and discover whether it falls within a ‘safe’ zone – where you are within 45 minutes to an hour – either by ambulance or helicopter – from a location where you can receive advanced trauma care.

Here’s a cross-country view of the country’s 60-minute access:

The purple shaded areas are the ‘safe’ zones, but the white areas lack rapid access to timely, life-saving care for the most serious injuries. While there is lots of purple blotches clustered in the northern and eastern regions, there are large swaths of white patches in the middle of the country and the western region.

Unfortunately, many of those areas are also popular tourist spots like Yellowstone National Park and the Grand Canyon. The problem areas are not isolated to the West either; many open areas lie in popular East Coast areas like Martha’s Vineyard and Nantucket, or farther south at Myrtle Beach and Key West.

Once again, this information underscores the need for adequate medical evacuation coverage – even on trips within the U.S. Check out our recent post on How much evacuation coverage do you need? for more information.

The Texas Division of Emergency Management (TDEM) and the Federal Emergency Management Agency (FEMA) recently joined forces to warn motorists that driving into dense smoke could result in fire-related death.

Many Texans have lost their lives during severe wildfire seasons because wildfire overtook them in their vehicles while driving. High winds can whip a wildfire around and cause it to change directions, jump across natural barriers like roadways and waterways, even propel it many yards at a gust.

Even when the wildfire is many miles away, strong winds force smoke low to the ground where it will often obscure traffic signs and make it difficult for drivers to know where they should stop to avoid accidents.

For drivers in Texas, Arizona, New Mexico, Oklahoma, California and Colorado  – states where wildfires are a common danger – it’s important that motorists pay attention to television and radio broadcasts and be aware of the weather conditions along their route. If a wildfire has been reported in the area where you will travel, do not drive into the smoke.

For more information on wildfire prevention, see the Texas Forest Service website.

In a recent press release, Squaremouthrecommended travelers purchase between $50,000 and $250,000 in emergency medical evacuation coverage depending on their destination. If you are traveling far from home and/or to a remote location at your destination, you’ll need more coverage than on a trip that’s closer to home and where there are medical facilities close by.

Evacuation limit recommendations from industry experts

Squaremouth’s recommendation is based on average medical evacuation costs from a number of travel insurance providers.

Here are a few specific recommendations:

• A Florida citizen traveling within the U.S., perhaps on a hiking trip in Yosemite, will probably find $50,000 in emergency medical evacuation to be enough.
• A New York senior citizen traveling in the Caribbean, Canada, or Europe, however, should have at least $100,000 – $150,000 in emergency medical evacuation coverage.
• A California businessman traveling in Asia, Africa, or Australia will need closer to $250,000 in medical evacuation coverage.

The rule of thumb here is: the more remote the location and the farther the traveler is from adequate medical facilities, the more medical evacuation coverage they’ll need.

One recent unfortunate story about a traveler seriously injured in a motorbike accident in Indonesia demonstrates the financial reasons for having travel insurance protection with emergency medical evacuation coverage. This man’s family may have to sell their family home in order to transport their son home where he can receive medical care and recover. It is our sincere hope that this family receives some help from the community and we wish them the absolute best.

Remind me again, what is evacuation/repatriation coverage?

Remember that emergency evacuation/repatriation coverage ensures that an injured traveler can be evacuated to a medical facility where treatment can be received. Once the traveler is stabilized, this coverage also ensures that the traveler can get back home – even if it means a specially equipped and staffed medical flight.

If you suffer a heart attack on a cruise in the Caribbean, for example, this coverage will help you get to a medical facility where you can receive proper care, and then it will also get you back home because, after all, the airlines won’t allow sick patients on board and your cruise ship has traveled onward.

This coverage also ensures that a traveler’s body is returned home for proper burial should they die on their trip. That’s the ‘repatriation’ portion of this coverage.

International Medical Group, known widely as IMG, is now available for review here on Travel Insurance Review.

IMG is a world leader in international medical insurance for travel and for working abroad, including employer-sponsored major medical plans for employers with international employees and expatriate employees. In fact, their GEO Group plan is unique in providing U.S.-style comprehensive health care for employees and their families. It includes primary health care benefits as well as mental health care, vision, and optional dental care at three levels. This plan is customizable, so the employer can choose the plan maximums and deductibles. For global employers, this plan may just fit their needs for employer-provided health care.

Coverage for Marine Crews
IMG has a unique commitment to covering health care needs for niche workers. One of the most unique set of coverages we found are IMG’s plans specifically designed for marine crews. The marine crew-specific plans offered by IMG cover medical needs due to recreational SCUBA diving and amateur sailboat racing.

• Global Crew Medical – offered in two levels for regions including or excluding the U.S. and Canada (where health care costs are higher than in other regions around the world), this plan is comprehensive medical for boat captains and their crew members.
• International Marine Medical – comprehensive medical insurance for groups of three or more marine crew members and their dependents. This plan also covers maternity and newborn care after 12 months of continuous coverage.
• CrewSelect International – offered at two plan levels, for three global ranges, and in three currencies, this plan is major medical insurance with some added benefits like trip interruption and high baggage coverage.

Coverage for Aid Workers

IMG also offers a unique set of plans specific to missionaries and aid workers:

• Outreach Travel Medical – available for individuals and groups, this is temporary travel medical for U.S. and non U.S. citizens traveling outside their home country in service.
• Global Mission Medical – offered at four benefits levels, this is short- or long-term major medical insurance for U.S. and non U.S. missionaries around the world. No cost for the first two young children (up to age 9) for the first year of coverage.
• MP+ International – for two or more travelers, this employer-sponsored, long-term, emergency medical coverage provides continuous coverage for two or more missionaries overseas and in the U.S. Options for life, dental, and evacuation, plus direct billing.

Just a gentle reminder – 10 things every world travelers should know:

1. Dress appropriately. If the locals aren’t in swimsuits at the bar, then you shouldn’t be either. Keep your shirt on when you’re not on a beach or by the swimming pool. The locals appreciate and may even expect it.
2. Don’t look like a tourist. You’ll be taken more seriously and you’ll melt into the crowd. Remember how frustrated you get when you encounter tourists in your home town? Make an effort to blend in.
3. Don’t act like a tourist either. Every country has had it’s share of drunken, loud-mouth, and rude tourists. You’re in another state or another country – be considerate and remember that a smile goes a long way.
4. Follow healthy eating and drinking protocols. You know these rules, especially in third world countries – boil it, peel it, cook it, or step away from it.
5. Getting lost isn’t the worst thing that can happen. In fact, it’s often the quickest way to a load of local fun, so go with it. You don’t have to see everything, but you really should enjoy the heck out of your travel experience.
6. Learn how to pack like a professional. You are not always going to land somewhere that has on duty bellhops to cater to your every whim. If you can’t carry it yourself, don’t pack it. Besides, aren’t you sick of paying the airline baggage fees yet?
7. Pay attention to immunization requirements, travel warnings, and health alerts. Have a little stroll through our Tips and Advice for planning advice, health advice, and security concerns while traveling.
8. Learn how to use chopsticks. You’d be surprised how many folks are impressed when you display any skill with these unique eating utensils. Of course, those same people will look on with pity if you ask for cutlery.
9. Learn a little of the local language and lingo. It’s a great ice-breaker and always appreciate even if it’s done badly, but with good intent. There are a number of mobile apps that can help with translations and reliable travel books will have a useful list.
10. Get a little travel insurance, please? Well, you’ve heard a number of horror stories and you are simply mad to risk your financial security, your health, or your luck.