Picture this: You’re gliding down the slopes of Verbier, enjoying the snow-capped mountains and the elation of the wind kissing your cheeks. As you make your way down the slope, you notice people gathering around a downed skier, and your heart stops as you recognize it is someone in your party. They’re having a medical emergency.

On top of having to contend with the trauma of having a loved one go through a medical emergency overseas, there’s another side of the coin: If you don’t have the right kind of coverage, you could be on the hook for all medical expenses, which could total into the hundreds of thousands of dollars.

This is why it’s imperative to think about financial protection before you head overseas — not just for hospital bills, but for the cost of getting appropriate care in the first place. To help you prepare, I’ll break down the hidden costs of international healthcare, what travel medical insurance typically covers, what emergency assistance programs are designed to handle and when extra coverage may not be necessary.

The hidden costs of getting sick or injured overseas

Normally, if you’re injured at home, your health insurance helps cover hospital care, tests and procedures. Overseas, that safety net may disappear, many U.S. health plans offer limited or no international coverage.

But medical bills aren’t the only expense travelers face. In serious emergencies, the cost of getting to appropriate care, or back home, can rival or exceed the hospital bill itself.

Here are the main types of costs that can come into play:

Medical treatment costs

These are the expenses most travelers expect, and they’re typically what travel medical insurance is designed to help cover:

Medical transport and evacuation costs

These are often the most expensive and least understood part of overseas emergencies, and they’re not always fully covered by standard health or travel insurance:

The ripple effects on your finances

Even when some medical bills are covered, emergencies can still trigger additional out-of-pocket costs, including:

Using the ski example, if your travel companion suffers a heart attack on the slopes, the costs may start with an on-mountain rescue and ambulance ride (about CHF 1,500, or roughly $1,900), followed by emergency care, cardiac procedures that can run tens of thousands of dollars and potentially medical transport to another hospital or back home.

Taken together, the total bill can climb quickly, even before factoring in travel disruptions and lost income.

How travelers can protect against expensive hospital and evacuation costs

Travel medical insurance is designed to help pay for medical treatment if you get sick or injured while abroad. More comprehensive policies may also bundle in trip-related benefits, but the medical portion usually includes:

Like other insurance products, policies come in basic, mid-tier and comprehensive versions, with higher premiums buying higher medical limits and broader coverage.

If you plan activities with higher injury risk — such as skiing, snorkeling or hiking — it’s important to confirm those activities aren’t excluded or buy a rider that covers them.

What emergency assistance programs are designed to do

Emergency assistance memberships, such as Emergency Assistance Plus, Global Rescue or Medjet, focus less on paying medical bills and more on handling the logistics and cost of medical transport when something goes seriously wrong.

These programs typically cover:

Unlike insurance, these are membership programs, not reimbursement policies. That means they usually arrange and pay providers directly for covered transport services, rather than requiring you to pay first and submit claims later. Annual memberships often start in the low hundreds of dollars.

Why some travelers carry both

Because travel medical insurance and emergency assistance programs cover different parts of the risk, some travelers choose to carry both: insurance to help pay hospital bills and assistance memberships to cover the cost and coordination of getting to appropriate care or home if treatment abroad isn’t sufficient.

Whether that makes sense depends on where you’re going, how remote your destination is and how much financial risk you’re comfortable taking on.

Do credit cards offer travel health insurance?

Yes, some credit cards offer travel insurance, which helps cover trip interruptions, rental car damage and lost luggage. Chase Sapphire Reserve cardholders receive up to $100,000 for medical services and transportation if the injury or illness occurs at least 100 miles from home.

The card also provides a medical and dental benefit of up to $2,500, with a $50 deductible to cover unexpected expenses while traveling. However, many credit cards have lower medical limits for travel insurance, making you vulnerable to high out-of-pocket costs.

Therefore, contact your card issuer to learn about your coverage and its limits, which can help you identify additional coverage you may need.

When is travel insurance not necessary?

There are times when you might not need travel insurance or an assistance program. If you plan to stay in a major metro area, having access to care next door will likely mean you won’t require additional coverage, such as evacuation services. Instead, you can buy a local health plan or use one offered by your credit card, if applicable.

Another reason you might not need it is if you have comprehensive medical coverage through your employer or the military. If this applies, check the coverage limits before traveling to ensure you’re comfortable with that level of coverage.

Check your medical and evacuation coverage before you go

Before setting out on your overseas voyage, here are a few considerations to keep in mind:

What to do when a medical emergency happens overseas

The first step is to remain calm and contact first responders, providing as much information about the situation. Doing this can help them prepare for what they need, including whether an air ambulance is needed.

Next, contact your travel insurance or assistance provider’s 24/7 hotline number. They’ll walk you through the process, including all the paperwork, on where to send the patient for treatment (some facilities may not be under their coverage) and tips for sharing documentation as it arrives from the medical facility.

Some travel assistance programs can also arrange for a guest to fly back or a nurse escort for the patient when they’re ready to go.

Following this process ensures everyone is on the same page, you have access to what you need and you won’t incur any out-of-pocket costs.

Enjoy the destination with peace of mind protection

Traveling overseas opens new worlds to you. By being prepared and having the right medical coverage on hand before leaving, you can rest easy knowing that even if the unthinkable happens, you won’t be on the hook for a very high bill.

(Sean Jackson is a personal finance writer and contributor to Kiplinger.com.)

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