Last Update: 12/30/15

By Ayesha Court, USATODAY.com

I used to pooh-pooh travel health insurance. 'I'll be fine,' I said to myself. Actually, my inner voice never said a word because it simply didn't cross my mind. 

I re-evaluated my scoffing during my one and only escorted tour. We were young and partying in Heidelberg, Germany in the days before those cautionary tales of VH1's Behind the Music.

After a visit to the biergarten, we returned to our hotel in a combined mental haze. About an hour later, I was yelled awake by my roommate. One person in our group, whom I'll call Michael, had fallen out of his window and was lying motionless on the concrete three stories below, in a locked garden. His back was broken. 

As the only one who spoke passable German, I was designated to talk to the hotel manager, who was refusing to open the garden gate or call an ambulance. A crude mixture of pantomime and high school Deutsch soon brought the reassuring wail of the ambulance.

The efficient and skilled German paramedics and hospital staff saved Michael's life. Airlifted home a few days later, he spent the rest of the year in a body cast. 

Do I sound like I'm trying to sell you insurance? Well, I am and I'm not. Before splurging on all that sexy underwriting, force yourself to read your regular health insurance policy. It may cover you completely from Chartres to Chiang Mai. But if it doesn't, figure out where the gaps are and then decide what needs to be filled and what can be ignored. 

I'm no fan of needless expenditures, so here's how I calculate travel risk factors: 

Where are you going? 

If it's a road trip to Las Vegas, your health insurance probably covers you. Ditto a visit to our wonderful neighbors, Canada and Mexico. Going Down under or to the Continent? Quality of care isn't as much the issue, cost is. Many health insurers - including Medicare - either don't cover you abroad at all, or only partially cover mishaps. 

And, if your policy is like mine, you can forget about a $10,000-plus medical evacuation. Medical evacuation coverage gives you the option to be airlifted - via private jet or helicopter - to the city or hospital of your choice.

Africa, Asia, the South Pacific and Latin America are destinations I think everyone should visit, but I recommend both travel health and medical evacuation insurance or a policy that combines the two.

Am I slighting all foreign-trained physicians? Certainly not. 

We're in the age medical choice and I'm choosing doctors I can speak to in our mutual native language who have been trained in the same conventions I'm used to at home. I don't want to try to say "I can't feel my left foot" and have it come out "please remove my right hand" - nor do I want to eat live eels to cure my incipient malaria. So, before I go, I look up English-speaking doctors listed by the International Association for Medical Assistance to Travelers. (And IAMAT's membership price is right - free!)

What will you be doing there?

A tour will generally include insurance in the cost or offer it for a bit more. (If it doesn't, read the fine print and check up on the operator with the U.S. Tour Operators Association or the Better Business Bureau.) 

If you've got more energy than me and are trying, say, canyoneering,parachuting or bungee-jumping off cliffs, your insurance is rather important and will probably cost more. In case you're tempted, don't lie on your form
and say you'll be strolling along the Champs-Elysees when you'll actually be hunting wild boar. The gunshot wound will give you away, and that risky-behavior exclusionary clause may put a damper on those retirement
plans. Permanently.

How long will you be there and how's your health?

Be honest about this. If you're a heart-attack risk or tend to black out while visiting monuments, it might behoove you (and your next of kin) to be insured.

On a related note - don't forget those prescriptions. Make sure you have enough with you so you won't run out during your trip. 

And, due to a few million bad drug-toting apples, crossing borders with prescriptions can be dicey. Many countries, especially in Southeast Asia and the Arab world, may find those electric blue pills in your days-of-the-week dispenser more indictable than adorable. Keep the prescription paperwork with you to avoid any problems. Though it might seem like it from here, being an American abroad is not a 'Get out of jail free' card. 

Speaking of special treatment for Americans - U.S. embassies abroad aren't there to cater to travelers who trip the Zambezi fantastic and then come crawling to the door for help. They tend to be busy with diplomacy and there isn't a healthcare and med-evac slush fund waiting to back you up. Instead, embassy staff can help you find local English-speaking doctors and hospitals, call your family and even arrange for money to be wired to you. 

Hmmm. I wonder if the State Department would help me figure out my HMO-ized health plan here...