Health & Insurance

Travel Insurance at a Glance

Check your existing insurance policies and credit card coverage before you buy travel insurance. You may already be covered for lost luggage, canceled tickets, or medical expenses.

The cost of travel insurance varies widely, depending on the cost and length of your trip, your age and health, and the type of trip you're taking, but expect to pay between 5% and 8% of the vacation itself. You can get estimates from various providers through InsureMyTrip.com. Enter your trip cost and dates, your age, and other information, for prices from more than a dozen companies.

Most tour operators and agencies who work in Cuba or book travel to Cuba offer a basic insurance package for around CUC$5 per day that includes in-country medical coverage with a zero-deductible of up to CUC$25,000; emergency evacuation and repatriation coverage of up to CUC$7,000; coverage for civil damages caused to third parties of up to CUC$25,000; and lost luggage coverage of up to CUC$400. Other coverage options also exist. These policies are invariably bought through Asistur (tel. 7/866-8527; www.asistur.cu).

Trip-Cancellation Insurance -- Trip-cancellation insurance will help retrieve your money if you have to back out of a trip or depart early, or if your travel supplier goes bankrupt. Permissible reasons for trip cancellation can range from sickness to natural disasters. (Insurers usually won't cover vague fears, though, as many travelers discovered when they tried to cancel their trips in October 2001.) In this unstable world, trip-cancellation insurance is a good buy if you're purchasing tickets well in advance -- who knows what the state of the world, or of your airline, will be in 9 months? Insurance policy details vary, so read the fine print -- and make sure that your airline or cruise line is on the list of carriers covered in case of bankruptcy. A good resource is "Travel Guard Alerts," a list of companies considered high-risk by Travel Guard International. Protect yourself further by paying for the insurance with a credit card -- by law, consumers can get their money back on goods and services not received if they report the loss within 60 days after the charge is listed on their credit card statement.

Note: Many tour operators, particularly those offering trips to remote or high-risk areas, include insurance in the total trip cost or can arrange insurance policies through a partnering provider, which is a convenient and often cost-effective way for the traveler to obtain insurance. Make sure the tour company is a reputable one, however, and be aware that some experts suggest you avoid buying insurance from the tour or cruise company you're traveling with. They contend it's more secure to buy from a "third party" than to put all your money in one place.

For more information, contact one of the following recommended insurers (although given restrictions on travel to Cuba, U.S. citizens will need to confirm that trips to Cuba are insurable): Access America (tel. 866/807-3982; www.accessamerica.com); Travel Guard International (tel. 800/826-4919; 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).

Medical Insurance -- For travel overseas, most health plans (including Medicare and Medicaid) do not provide coverage, and the ones that do often require you to pay for services upfront and reimburse you only after you return home. Even if your plan does cover overseas treatment, most out-of-country hospitals make you pay your bills upfront, and send you a refund only after you've returned home and filed the necessary paperwork with your insurance company. As a safety net, you may want to buy travel medical insurance, particularly if you're traveling to a remote or high-risk area where emergency evacuation is a possible scenario. If you require additional medical insurance, try MEDEX Assistance (tel. 410/453-6300; www.medexassist.com) or Travel Assistance International (tel. 800/821-2828; www.travelassistance.com; for general information on services, call the company's Worldwide Assistance Services, Inc., at tel. 800/777-8710).

Lost-Luggage Insurance -- On domestic flights, checked baggage is covered up to $2,500 per ticketed passenger. On international flights (including U.S. portions of international trips), baggage coverage is limited to approximately $9.07 per pound, up to approximately $635 per checked bag. If you plan to check items more valuable than what's covered by the standard liability, see if your homeowner's policy covers your valuables, get baggage insurance as part of your comprehensive travel-insurance package, or buy Travel Guard's "BagTrak" product. Don't buy insurance at the airport, where it's usually overpriced. Be sure to take any valuables or irreplaceable items with you in your carry-on luggage, because many valuables (including books, money, and electronics) aren't covered by airline policies.

If your luggage is lost, immediately file a lost-luggage claim at the airport, detailing the luggage contents. Most airlines require that you report delayed, damaged, or lost baggage within 4 hours of arrival. The airlines are required to deliver luggage, once found, directly to your house or destination free of charge.

Health & Safety

Staying Healthy -- Despite ongoing economic troubles and shortages, Cuba's healthcare system remains one of the best in Latin America. The country takes extremely proactive steps toward preventive public health, and common tropical diseases like cholera, malaria, and dengue fever are either uncommon or have been totally eradicated. You don't need any vaccinations to travel to Cuba, unless you are coming from a region with cholera or yellow fever, in which case the Cuban authorities will require proof of immunization.

Staying healthy on a trip to Cuba is predominantly a matter of common sense: Know your physical limits and don't overexert yourself in the ocean, on hikes, or in athletic activities. Cuba is a tropical country, so limit your exposure to the sun, especially during the first few days of your trip and, thereafter, from 11am to 2pm. Use a sunscreen with a high protection factor and apply it liberally. Remember that children need more protection than adults do.

There are no poisonous snakes in Cuba, which will put many minds at ease. In terms of biting bugs, your standard array of bees, wasps, mosquitoes, and sand fleas are present. Sand fleas are a slight nuisance at most beaches if there's no offshore breeze to clear them, particularly around sunrise and sunset. While there are also ticks and chiggers, so far, Lyme disease is not considered a problem. Bring repellent and wear light, long-sleeved clothing.

Overall, while water is potable throughout most of Cuba, I still recommend you stick primarily to bottled water, just to err on the side of safety. Virtually every hotel and restaurant catering to travelers will carry bottled water. Ask for agua mineral sin gas.

Contact the International Association for Medical Assistance to Travelers (IAMAT) (tel. 716/754-4883 or, in Canada, 416/652-0137; www.iamat.org) for tips on travel and health concerns in the countries you're visiting, and for lists of local, English-speaking doctors. The United States Centers for Disease Control and Prevention (tel. 800/311-3435; www.cdc.gov) provides up-to-date information on health hazards by region or country and offers tips on food safety. The website www.tripprep.com, sponsored by a consortium of travel medicine practitioners, may also offer helpful advice on traveling abroad. You can find listings of reliable clinics overseas at the International Society of Travel Medicine (www.istm.org).

What to Do if You Get Sick Away From Home -- Cuba has an excellent nationwide system of hospitals and clinics and you should have no trouble finding prompt and competent medical care in the case of emergency. See the "Orientation" or "Fast Facts" sections of the individual destination chapters for specific recommendations. The system is entirely free for Cubans, but foreigners are charged for services. This is actually a significant means of income for the country; however, fees for private medical care are relatively inexpensive by most Western standards.

The country also has a strong network of pharmacies. However, it is always a good idea to carry a sufficient supply of any necessary prescription medicines you may need (packed in their original containers in your carry-on luggage), and a small first-aid kit with basic analgesic, antihistamine, and anti-diarrhea medications. You might also bring a copy of your prescriptions, with the generic name of the medication in case the pharmacist doesn't recognize the brand name. Don't forget an extra pair of contact lenses or prescription glasses.

If you suffer from a chronic illness, consult your doctor before your departure. For conditions like epilepsy, diabetes, or heart problems, wear a MedicAlert identification tag (tel. 888/633-4298; www.medicalert.org), which will immediately alert doctors to your condition and give them access to your records through MedicAlert's 24-hour hot line.

The Safe Traveler -- Cuba is an extremely safe country. Street crime is relatively rare. With the recent upsurge in tourism, there have been some reports of pickpocketing and muggings, but these are by far the exceptions to the rule. There's a strong security and police presence in most popular tourist destinations, and even outside the well-worn tourist routes theft and assaults are quite uncommon.

That said, you should be careful and use common sense. Given the nature of Cuba's socialist system, there exists a huge disparity in wealth between the average Cuban and any foreign visitor, even budget travelers. Don't flash ostentatious signs of wealth, and avoid getting too far off the beaten path, especially at night. Don't leave valuables unattended, and always use your hotel-room or front-desk safe.

Eco-Tourism -- The International Ecotourism Society (TIES) defines eco-tourism as "responsible travel to natural areas that conserves the environment and improves the well-being of local people." You can find eco-friendly travel tips, statistics, and touring companies and associations -- listed by destination under "Travel Choice" -- at the TIES website, www.ecotourism.org. Ecotravel.com is part online magazine and part ecodirectory that lets you search for touring companies in several categories (water-based, land-based, spiritually oriented, and so on). Also check out Conservation International (www.conservation.org) -- which, with National Geographic Traveler, annually presents World Legacy Awards (www.wlaward.org) to those travel tour operators, businesses, organizations, and places that have made a significant contribution to sustainable tourism.

There is a Cuban travel agency called Ecotur (tel. 7/649-1055), but I don't find them to have any specific expertise or orientation toward what I would consider true eco-tourism.

There are several swim-with-dolphin programs across Cuba, and I deal with each of these on an individual basis in the different destination chapters. For information about the ethics of swimming with dolphins and other outdoor activities, visit the Whale and Dolphin Conservation Society (www.wdcs.org) and Tread Lightly (www.treadlightly.org).