Health & Insurance

Travel & Rental Car Insurance

There are several kinds of travel insurance: for trip cancellation or interruption, for medical costs, and for lost or delayed luggage. Typically, they are sold together in a per-trip or annual comprehensive plan. Insurance for trip cancellation or interruption is a must if you have paid the large cash deposits demanded by many Alaska outfitters, fishing guides, wilderness lodges, package tour operators, and cruise companies. A premium of 5% to 7% of the cost of the trip is well worth the protection against the uncertainty of Alaska weather (most deposits are lost in case of weather delays or cancellations) or unexpected crises that might prevent you from being able to depart as planned. Interruption insurance will get you home under covered circumstances. Major insurers such as those listed below offer policyholders access to 24-hour phone assistance to help handle crises. Read the policy carefully to find out when you are covered. Do not buy insurance through the operator holding your deposit, even though the insurer itself is a different entity. Policies often do not cover losses related to the company that originally solicited your business. Instead, buy your insurance directly from the insurance company without the involvement of anyone selling you travel products.

Insurance on your baggage is included in most travel insurance plans. If not, consider the pros and cons of a separate policy. Your baggage is often covered under your homeowners' policy or credit card benefits, but that coverage may expose you to high deductibles or sneaky exclusions, so read the fine print carefully and, if relying on a card, make sure to use that card for everything relevant to the coverage. If an airline loses or damages your bags, they are usually responsible for up to $2,500 per passenger on domestic flights or, on international flights, up to approximately $635 per checked bag, excluding expensive items such as jewelry and cameras. Good luck getting them to actually pay in a reasonable period of time, however, as it is notoriously difficult. The simplest course is to leave valuables at home or carry them with you, insuring your baggage only if justified by the worth that you can prove. You would need to establish the value of your lost clothing and such with bills of sale or similar documentation for each item.

Various companies sell travel insurance online, including AIG Travel Guard (tel. 800/826-1300; www.travelguard.com), Travel Insured International (tel. 800/243-3174; www.travelinsured.com), and Travelex Insurance Services (tel. 888/457-4602; www.travelex-insurance.com). Or look for the best deal around by going to www.insuremytrip.com. The site allows travelers to get instant quotes from many insurance companies at once by providing the dates of the trip, amount and type of coverage, and ages of the travelers.

With rental cars, you face a whole different set of insurance considerations. Most of these are the same as renting a car anywhere, and a few simple preparations will get you through. Before you leave home, check your own auto policy for your liability coverage with a rented car (bringing proof of insurance along is a good idea), and check with your credit card issuer for coverage for damage to a rented car (make sure to use that card when you rent, too). Chances are, you are already covered and don't need to buy the unreasonably priced insurance offered by the rental car company when you rent, but if you are not covered, do buy it: The potential costs you face are even larger than having a crash at home, because they include the rental company's lost business.

One special Alaska consideration: Ask the reservation agent or check the rental contract for rules about driving on unpaved roads, such as the Dalton, Denali, or Steese highways. I have listed two companies in Fairbanks that rent for use on unpaved highways; very few allow it. Cars do get damaged on these roads, and you may be setting yourself up for a real headache if you violate the rental contract and that happens. I've suggested alternatives if you want to go to drive the Copper River Highway from Cordova or the McCarthy Road in Wrangell-St. Elias National Park.

Crime & Emergency Services

Crime -- Sadly, crime rates are not low in Alaska's larger cities, although muggings are rare. Take the normal precautions you'd take at home. You're safe in daylight hours anywhere tourists commonly go, less so late at night leaving a bar or walking in a lonely place. Women need to be especially careful on their own, as Alaska has a disproportionately high rate of rape. This doesn't mean women shouldn't travel alone in Alaska, only that they should be cautious. Most women I know avoid walking by themselves at night, especially in wooded or out-of-the-way areas. The late-night sunlight can be deceiving -- just because it's light out doesn't mean it's safe. Sexual assaults occur in towns big and small. Women should never hitchhike alone. If you are a victim of a crime, you can reach police almost anywhere by calling 911.

Medical Emergencies -- You'll find modern, full-service hospitals in each of Alaska's larger cities, and even in some small towns that act as regional centers. There's some kind of clinic even in the smallest towns, although they often are staffed by physician's assistants rather than medical doctors. Call those numbers, too, for referrals to a dentist or other health professional. In an emergency, call 911.

If health is a particular concern, consider joining MedicAlert (tel. 800/ID-ALERT; www.medicalert.org) and wearing their engraved bracelet, which will inform emergency medical personnel of a primary preexisting medical condition and provide them with access to the organization's response center for your information on file, such as medications and physician and family contacts. The cost is $40 for the first year, then $25 a year.

Health Insurance

Travelers from within the U.S. are often covered under their regular health insurance as long as they remain in the country. Take a minute to check your coverage, making sure it adequately covers emergency medical transportation and treatment, especially if you will be adventuring in remote areas. The cost of a med-evac flight can easily be in the five figures. Check the coverage offered by your credit cards or buy a travel insurance policy to cover you just for the trip.

International visitors should make health insurance arrangements before traveling to the U.S. Doctors and hospitals are expensive and often require proof of coverage before they render services (in an emergency, of course, you'll always get quick treatment regardless of ability to pay). Good policies will cover the costs of an accident, repatriation, or death. Packages such as Europ Assistance's Worldwide Healthcare Plan are sold by European automobile clubs and travel agencies at attractive rates. Worldwide Assistance Services, Inc. (tel. 800/777-8710; www.worldwideassistance.com), is the agent for Europ Assistance in the United States.

Outdoor Health & Safety

Avalanche -- When snow sliding down a mountain comes to a stop, it hardens to a consistency that only metal tools can dig through. Avalanche survivors describe the terror of being helplessly locked in this unyielding material hoping for rescue. Understandably, survivors are in the minority. Victims die if not dug out quickly (well before emergency personnel can arrive at a remote slope). No one should go into the snowy backcountry without training in avalanche avoidance and recovery equipment, including locator beacons, probes, and shovels. Go with a guide if you are unsure.

Bears & Other Wildlife -- Being eaten by a bear is probably the least likely way for your vacation to end. More people die from dog bites than bear attacks. But it's still wise to be prepared for bears and to know how to avoid being trampled by a moose, which can be fatal.

The first safety rule for bears is to avoid attracting them. Be tidy with your food and trash when you're camping, putting everything away in sealed containers. When backpacking, you can protect your food by hanging it from a long tree branch or, above tree line, storing it in a bear-resistant canister (for rent or loan in Anchorage or at Denali or Wrangell-St. Elias national parks). Be careful not to spread food odors when you're cooking and cleaning up. Clean fish away from your campsite. Never keep food, pungent items, or clothing that smells like fish in your tent.

Make noise when walking through brush or thick trees to avoid surprising a bear or moose. Call out, sing, or carry on conversation. You might not scare a bear away this way, but at least you won't startle it. At all costs, avoid coming between a bear and its cubs or a bear and food (if a bear wants the fish you just caught, that's his food, too). Moose also are strongly defensive of their young, and a moose on its own can attack if it feels you're getting too close or if it previously has been stressed by contact with people or dogs. People are badly hurt every year trying to sneak by a moose on a trail. I see moose every day when I ski, bike, or run near my house in Anchorage; when the moose wants the trail, I either find a way around or go back the other way.

If you see a bear, stop, wave your arms, make noise, and, if you're with others, group together so you look larger to the bear. Avoid running, tempting the bear to chase (unless, of course, you can run a few steps to your car); depart by slowly backing away, at an angle if possible. If the bear follows, stop. Once in a great while, the bear may bluff a charge; even less often, it may attack. If you're attacked, fall and play dead, rolling into a ball face down with your hands behind your neck. The bear should lose interest. In extremely rare instances, a bear may not lose interest, because it's planning to make a meal of you. If this happens, fight back for all you're worth.

Many Alaskans carry a gun for protection in bear country, but that's not practical for visitors or for anyone not practiced in shooting. (A few years ago, a greenhorn got flustered and threw his gun at a bear.) For most of us, a better alternative is a bear-deterrent spray. These are canisters that you fire to produce a burning fog of capsaicin pepper between you and a threatening bear. While less deadly than a gun, and with limited effectiveness in wind or rain, research shows they have a better overall track record against bear attacks than guns. The sprays also are legal in national parks and okay to carry across the Canadian border -- two big advantages over firearms. However, you can't bring bear-deterrent spray on an airplane, even in your checked baggage, so if you fly, you will have to buy it on arrival and get rid of it before you leave. The product is easily available at Alaska sporting goods stores for about $45, or order direct from Counter Assault (tel. 800/695-3394; www.counterassault.com). Be sure to get a holster, too, as the spray is of no use buried in your backpack. If you do take a gun, it had better be a big one, such as a .300-Magnum rifle or 12-gauge shotgun loaded with slugs. No handgun is big enough to stop a large bear bent on attacking.

Boating Safety -- Because of the cool temperatures, unpredictable weather, and cold water, going out on the ocean or floating a fast river is more hazardous in Alaska than in most other places, and you should go only with an experienced, licensed operator unless you know what you're doing. There's little margin for error if you fall into the water or capsize in this cold water. Many boating deaths occur when good swimmers who are not wearing lifejackets immediately sink -- apparently, the shock of falling in is so intense they shut down and fail to swim. With a life jacket on, it takes a few seconds to get used to the cold water, and then you can concentrate on getting out. You have 15 minutes to half an hour before cold immobilizes you. Equally important, however, is getting warm and dry after you are out of the water. The body temperature of a wet, cold person can easily sink so far he or she cannot get warm without external heating, a deadly condition called hypothermia. If you're sea kayaking or canoeing, always wear a life jacket; stay close to shore; and use rubberized dry bags (also called float bags) to pack everything you need to quickly warm a person who gets wet. Having a way to get help in an emergency is also important.

Dangerous Plants -- Two shrubs common in Alaska can cause skin irritation, but there is nothing as bad as poison ivy or poison oak. Cow parsnip, also called pushki, is a large-leafed plant growing primarily in open areas, up to shoulder height by late summer, with white flowers. The celery-like stalks break easily, and the sap has the quality of intensifying the burning power of the sun on skin. Wash it off quickly to avoid a rash or blisters. Devil's Club, a more obviously dangerous plant, grows on steep slopes and has ferocious spines that can pierce through clothing. Also, don't eat anything you can't positively identify, as there are deadly poisonous mushrooms and plants.

Drinking Water -- Unpurified river or lake water may not be safe to drink. Hand-held filters available from sporting-goods stores for around $75 are the most practical way of dealing with the problem. Iodine kits and boiling also work. The danger is a protozoan cyst called Giardia lamblia, which causes diarrhea and is present in thousands of water bodies all over the United States, even in remote areas, where it may have been carried by waterfowl. It may not show up until a couple of weeks after exposure and could become chronic. If symptoms show up after you get home, tell your doctor you may have been exposed so that you can get tested and cured.

Getting Lost/Wilderness Communications -- Even experienced people get lost outdoors. Hiking off-trail or voyaging in a canoe, raft or kayak, you quickly find that one mountain looks a lot like another. If you are unsure of your navigational skills, maps, or equipment, don't go. Beyond those basics, the most important safety precautions are to go with another person and to make sure someone knows where to look for you if you don't come back. For extended trips (more than a day hike), leave a written trip plan with a person who will call rescuers if you are late. At the very least, leave a note in your car indicating where you are bound. Cell phones sometimes work near towns and highways, but not reliably, and there is little coverage beyond populated areas.

For serious outdoors people, technology can add an extra safety backup outdoors. Personal locator beacons with built-in GPS are the state-of-the-art solution. The beacon is a small device that, when activated, transmits a distress signal and your exact location to an orbiting satellite. Authorities receive the message and find out who you are from a database. After verifying you are really missing, they can then go to the exact spot where the beacon is broadcasting. ACR Electronics' AquaFix or TerraFix PLB (for marine or land use, respectively) cost around $500 at stores such as West Marine or REI.

If you don't want to shell out that much money, or if you want a device that also allows you to stay in touch in the wilderness, it is possible to rent an Iridium satellite phone that will work outdoors anywhere on Earth. The drawback of this approach is that it is less useful in an emergency than a beacon: You need to know where you are and whom to call, and you have to be able to get the phone to work. I rented one for a 2-week wilderness trip and found it rather finicky; I was always able to make a call, but I wouldn't have wanted my life to depend on doing it quickly. I was happy with the customer service of the firm I rented from, RoadPost (tel. 888/290-1616 or 905/272-5665; www.roadpost.com). Prices start at $9 a day, $1.79 a minute, plus a $35 delivery fee (inbound direct-dial calls and text messages are free). The phone arrives with all needed accessories in an express package, which contains a prepaid return envelope to send it back.

Hypothermia -- A potentially fatal lowering of core body temperature can sneak up on you. It's most dangerous when you don't realize how cold you are, perhaps in 50°F (10°C) weather on a damp mountain hike or rainy boating trip. Dress in material (whether wool or synthetic) that keeps its warmth when wet, choosing layers to avoid chilling perspiration. Eating well and avoiding exhaustion also are important. Among the symptoms of hypothermia are cold extremities, an uncommunicative manner, poor judgment or coordination displayed, and sleepiness. A shivering victim still has the ability to warm up if better dressed; a lack of shivering means the body has gone beyond that point and warmth must be added from the outside or from warm drinks. Get indoors, force hot liquids on the victim (except if not fully conscious, which could cause choking), and, if shelter is unavailable, apply body heat from another person, skin on skin, in a sleeping bag.

Insect Bites -- The good news is that Alaska has no snakes or poisonous spiders. The bad news is that Alaska makes up for it with mosquitoes and other biting insects. West Nile virus has not arrived here, so the mosquitoes are not dangerous, but they can ruin a trip. Effective insect repellent is a necessity, as is having a place where you can get away from them. We use shirts with hoods of netting when the bugs are at their worst. Mosquitoes can bite through light fabric close to the skin, which is one reason why people in the Bush wear heavy, baggy Carhartt pants and jackets (made of canvas) even on the hottest days. Benadryl tablets or other antihistamines will often relieve swelling caused by mosquito bites.

River Crossings -- Hiking in Alaska's backcountry often requires crossing rivers without bridges. Use great caution: It's easy to get in trouble. Often the water is glacial melt, barely above freezing and heavy with silt that makes it opaque. The silt can fill your pockets and drag you down. If in doubt, don't do it. If you do decide to cross, unbuckle your pack, keep your shoes on, face upstream, use a heavy walking stick if possible, and rig a safety line. Children should go in the eddy behind a larger person or be carried.

Seasickness -- Most summertime visits to Alaska involve boat rides for fishing or sightseeing. Seasickness probably ruins more of these outings than any other cause. Avoid seasickness by abstaining from alcohol the night before, eating a light breakfast, limiting coffee, and sitting low and near the middle of the boat, away from odors and with your eyes on the horizon -- no reading. Some people use alternative medicine cures, such as ginger or acupressure, which have no proven benefits, but nonetheless work for many of those who believe in them -- a placebo, such as a sugar pill, is 40% effective with seasickness if the patient has faith. My experience and the advice of experts suggests, however, that using seasickness drugs is worthwhile. The very best is the scopolamine skin patch, available only by prescription, which lasts up to 3 days. The main choices for over-the-counter drugs are meclizine (brand names Bonine, Antivert, or Dramamine II) and dimenhydrinate (original Dramamine). Both are drowsiness-inducing antihistamines, but there's less of that side-effect with the newer meclizine. To be effective, the drugs need at least 2 hours to get through your digestive system, so you must take the pill well before you get on the boat. For best effectiveness, take a tablet before bed and another on the morning of the outing. If you've taken nothing and feel yourself getting seasick, there is a last-minute cure that sometimes works: Chew up the tablets but don't swallow them, holding the mush under your tongue or against your cheek. The drug is partly absorbed through the lining of the mouth.

Shellfish -- Don't eat mussels, clams, or scallops you pick or dig from the seashore unless you know they're safe to eat. Generally, that means you need some specific and reliable local knowledge. There is a government program to ensure that commercial shellfish areas are safe, but the only easily accessible beaches it affects are on the eastern shore of Kachemak Bay. The risk is paralytic shellfish poisoning, a potentially fatal malady caused by a naturally occurring toxin. It can cause total paralysis that includes your breathing. A victim may be kept alive with mouth-to-mouth resuscitation until medical help is obtained. For more information, check the Alaska Department of Environmental Conservation website at www.dec.state.ak.us/eh/fss/seafood/psphome.htm, or go to www.alaska.gov and search for "psp."

Driving Safety

Road Reports -- The Alaska Department of Transportation has centralized highway reports with a handy toll-free phone and Internet system (tel. 511; http://511.alaska.gov). Even in dry summer conditions, it is worthwhile to make the call or check the site before heading on an intercity drive, because road construction can cause long delays -- at times, workers will close a major highway overnight for work. In winter, checking on conditions is a safety essential. Here are more seasonal tips.

Summer -- Alaska's highways are two-lane except close to Anchorage and Fairbanks. Keep your headlights on all the time to help oncoming vehicles see you. Drivers are required to pull over at the next pullout whenever five or more cars are trailing them on a two-lane highway, regardless of how fast they're going. This saves the lives of people who otherwise will try to pass. When passing a truck going the other way on a gravel highway, slow down or stop and pull as far as possible to the side of the road to avoid losing your windshield to a flying rock. Always think about the path of rocks you're kicking up toward others' vehicles. Make sure you've got a good, full-size spare tire and jack if you're driving a gravel highway. For remote driving, bring along a first-aid kit, emergency food, a tow rope, and jumper cables, and keep your gas tank full.

Winter -- Drivers on Alaska's highways in winter should be prepared for cold-weather emergencies far from help. Take all the items listed for rural summer driving, plus a flashlight, matches and materials to light a fire, chains, a shovel, and an ice scraper. A camp stove to make hot beverages is also a good idea. If you're driving a remote highway (such as the Alaska Hwy.) between December and March, take along gear adequate to keep you safe from the cold even if you have to wait overnight with a dead car at -40°F (-40°C). Never drive a road marked "Closed" or "Unmaintained in Winter." Even on maintained rural roads, other vehicles rarely come by in winter. All Alaska roads are icy all winter. Studded tires are a necessity. Also, never leave your car's engine stopped for more than 4 hours in temperatures of -10°F (-23°C) or colder. Virtually all vehicles in Alaska have electrical head-bolt heaters installed to keep the engine warm overnight; you'll find electrical outlets everywhere in cold Interior Alaska areas.