What travel insurance should I buy, if any?

January 20, 2016 10:49 AM

I'm an American who has moved to the UK. Should my spouse and I get insurance for travel to the US (and other countries)? If so, do you have recommendations?

Last year, we moved to the UK from the US. I use the NHS for healthcare and my spouse's employer provides additional health insurance coverage beyond that, but it's my understanding that coverage can be limited outside the EU. In particular, I was thinking about planned trips to the US this year. What happens if I get sick or injured while in the US? I know that even a minor injury could lead to huge bills in the US, if un- or under-insured. Is travel insurance the best way to handle this (hopefully forever unrealized) risk?

I've looked a little bit at insurance options and the number and variety of options is overwhelming. What insurance companies are reputable and what should I look for when shopping? (For what it's worth, I don't care much about insurance for delays or lost luggage and my credit card already provides a lot of coverage for that).

posted by ddbeck to Travel & Transportation (13 answers total)

I've really struggled with this. The best I've come up with for trips to the US is World Nomads, but I've never actually had to claim. Watch out for some companies that specifically exclude Americans travelling back to the US from coverage.
posted by EtTuHealy at 11:06 AM on January 20, 2016

I've purchased travel insurance for several US to UK trips. I paid for coverage for a medevac back to a US hospital, potentially a huge expense: Charter flight, medical personnel, etc.

This was premised on my understanding that, while I could receive emergency care at a UK facililty, if I required extended hospitalization beyond the capacity of my other coverage, my choices would be to pay a UK facility out of pocket or return to the U.S. for care covered by my US health insurer.

Presumably, much the same would apply in your case visiting the US from the UK.

Also, are you required to maintain US health insurance? Does it cover these kind of visits?
posted by justcorbly at 11:15 AM on January 20, 2016

I am an American. I have a friend who is English. We were in Mexico together, and he had an accident that required hospitalization. The hospital in Mexico called the NHS and arranged for the NHS to pay for his care in Mexico. There was never any problem with that.

My friend is an English citizen, and that probably makes a difference. But you might look into what the NHS will cover for whatever your status is.
posted by OrangeDisk at 11:25 AM on January 20, 2016

OrangeDisk: I have never heard of such a thing. I'm not aware of NHS agreements from outside Europe aside from these. Can you get more information from your friend?

I'm an American in the UK. I just buy medical travel insurance to cover my US trips. We are using Allianz Worldwide at the moment but I can't say how good they are as I've never used them.
posted by vacapinta at 11:49 AM on January 20, 2016 [2 favorites]

Best answer: If you go onto any UK-based insurance provider and select 'US' as your destination, you'll see the premium and coverage values all jump substantially, as US healthcare is so expensive to the uninsured and there are no reciprocal agreements as there are between the NHS and other EU health systems. So yes, unless you have extant US health insurance (which it doesn't sound like you do), you'll need travel insurance.

I've used InsureandGo before and they were fine, I guess. If you have a UK bank account, it may come with travel insurance if you pay for it, so I'd check that before you do anything. If you want to compare premiums and coverage, I'd go to MoneySavingExpert and check out their comprehensive guide.
posted by Happy Dave at 12:06 PM on January 20, 2016 [3 favorites]

I can't say off the top of my head what it costs for someone who's in good health, but a worldwide annual travel insurance policy in the UK costs me (with a chronic illness) about £120 a year including coverage in the US, £80 without the US. I think it's about half that for people in good health. It is quite likely that worldwide travel insurance is also already within your spouse's private health insurance package.

If you're travelling within the EU/EEA, you get treated exactly like a local once you've proved you're covered by the NHS (as any UK resident is), as you also do in Australia and New Zealand, and a few other countries. It's probably easier to use this (the EHIC card) than going through travel insurance should anything happen.
posted by ambrosen at 12:32 PM on January 20, 2016

Best answer: Talk to your bank. I am an expat American living in Ireland and just as a datapoint, we buy annual worldwide travel insurance including cover for US trips and it's about €80 for the year for both of us. When I lived in the UK I bought through the Coop, which was my bank.
posted by DarlingBri at 12:35 PM on January 20, 2016 [1 favorite]

If you're a resident of the UK, then you can and should take out UK travel insurance for trips to the US (or anywhere else, for that matter, including Europe).

And, as always with questions about banking, insurance and consumer investments, the most up-to-date and reliable clearing house for information is Money Saving Expert. Check there for an explanation of the coverage you need, and recommendations for specific insurance plans and providers.
posted by caek at 1:38 PM on January 20, 2016

My partner and I are US citizens, and are residents of the UK with ILR. We have a joint platinum account at NatWest which includes travel insurance that covers us for any trip outside the UK, including the US. You should definitely have an EHIC card (linked above in ambrosen's comment) which will allow you to receive free healthcare in Europe (or at the very least you will have to pay and then be reimbursed, but this is less common). And for travel in the US, the NatWest insurance provides basic medical and travel coverage. You might want to check out how much this would cost you because it also comes with a lot of other benefits. Do note, however, that it is exceedingly difficult to get coverage through any provider once your trip has started, or if you want to be out of the UK for longer than 30 days at a time without arranging it beforehand. The one time we were in the US for longer than 30 days we were able to "top up" and pay about 20 pounds for an extra week for the both of us, but this is because we arranged it before the departure date. Also we've made claims to them due to delayed baggage and got reimbursed for extra expenses. Most banks offer this kind of "top end" account which can work out to be a bargain depending on how much you travel. I also like it because I don't have to think about it each time I travel -- it's just there if I need it.
posted by tractorfeed at 7:30 PM on January 20, 2016

Yep, American ex-pat living in the UK 2012-2014, and I used InsureAndGo. They had some good add-ons for things like skiing (which was a component of some of my return trips) that are otherwise excluded from coverage. And you do need it - the US does not have reciprocal agreements with any other country's healthcare system. Some American insurance plans will cover you abroad, but not all, so if any American is telling you there's reciprocity, they are incorrect.
posted by olinerd at 2:21 AM on January 21, 2016

Just because a few people have mentioned it, here is a list of non-EU countries with reciprocal arrangements with the NHS. Mostly Commonwealth or non-EU Europe. Anywhere else outside of the EU and you will be paying the cost yourself, and I have certainly known several different patients who have run up enormous medical bills in the US by rocking up uninsured and hoping for the best (if you are on dialysis and thus uninsurable, please do not go to the most expensive country in the world and then try to skip dialysis for two weeks "because they charge too much". It will not end well).

It's also worth noting that these reciprocal arrangements only apply in state hospitals. You can't go to a private hospital and get your bills paid. This trips up a fair few people on holiday within Europe - they pitch up to the shiny English-speaking private clinic (often the only clinic in touristy areas like ski resorts), and then find they aren't covered. You will also have to pay for things that locals pay for (like co-pays and prescription charges). Medical and post-mortem repatriation is also not covered. It's always worth having travel insurance, even for European travel (no, nobody plans on dying on holiday, but plenty of people do).
posted by tinkletown at 3:15 AM on January 21, 2016

I'm going to the US for the first time as an adult (ie. doing the booking) and taking my mother. Both of us are costly to insure, thanks to long-term conditions - even though mine is very very unlikely to cause a problem, I didn't want to, say, break my leg and then be told I wasn't covered. So the companies I used may not be the most useful for you, especially as I am not eligible for annual travel insurance, apparently. I think I used CompareTheMarket to get an idea of who would be most likely to cover both of us, and went from there.

I did notice that there seemed to be two categories - US/Canada/Caribbean and Rest Of World - as HappyDave says, it will be more expensive.
posted by mippy at 5:01 AM on January 22, 2016

Response by poster: Thanks to everyone for your answers. You've helped me narrow things down considerably (including an option provided by my bank) for an annual policy, and I have an EHIC. I feel a lot more prepared for my upcoming trips. Thanks again!
posted by ddbeck at 12:03 PM on January 26, 2016