Our good friends at Global Underwriters recently sent out an email about cover for church (and other) groups on missions abroad. The primary focus of the email was about the risk of terrorism, but it occurred to me that there's another pretty significant exposure, as well:

Ebola has been much in the news of late, and I wondered how (or even if) a travel medical policy might cover that. Believe it or not, we first covered insurance for folks undertaking a mission overseas in our very first year:

"Once such gentleman – my client, in this case -- is headed over to Tanzania later this month. He’s part of a medical supply effort undertaken by the Rotary Club. They’re delivering over 400,000 doses of medication, donated by one of those evil, greedy, profit-driven pharmaceutical companies, obviously in direct violation of said company’s pact with Satan. My client and his daughter are accompanying the life-saving medications as distribution auditors."

Fast forward 9 years, and here we are again. This time, though, the stakes may be much higher.

First, though, a quick review: generally, Medicare coverage "stops at the border," so seasoned citizens often buy medical plans that cover them overseas. Likewise, most group and individual major medical plans offer limited (or no) coverage outside the country, and of course, that hospital in Nigeria (or Liberia) is unlikely to be in-network. Then there's the little matter of getting you back to the States for more advanced treatment - medevac flights ain't cheap (up to $75,000 or more!), and which is also unlikely to be covered by your regular insurance (or at least capped at a fraction of the actual cost).

[ed: click here for a more detailed explanation of Travel Medical plans and how they work]

So, you're on a church-related mission to Sierra Leone, and you contract Ebola. What happens next will depend in large part on whether you (or your organization) purchased a Travel Medical plan before you left.

So what are the issues here? We turn once again to Peter Schulteis, GU's Executive Vice President, who graciously lent us his expertise:

As always, the devil is in the details; Peter reiterated that any and all coverage (and exclusions) will be found in the policy. And that exclusion list may be critical in this case, since some plans exclude claims arising from endemic diseases. Then again, those that do so may offer a rider allowing one to "buy back" that cover.

And don’t forget to check your own individual or group plan for such an exclusion, either.

Something I hadn't considered, but which Peter mentioned, is that there might also be Workers Comp issues in play. So if your employer is sending you off to head up the new Freetown office, you might want to check with your WC carrier about how they might handle an Ebola-related claim.

The key issues, though, are local, on-site facilities and medical evacuation costs. Places like Sierra Leone and Liberia aren't exactly known for their cutting edge medical establishments, which are now becoming even more overwhelmed as the latest outbreak worsens. But if you do find yourself being treated at Saint Joseph´s Catholic Hospital in beautiful downtown Monrovia, be aware that you're going to be out of Anthem's network (and Humana's, and all the rest). And heaven help you if your plan does have that endemic disease exclusion.

So now you're stabilized, and ready to get out of Dodge (or Freetown). You can't just hop on the next 747 for LAX; you need specialized transport, which means a Medevac plane and crew. As we noted above, this can run into the tens of thousands of dollars (and they don't take American Express). Fortunately, plans like the ones Global Underwriters sell cover these costs for you (up to $500,000 in GU's plan). So again, worth checking the plan you're considering to see what emergency evacuation benefits are available (or even if they're covered at all).

You might also want to check with your disability insurance carrier (you do have DI coverage, right?) to see if there are any issues there. After all, you're likely to be out of the office for a while.

Bottom line is: don't assume you have coverage. It may well be available, but you need to read the fine print, and ask the right questions. Have a great trip!
 
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