Ensure you're well covered before you set off or your holiday could lead to a big bill. Laura Slattery reports.
If you're reclining on a beach somewhere and you need to consult a phrase book just to order a cocktail, a medical emergency will naturally leave you and your travelling companions feeling distressed and helpless.
The onset of a sudden illness or injury can cause panic on safe home territory. Unfamiliarity with overseas healthcare systems, coupled with potential language barriers, makes the experience even more disconcerting.
Yet, in the desperate rush to wrap up work commitments, get out of the office and to the airport on time, many stressed-out holidaymakers don't think about how they might cope in the event of them needing medical care.
But unless people think about the precautions they need to take, a medical emergency could saddle them with the legacy of a nasty hospital bill.
Cross the Atlantic without a decent travel insurance policy (ie one that's light on caveats) means risking joining the tens of thousands of uninsured American citizens who have been crippled by long-term medical debts.
Although the exact figures will depend on the severity of the condition, and the hospital and state in which it is located, five-figure bills per night's stay are to be expected, and that's before the fees for diagnosis and treatment are tacked on.
It won't be long before the typical overseas emergency cover of €55,000-€100,000 available under standard health insurance policies runs out - that's assuming the unfortunate holidaymaker is covered for health insurance by either VHI, Bupa or Vivas in the first place.
Although health insurance policies will usually cover the cost if policyholders have to be transported back home, the health insurers don't make any secret of the fact that the overseas cover included in their main hospital plans is far from sufficient in some countries.
"Our overseas cover is not intended to replace travel insurance and we tell this to anyone who contacts us before travelling," says a spokeswoman for Bupa.
"If someone is going to America or Canada, €55,000 won't go very far if you had an accident. It can cost something like €12,000 a night in hospitals in the US or Canada."
Annual multi-trip travel insurance policies, which usually cover emergency overseas medical costs up to at least €2 million, can be purchased for less than €40.
Some travel insurance providers will now send policyholders an instant text message that means their travelling companions won't have to root around their suitcases for their policy documents while they're receiving treatment.
The message contains details of their policy number, the telephone number they should call if they have an emergency abroad and the number they should call prior to travel in order to declare any pre-existing illness.
Failure to declare a pre-existing illness, for example, a serious heart condition, and the travel insurer's underwriters will refuse to pay out in the event the policyholder suffers a heart attack on holiday.
But travellers who find themselves in this situation should remember that their health insurance provider won't take the same attitude, as long as they haven't just bought the policy. People buying VHI's multi-trip travel insurance can also get automatic cover for pre-existing conditions.
Holidaymakers whose claims are turned down by travel insurers because their injuries were incurred while taking part in sports or activities excluded under the terms of the policy should also remember to contact their health insurer, as it won't care if their leg was broken because they were knocked over by a car or if their ill-advised attempt at a snowboarding manoeuvre went badly wrong.
In some isolated or less tourist-friendly destinations, however, local hospital authorities can still drag their heels when it comes to recognising whatever cover is in place.
One traveller to Croatia told The Irish Times about an incident where VHI's emergency overseas helpline, based in the Netherlands, initially couldn't confirm that his wife, who had suffered severe facial injuries after falling off a bike, was covered under its policy.
It then sent a fax to the Croatian hospital agreeing to cover hospital costs for his wife up to a limit of just €300.
Angry that this proposed limit was far less than the €5 million cover promised under the VHI multi-trip policy, he eventually paid private doctors to care for his wife.
"The treatment was very good, but you do have a feeling of helplessness," he said.
A spokeswoman for VHI said it paid the hospital's bill of just over €200 and that the fax had indicated that it would have covered the full cost if the cost of the treatment had exceeded the €300 limit.
"Our experience has shown that if you put in the letter that the person is covered up to €5,000 or €10,000, the bill charged by the hospital tends to rise. But there is a clause in the letter to say that if your costs are above the limit, we will cover it. In this way, we are not giving the local hospital an open cheque," says the spokeswoman.
The story shows the kind of confusion that can arise for holidaymakers in overseas hospitals at times of heightened emotion.
In many cases, travellers will end up paying upfront for treatment bills, often on their credit cards, then have to wait until they get home until they can seek reimbursement.
One entitlement that short-haul travellers often forget about is the European Health Insurance Card (Ehic). The card, which replaced the E111 form in June 2004, entitles the holder to immediate treatment under the state-funded healthcare system in any EU country, as well as Iceland, Norway, Switzerland and Liechtenstein, although not Croatia.
The card, which is designed to make it easier to get treatment quickly and without having to pay upfront, is for emergencies only: it can't be used by so-called health tourists to travel abroad with the intention of getting lower cost healthcare. "A lot of younger people just buy travel insurance when they're going overseas," says a spokeswoman for the Health Service Executive (HSE), which co-ordinates the issuing of the cards through local health offices.
But as most travel policies will only cover single trips up to a maximum of around 60 days, keeping the card in your wallet will be a good idea for longer stays.
More information about the Ehic and application forms are available from local health offices and www.ehic.ie