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Heathcare Abroad & Travel Insurance

Last Updated: 22/04/2016

Obtaining medical treatment abroad depends on each countries infrastructure and whether there is  an established reciprocal agreement with your country of residence. A tourist office or embassy may be able to provide you with advice. The information on this page should give you a better understanding of issues relating to obtaining heath care abroad.

Insurance

medic

You must ensure you have a valid travel insurance policy when travelling to protect you in the event of a flare of your disease. When obtaining insurance, it is important that you inform them that you have IBD,otherwise you will not be covered in the event of an emergency. Some insurers will charge a premium because you have IBD so it is worth shopping around for a good quote.

Free insurance provided by a tour operator, credit card or bank may not cover pre-existing medical conditions such as inflammatory bowel disease so it is a good idea to call the insurer to check as you may only need to pay a small premium to get the correct cover.

It may be more difficult to obtain insurance if you:

  • Have recently had, or are awaiting surgery,
  • Have been admitted into hospital within the last year,
  • Are waiting for the results of tests because of on-going symptoms,
  • Have other medical problems in addition to IBD. 

Many insurance companies will expect you to confirm with your doctor and sometimes provide written confirmation that you are fit to travel.

Where can i find Insurance to cover my IBD?

A list of insurance companies in the UK that provide cover for pre-existing medical conditions can be found on the crohn’s and colitis UK website ‘insurance and IBD factsheet: 

Insurance checklist

  • Ensure your travel insurance covers your IBD! 
  • Shop around for the best quote. Having IBD should not equal higher premiums, especially if you are in remission. 
  • Read your policy! Know what your insurer will pay for and more importantly, what they will not pay for!
  • Know your medication - knowledge of generic names and local brands can make all the difference
  • Keep names and contact details of your healthcare professionals and reliable friends
  • If you need emergency repatriation, contact your countries embassy  officials
  • Ensure you take your policy documentation with you
  • Keep all receipts of everything you pay for, and further evidence if possible such as labels and price tags

Insurance for if you have a stoma

Having a stoma will not cause increased insurance premiums but the pre-existing condition that resulted in the stoma might.

When asking for insurance make sure you declare everything. Declare the stoma and the medical condition that resulted in your stoma. And don’t forget to declare any other pre-existing medical conditions. If you fail to do this it may invalidate the insurance. The more recent your surgery and the longer your stay in hospital the higher the premium loading is likely to be. In insurance terms one year is a good milestone. If you have been out of hospital and treatment free for a year then this will help to keep the loading of the premium down. If you decide to travel 11 months after your treatment it might be worth delaying this until 12 months have passed as you may well benefit from a better premium.

A list of insurance companies in the UK that provide cover for pre-existing medical conditions can be found on the crohn’s and colitis UK website ‘insurance and IBD factsheet

or if you have a stoma you can also contact the colostomy association http://www.colostomyassociation.org.uk

or the Ieostomy and internal pouch http://www.iasupport.org/

Crohn’s and Colitis organisations in other countries should have similar lists if you contact them (see our useful links page).

Obtaining healthcare overseas

For detailed country-by-country information regarding healthcare arrangements, please see the interactive world map which will provide details on how to access medical care in each country.

Many countries have reciprocal healthcare agreements with each other, meaning that free or significantly reduced healthcare can be obtained if your country has an agreement with your travel destination.If there is no reciprocal agreement in place then you will most likely need private medical or travel insurance to cover the cost of treatment.

Further details regarding reciprocal health agreements can be found below.

Travel within Europe

The European health insurance card (EHIC) lets you get state healthcare at a reduced cost or sometimes free in all European Economic Union countries (Europe, Iceland, Norway, Liechtenstein and Switzerland). It will cover you for pre-existing medical conditions and treatment that is needed to allow you to continue your stay until your planned return, For example, If you are symptomatic from your IBD and need to see a Dr whilst abroad.

It is important to have both an EHIC and a valid travel insurance policy as countries within Europe will also require travel insurance to cover any private medical healthcare or costs such as being flown back to the UK.

Some insurers now insist you hold an EHIC when travelling within Europe and many will waive the excess if you have one.

Apply for the free card online here https://www.ehic.org.uk/Internet/startApplication.do   or call 0300 3001350. 

If you find yourself in an emergency during your visit in Europe dial the European emergency number 112, which free of charge and valid all in all EU/ EEA member states.

Travel outside Europe

The UK has reciprocal healthcare agreements with the countries listed below. If you are visiting any of these countries and need urgent or immediate medical treatment, it will be provided at a reduced cost or, in some cases, free. The agreements do not cover the cost of returning you to the UK (repatriation) or routine monitoring of pre-existing conditions. The range of medical services in these countries may be more restricted than under the NHS.

Table showing countries with reciprocal healthcare agreements

Country Kyrgyzstan
Anguila Macedonia
Armenia Moldova
Australia Monserrat
Azerbaijan New Zealand
Barbados Russia
Belarus St Helena
Bosnia & Herzegovina Serbia & Montenegro
British Virgin Islands Tajikistan
Falkland islands Turkmenistan
Georgia Turks and Caicos
Gibraltar Ukraine
Kazakhstan Uzbekistan

If you are travelling to any country that is not listed above then they do not have reciprocal healthcare agreements with the UK. This means that should you need any medical treatment in these countries,  you will probably need to pay all medical costs and then claim them back from your travel insurance company. It is therefore vital that you obtain a high level of comprehensive and appropriate travel insurance before travelling to any country without a healthcare agreement with the UK. Make sure you keep all receipts for any healthcare you pay for overseas to enable you to claim the money back on your travel insurance. 

Receiving infliximab and humira overseas

If you are currently receiving medication such as infliximab (Remicade) or adalimumab (Humira) and plan to move or have an extended visit overseas to one of the reciprocal agreement countries listed above, you may still be able to receive this treatment whilst abroad as it may be covered under a ‘highly specialised’ medication agreement. This will depend on your personal circumstances and each country’s funding arrangements.

Setting this sort of arrangement up will usually require a referral from your IBD team to the overseas hospital. Some larger hospitals will have an overseas department that can advise your IBD team on what treatments are available overseas and how to access them in each country.

Top Tips on how to arrange medical treatment overseas 

 

If you  are planning to travel or move abroad for an  extended period you may find  the following tips  helpful to facilitate easy transition of your medical care:

  • Plan ahead! Allow at least 8-10 weeks prior to departure to get everything in place ready for your trip.  Arranging medical treatment abroad can be done depending on the destination of travel  but does take time  to arrange.
  • Ask your IBD team to obtain the name and contact details of a Gastroenterologist at the travel destination. This can be done either via the IBD Network page or sometimes, in the case of receiving biologics abroad, the manufacturer of the drug  can help to locate and contact a doctor at the destination.  One such tool for finding  biologics infusion clinics in America is www.2infuse.com , which is a programme run by Janssen. Other companies may have similar programmes.  
  • It is usually necessary for your  current IBD team to send a  letter of referral outlining your medical history and  medications to the Gastroenterologist at the travel destination. This is to ensure they  have all the necessary information and to avoid treatment delay, whilst also ensuring  you have approval for bringing all medications into the destination country.  Please note that some countries may also require additional special permission for controlled drugs such as Codeine. More information on this can be found on the travelling with medication page.
  • Always carry a copy of your most recent clinic letter outlining your medical history, recent investigations and medications .  This can be either in paper form or you can download the My Wellness Journal App, which allows you to securely carry your medical records on your mobile device.
  • Once you arrive at the travel destination you will usually have to either register with the local healthcare system or with a private medical insurance company, depending on local arrangements and the reason for your visit (i.e Travel for business may be covered by private medical insurance.) After this has been done you can then arrange an initial appointment with  the IBD team to whom all the correspondence has been sent.  
  • In the case of biologics, the IBD team at your travel destination may have to apply for funding according to their local guidelines before treatment can  commence.  Regular travel insurance policies will not cover treatment with biologics, even if your insurance covers pre-existing illness such as Crohn’s or Colitis.

Can I have blood monitoring for drugs like azathioprine or methotrexate  whilst abroad?

 

Travel insurance policies will not usually cover routine care such a blood tests and will generally only cover any emergency medical  treatment  you may require. You  must always ensure that you tell the travel insurance company  about your IBD BEFORE you travel.

If you are travelling for a long period of time and will require blood monitoring for  medication you are taking, this may have to be done in a private medical facility and will incur personal cost to you. Most hotels or travel representatives  in the country you are visiting should be able to tell you where the nearest medical facility is.  Discuss this prior to travel with your IBD team.

What if my itinerary involves travel to various different locations?

 

This can often prove more difficult. Depending on the length of time at each destination, the above information may still be applicable. If the duration at each destination is short, or if you plan to move around a lot within a particular country, then arranging continuation of medical treatment abroad may not be possible. If you are taking the biologic medication Humira or Golimumab, cooling wallets are available in order to transport your medication whilst travelling.

 Humira can also be kept out of the fridge at room temperature (25 Degrees C) for up to 14 days. Once it is taken out of the fridge it must be used within 14 days or discarded.   Your travel insurance will cover any emergency medical care you require but you must ensure that you tell them about your IBD BEFORE you travel otherwise you risk not being covered for any IBD-related illness.  Unfortunately there is sometimes no easy answer to the issues raised above and you may have to consider altering your itinerary to something more suitable for your situation. 

 

Alternatively you can look at our interactive map for country specific  information and details of IBD centres.

Source of information:

  1. National health Service Choices website. Healthcare abroad 
  2. Crohn’s and Colitis UK. Travel and IBD information sheet https://www.crohnsandcolitis.org.uk/about-inflammatory-bowel-disease/publications/travel-ibd
  3. The colostomy association website http://www.colostomyassociation.org.uk
  4. The ileostomy and internal pouch organisation http://www.iasupport.org/
  5. Crohn’s and Colitis UK. Insurance and IBD information sheet  https://www.crohnsandcolitis.org.uk/about-inflammatory-bowel-disease/publications/insurance-ibd

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