Illustration by Mikey Burton for MONEY
By Lisa Zamosky
July 7, 2016

No one wants to think about mid-vacation health scares. But emergencies happen, and your regular insurance may not cover your care overseas. To avoid any expensive surprises, lay the groundwork before you board a plane.

Mind the gaps

Once you go abroad, most policies cover emergencies that jeopardize your health—a heart attack, for instance, or broken hip. But it will be out-of-network care, so you may face high deductibles and coinsurance payments—and you’re on your own for lesser issues. “If you get a bad cold and decide to get it checked out, expect to pay out of pocket,” says San Diego insurance agent Craig Gussin. Details vary, so check your plan’s non-U.S. rules, co-insurance rates, and out-of-pocket maximums.

Medicare is a special case: It rarely covers services outside the U.S. except in certain circumstances—on a cruise ship within six hours of a U.S. port, for instance. You’ve got some coverage built in if you have one of the Medigap plans (C, D, F, G, M, N) that pay 80% of bills for emergency care as long as it’s during the first two months of a trip abroad. (There’s a $250 annual deductible plus a lifetime limit of $50,000 for foreign-travel emergency care.)

Buy extra protection

Worried about high out-of-pocket costs? You can get a supplemental travel medical policy to kick in on care your primary insurer won’t cover. Compare options on sites like InsureMyTrip or eHealth. An Ohio couple in their fifties planning a two-week trip to France, for example, could get a $100,000 medical limit and $500,000 for a medical evacuation, with a $100 deductible, for about $100. Aim for $50,000 to $100,000 in medical expense coverage, suggests Los Angeles travel agent Terry Bahri.

Cover preexisting conditions

Travel medical plans usually have exceptions for emergencies related to ongoing conditions. If you have health issues that might require medical care, choose a broad travel policy—covering things like trip cancellations and baggage loss—and tack on a preexisting-condition waiver. (For that Ohio couple, this would cost around $300.)

Line up local pros

If you run into trouble mid-trip, call your carriers right away. Travel insurers can recommend local care options, and even U.S. plans may be able to identify the most appropriate nearby facility. For extra help, join the International Association for Medical Assistance to Travellers, a nonprofit with a global network of English-speaking doctors and health professionals.

Keep your paperwork

When you get home, you’ll need all of your receipts in order to get reimbursed. And get copies of medical records outlining the care you received. “A credit card statement will not be sufficient,” says Brian McGuire of insurer UnitedHealthcare Global.

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