On which basis should I decide for a travel insurance for Nepal?

Question

I am from Germany and I will go trekking in Nepal in March for 3 weeks. I want to have health insurance in that time. While the health insurances within Germany are super similar, I have no idea about insurances abroad.

What I looked at

• DEVK: 8.30 EUR/year; 42 days per travel insured; they pay 100% for doctors, treatment, medication; "first-aid" for tooth pain is covered; hospitals: transport, stay, operations; transport back to Germany if necessary
• Ergo Direkt: 9.90 EUR/year, looks very similar (identical?) to DEVK
• HanseMerkur: 17.00 EUR/year or 9.90 EUR/year if I book via a portal, looks very similar (identical?) to DEVK

There are two things that worry me:

• Can I have this insurance only for my trip and resign the contract after it? So is it really only 8.30 EUR / 9.90 EUR once? HanseMerkur stated clearly that one has to resign 1 month ahead, otherwise the contract will be prolonged for another year. So there it is for sure possible to have it only for one year.
• How easy will it be to get the medical services? Do I have to pay in advance and then just hand in the bills? Is there any way to see how much of a hassle that will be? Do I have to call the insurance before?

Answer 1

Yes, travel health insurance is usually that cheap (at least in Europe/Germany). Most policies are valid for one year after you take them, and renew after each year.

You can cancel it after the first year, but given the low price for this essential insurance, it makes often sense to just keep it.

What to look out for

People here won't read all those policies for you. You'll have to check the terms on your own and see what works for you - or you can check if some consumer group in your country did a comparison.

Some things you can you look out for in general:

• Do they cover the country that you're going to?
• What is the maximum trip duration that is covered?
• Do they cover the cost of airlifting you back home, if needed?
• Will they pay for search&rescue, if necessary?
• Is there a deductible, or a limit of their coverage?
• Do they exclude any "high-risk" activities, or sports injuries in general?
• Do they include any pre-existing conditions, or do they have a list of conditions that are not covered?
• Do they refuse payment under any circustances (e.g. in case of war, or if there was a government travel advisory for that country?)
• Do they have an emergency number that you can call around the clock?

How does it work?

How easy it is to get services depends on the country you're in, and the facilities that you use. Your travel insurance can't really change the level of medical care in the country that you're in; although they may have a hotline that may offer some assistance in finding a doctor. That's why it is important that they cover transport back home if needed.

The insurance may also not be able to directly deal with all doctors or facilities, at which point you may have to pay on your own and later claim the money back from the insurance.

You don't usually have to call first before getting treatment. However, for anything more than minor problems it makes sense to get in touch and work with them to do things "right", and also to arrange payment for things you can't cover by yourself.

You should always collect all documentation and make your claim as soon as possible in any case.

Ask questions

Finally, if you have specific questions, there's an easy solution: Just ask. Email the company and ask if they cover x and y, and if the can confirm that to you in writing, before you take the contract.

Don't let them upsell you, though. Insurances would rather like you to take out a much more expensive "package" with baggage insurance, cancellation insurance and whatnot. Just stick with the things you really need.

Credit Cards

Be careful with insurance options included in credit cards. They often have more limitations than a good "normal" insurance.

Answer 2

In the end, I took Ergo Direkt (going by averells answer). And I needed a helicopter rescue, although having had several acclimatization days and a guide. Insurance-wise, everything worked fine.

How it worked

1. I signed the contract (online, no real "signature")
2. They send me lots of paperwork, including my insurance number.
3. I wrote down the insurance number and the name of the insurance in my "travel book". I left everything at home, except for this number. But this I put in a spot where I could find it easily.
4. I was struggling the day after Gorak Shep. I was not feeling good the days before either; the cold nights, a sore throat and stomach problems made me feel really shitty. My hiking partners told me I was stumbling all the time. I had a REALLY hard headache. At some point my guide (Ujjwal Rai, nice and experienced guy; speaks English fluently and learns Spanish) told me that I need to go back to Kathmandu. He called somebody (the helicopter company?). They wanted to know my insurance number. We finished the day trip and went to the helicopter landing site.
5. The helicopter took me to Lukla and then another one to Kathmandu. My guide arranged it that I went to a central hospital (ERA Hospital - they took great care of me and the medical staff spoke English fluently).
6. Within the hospital, after a first initial screening, they wanted to see my insurance card. Which I didn't have. After saying the name of the insurance and showing them my note with the number, they called a more senior doctor. He heard the name and said something like "that works". I felt super insecure at that moment. I wished I had taken the page with the insurance number with me.
7. The next day, the insurance called me. They asked if my room / the treatment was good.

What to learn from this:

1. Ergo Direkt is good; stick with an insurance that might be better known.
2. Take the paper with your insurance number with you!
3. Maybe write down the number of a helicopter rescue company / the number of the ERA hospital. Or make sure your guide really knows what to do in case of Emergency.

What I got

1. Helicopter rescue: This was likely the most expensive part
2. 3 days at hospital: A single room and 3 meals a day. The room was nicer than my first 40 USD/night hotel room.
3. Medicine + medical consultation: On my 3rd day (in Namche Bazaar) I had severe breathing problems. There is a health post. I paid in cash (USD, NPR and VISA was accepted, not master card!). Turned out the breathing problems were related to my stomach. Who would have thought. I later send the documents / the receipt to my insurance and got the money without and problem back.

While I was waiting in Lukla for the second helicopter flight to the hospital in Kathmandu, I've heard a pilot answer a request for a luxury flight. He wanted 1500 USD for a flight from Lukla to Gorak Shep and back. Just that you have a ballpark estimate how expensive that rescue flight might have been. I'm really happy I was insured. And really happy that Ergo Direkt turned out to work that well.