Insurance Considerations for Travelling Cancer Patients

Over the past 40 years, I’ve travelled to all seven continents and most of the US states. I didn’t feel much like travelling most of the time I was on cancer treatment, but now that I’m feeling fairly normal on Xalkori, I’ve begun to venture out again.

When I buy expensive tickets on common carriers (airlines, cruise ships, train), I buy travel insurance. Before I was diagnosed with lung cancer, I bought it primarily to cover non-refundable payments in case I had to cancel due to illness or family emergency, or to cover lost luggage and medical expenses abroad. Now that I’ve got metastatic cancer, and I’ve learned how much quality of cancer care varies, I’m more concerned with covering expenses if I have cancer-related problems while on a trip.

The CDC has a good page that summarizes the three types of insurance for travelers: travel insurance, travel health insurance, and medical evacuation insurance. Here’s what I’ve learned from the travels of myself and others.

Travel Insurance and Travel Health Insurance

These policies are usually purchased for a specific trip, and cover the following travel medical problems, along with baggage insurance and other things.

Trip cancellation provides reimbursement for non-refundable trip payments and deposits if I must cancel the trip before it starts. If the trip is expensive — say, a two-week cruise — and purchased many months in advance, I want my deposit and payments to be reimbursed if changes in my treatment plan (say, radiation for a new met) force me to cancel my trip.

Trip interruption provides reimbursement for non-refundable trip payments and out of pocket expenses if the trip is interrupted after it starts. If I have a health problem on the cruise, and the ship departs without me while I’m waiting on a doctor or hospital, I will get reimbursed for the extra airfare to catch up with the ship after treatment, and meal expenses I had to pay out of pocket while I’m off the ship.

Emergency medical and dental pays medical or dental expenses incurred on the trip. Cruise ship doctors are pricey, and expect payment at time of service. Medicare and Medicare supplements usually do not cover medical expenses incurred outside the USA.

Emergency medical transportation arranges and pays to medically transport me to an appropriate medical facility when I need care, and get me home after I’ve received care. More on this under Medical Evacuation Insurance.

Frommer’s has compiled a list of companies that offer travel insurance and travel health insurance. The US State Department has another list of companies that provide coverage for overseas travelers. AAA-hosted trip usually book me through Allianz, and I’ve booked through Allianz myself online.

Medical Evacuation (Medevac) Insurance

If I become severely injured or ill while away from home, I might need an air ambulance to transfer me to a major medical center, or even my home hospital. Such transfers are EXPENSIVE. A friend with cancer paid $20,000 to be flown by air ambulance from Seattle to Kentucky. If you’re overseas, the cost could be $100,000 or more if you’re in a remote area with little medical care available. Travel insurance policies often don’t provide sufficient coverage for this.

Medevac policies can be purchased separately or in combination with travel insurance. Some Medevac insurance providers have their own network of specially-equipped airplanes whose flights are not restricted to airline timetables and routes; other providers are simply brokers that make arrangements for evacuation with contractors. Most medical evacuation insurance companies offer policies that cover the insured on all trips during a set period, be it short- or long-term. Annual policies are typically around $200. Terms and availability vary from carrier to carrier.

Some carriers that offer Medevac insurance are listed below. I don’t have personal experience with any of them; this list is just offered as a starting point for readers.

Global Rescue
TravelAssist Network
Travel Guard MedEvac Plan

Buyer Beware

Here are a few lessons learned from my own experience:

1. Read the insurance policy to be sure my specific travel situation is covered. Some policies will allow me to cancel within a short period after purchase if I discover my situation isn’t covered.
For my first trip to Denver for a clinical trial, I bought Alaska Airlines travel insurance through what was then AccessAmerica (now Allianz). The full policy was emailed to me after I bought it. Good thing I read it immediately: it didn’t cover travel for medical treatment! Fortunately I was able to cancel and get a full refund within 10 days, if I hadn’t already left on the trip. Without travel insurance, however, I would have to forfeit my cheap non-refundable ticket if the clinic changed my appointment day. I was able to reschedule a non-refundable flight for free once by playing the cancer card, but I wouldn’t want to rely on that approach.

2. Disclose pre-existing conditions (lung cancer!) and check for pre-existing conditions waivers that might disqualify me for coverage.
Because I have lung cancer, AAA travel agency told me I had to buy non-refundable travel insurance at the time I made my initial deposit on a cruise, months in advance of the trip. If I had waited to buy the insurance, any claims related to my lung cancer would not be covered. My healthy son was able to wait to buy his insurance until he made his final payment for the cruise.

3. Check for dollar limits, deductibles, and terms regarding medical evacuation.
Be sure the coverage limit is high enough to pay for evacuation from wherever I plan to travel. Ask what air carrier the insurance company would use for evacuation from the travel location—they may not have contractors in all countries. Check the policy to see who decides whether I’m sick enough to qualify for air ambulance, and whether I would be transferred to “the nearest appropriate hospital” or a hospital of my choosing.

The Places I’ve Been … June 2013 Edition

I’ve been neglecting this blog for over a month for two reasons:

1. I helped my Aspie son with a 70-page college geology term paper (serving as typist, scribe, interpreter, cheerleader, and organizational consultant), and

2. Hubby and I took a two-week road trip through six states (Washington, Idaho, Montana, Wyoming, Colorado, and Oregon), three national parks (Yellowstone in WY, Grand Tetons in WY, and Craters of the Moon in ID), two national monuments (Fossil Butte in WY and Hagerman Fossil Beds in ID), and my monthly clinical trial visit in Denver.

The summary: we had a great trip, I had another clean PET-CT scan, AND the kid earned a 3.7 out of 4.0! I intend to write some entries about traveling with lung cancer, geology, and the sites I was privileged to see … as soon as I recover from vacation.

In the meantime, here are some previews of coming attractions:


Old Faithful in Yellowstone National Park


Grand Tetons National Park


Craters of the Moon National Park

Coming Out of the Storm

Early this week I traveled to Denver for my April trial check-in and scans. In addition to the bimonthly PET-CT scan, I was scheduled for my semi-annual brain MRI to see if my lung cancer had spread to the brain. I had been having more headaches and neurological issues over the preceeding month, and I left for Denver apprehensive about what the scans might find.

I had my scans Monday April 22 (read a summary of my scan day), but had to wait for my Tuesday appointment with the oncologist to learn the results of the scan. While I kept busy Monday evening visiting with my nephew and his wife, and helping my son via phone with his geology assignment, my scanxiety hovered quietly in the background. However, it made its presence known by waking me several times during the night, and ensuring my eyes flew open Tuesday at 4 AM Denver time (3 AM by my body clock). I gave up on the idea of sleep around 7 AM and rose early to find this awaiting me.


My rental car was under three inches of powder snow, and white stuff was still falling. Denver’s had a snowstorm every time I’ve visited it for the past four months. I checked the local weather on my iPad. Although Denver is well-prepared to handle snow, the roads weren’t cleared yet, and the freeways were gridlocked by accidents.

I skipped breakfast and headed into the belated winter chill. After brushing snow from the windows and doors, I started the car, turned the heat and defroster to max, and connected the GPS to its traffic cable. The suggested route avoided freeways, offering side streets for the 22-mile trek.

On the 90-minute crawl to the University of Colorado Cancer Center, my mind wandered to what ifs: What if they did find a brain tumor? Then the light would change, and the demands of the drive would yank me back to the present. At the next back-up, my thoughts wandered again: What if my cancer has spread elsewhere? What if I have to leave the trial? What if I have to go elsewhere for the next trial?

It was indeed a long drive.

I arrived at UCCC with just enough time to grab a quick breakfast at the cafe and hustle up to my appointment. I was on time, but other patients delayed by the snowy streets created a 45-minute wait for the oncologist. I was shuffling back and forth between the lab results on my UCCC iPhone app and previous months’ lab results on my iPad when the doctor walked in.

His big smile said it all. “I’m so glad to be able to give good news.”

Both my scans were clean. I was still dancing with NED (No Evidence of Disease).

By the time I left the clinic, the streets were bare and dry, and the sun blazed bright. The snow had simply evaporated, along with all my fears. I plugged my phone into the car’s stereo and sang along with the Eagles all the way to my nephew’s house.

Even when mind storms make the road look bleak, there’s eventually sunshine to be found.

On the flight home the next day, I looked out the window into the unusually clear skies over Washington and saw the bright side of snow.


Yep, the scanxiety is cured.