Amy Rossmark has a backup plan in case her wallet disappears during her trip to France this month.
She's prepared for the temperamental weather. She has her map marked with good areas and bad areas of Paris. But if Rossmark, 30, of Columbia, gets sick, really sick, she might not have any safety net at all.
Health plans may not cover doctor visits or hospital stays abroad, and travel experts fear too many travelers don't know about the missing coverage until they have the bill in hand. Some plans won't cover health-care costs for people traveling within the United States.
"Most people are traveling for a short time, and they just roll the dice and plan for everything to go fine for a week or so," said Nick Stat, manager of Round the World Travel in Baltimore.
And most of the time, tourists come back just fine. A majority of overseas ailments result from unusual foods or drinking water and can be handled with over-the-counter medicines, travel experts said, but extra coverage can't hurt.
Rossmark said she just assumed her BlueCross BlueShield plan covered her during her travels. But that's not always true, said Debbie McKerrow, a manager at Carefirst BlueCross Blue-Shield, which handles policies in Maryland, northern Virginia and Washington.
"When people are traveling and they have concerns, we get them in touch with a program called BlueCard WorldWide," she said. "But even there, some countries, you show the card and you're fine. Some hospitals have agreed to accept it and some don't."
Even those going for a short break should be prepared, said Evelyn Hannon, editor of Journeywoman, an online travel magazine for women (www.journeywoman .com).
"Hopefully, people are thinking about it, but I wonder if they really do," she said. "Even going across the border from Canada to the U.S. for one day, if you land in a hospital without insurance, can you afford it?"
Pregnant woman and older travelers particularly need to read the fine print of their insurance coverage -- and specifically ask about their conditions when buying travel insurance, she said. Finding the right kind of insurance is also important; it won't do any good to get extra coverage that does not include personal watercraft accidents if using the watercraft is a major part of the vacation, Hannon said.
Those traveling to developing countries may want to bring their own needles, she warned, because sterilization isn't always automatic.
Although Hannon said it cannot hurt to be too careful, many fears go unfounded.
"I had a friend who had a miscarriage in Tunisia and thought she would have to have a blood transfusion," she said. "Everyone here was very worried, but she said she felt her hospital care there was better than a lot of what's here in North America."
That wasn't the case for Valerie Fudge. During a trip to England in 1990, she hurt her foot while riding a bicycle. Because she was working in London with a student work permit, she was covered under the country's health plan.
"When I went to the clinic, she examined my foot, but didn't take any X-rays," said Fudge, 28. "She didn't think I had broken anything, but she just thought I should wear a metatarsal support."
But Fudge, then an undergraduate student at Virginia's James Madison University, had indeed broken a bone, and when it wasn't corrected, it healed improperly, causing a great deal of pain. Two years after her trip, she had an operation to correct the break.
"A doctor here didn't catch the break either, even when he looked at the X-rays. So I don't know what's worse, not to have taken X-rays in the first place, or to take them and not catch the break," she said.
Although students tend to take longer trips because they have longer summer vacations, only about a third even inquire about health insurance, said Shannon MacDowell, a reservation agent at Council Travel, a national student travel agency based in Boston.
"It's mostly only the older ones who ask [about health insurance]," said MacDowell, 23, who described "older" as ages 25 to 35. She said getting sick wasn't something she considered during her own travels to Scotland, Kenya or Barbados.
"In Kenya I did get sick, but it was just more or less weird food sickness," she said. "I just took Sudafed or some over-the-counter medication and I was fine."
The agency encourages students to purchase an International Student I.D. card, which has emergency insurance for hospital costs. Those wanting to purchase coverage for doctor's visits or trip cancellation insurance must buy additional coverage from another company, MacDowell said.
Hannon, of Journeywoman, the online magazine, said often the worst thing about getting sick while traveling is not knowing a reputable doctor or hospital.
She pointed to a new online service for women that connects female travelers with overseas residents in times of emergency (www.hermail.net).
"So if you're in Prague and you have to go to a doctor, you can sign on and send an e-mail to a resident, whose name remains anonymous until she contacts you, and then she can help you get to the best resource," she said.
For many travelers, those resources remain far from the foremost concern.
Emily Thompson is focusing more on which museum to see on what day during her five-week study-abroad program in France this summer.
Luckily, the 21-year-old Fordham University student's program made sure she was covered during her stay in Paris, where she will be joined for a week by her cousin, Amy Rossmark, and then for several weeks in Annecy, a city on the France-Switzerland border.
"The program required all that stuff; they made sure you were covered by insurance," she said, adding that, as a student, she is covered under her parents' policy.
Although Thompson has no major medical concerns, she is bringing extra prescription medication for her eczema, just in case.
"I'll bring plenty so I'm covered for a few weeks. And if I run out, the worst thing that will happen is that I'll have very dry skin," she said.
"I'm not really thinking about that. I just want to see as much as I possibly can."
STAY HEALTHY ON YOUR TRIP
The Mayo Clinic Women's HealthSource newsletter offers these tips for people planning to travel abroad:
* First, do research. The Centers for Disease Control Web site (www.cdc.gov/travel/index. html) provides comprehensive information "about the risks you're likely to face where you're going and what you need to do to protect yourself." The CDC also has a 24-hour Voice Information Service at 888-232-3228.
* Learn how your health insurance handles medical care when you're out of the country.
* If you do not speak the language of the country you are visiting, be sure to "prepare a list of names, addresses and telephone numbers of English-speaking hospitals and doctors at your destination." Help is available by writing to the U.S. State Department's Office of Overseas Citizens Services, Room 4811, 2201 C St. N.W., Washington, D.C. 20520. Send a self-addressed, stamped envelope, and allow several weeks for a reply. The telephone number is 202-647-5225; the fax number is 202-647-3000.
* See your doctor at least six weeks before your trip, and obtain all necessary immunizations.
* "Use common sense to protect yourself from harm. Don't explore unknown territory alone or at night; keep your hotel room locked; don't carry a lot of cash; and practice safe sex."
Pub Date: 07/04/99