Health & Insurance

Travel Insurance

If you're buying travel insurance, 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.

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. 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: 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 -- Most health insurance policies cover you if you get sick away from home, but they are not likely to provide for medical evacuation in case of life-threatening injury or illness. It's a good idea to buy a travel insurance policy that provides for emergency medical evacuation. If you have to buy a one-way same-day ticket home and forfeit your nonrefundable round-trip ticket, you might be out big bucks. And the cost of a flying ambulance could wipe out your life's savings.

Check with your insurer, particularly if you're insured by an HMO, about the extent of its coverage while you're overseas. With the exception of certain HMOs and Medicare/Medicaid, your medical insurance should cover medical treatment -- even hospital care -- overseas. However, most out-of-country hospitals make you pay your bills upfront, and they send you a refund after you've returned home and filed the necessary paperwork.

If you require additional insurance, try one of the following companies:

• MEDEX International (tel. 888/MEDEX-00 [633-3900] or 410/453-6300; fax 410/453-6301; www.medexassist.com)
• 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.
• The Divers Alert Network (DAN; tel. 800/446-2671 or 919/684-2948; www.diversalertnetwork.org)

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, or get baggage insurance as part of your comprehensive travel-insurance package. 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.

Health & Safety

Staying Healthy -- Puerto Rico poses no major health problem for most travelers. If you have a chronic condition, however, you should check with your doctor before visiting the islands. For conditions such as epilepsy, diabetes, or heart problems, wear a MedicAlert Identification Tag (tel. 800/825-3785; 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.

Finding a good doctor in Puerto Rico is easy, and most speak English.

If you worry about getting sick away from home, consider purchasing medical travel insurance and carry your ID card in your purse or wallet. In most cases, your existing health plan will provide the coverage you need.

Pack prescription medications in your carry-on luggage, and carry prescription medications in their original containers. Also bring along copies of your prescriptions in case you lose your medication or run out. Carry the generic name of prescription medicines, in case a local pharmacist is unfamiliar with the brand name.

And don't forget sunglasses and an extra pair of contact lenses or prescription glasses.

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).

It's best to stick to bottled mineral water here. Although tap water is said to be safe to drink, many visitors experience diarrhea, even if they follow the usual precautions. The illness usually passes quickly without medication if you eat simply prepared food and drink only mineral water until you recover. If symptoms persist, consult a doctor.

The sun can be brutal, especially if you haven't been exposed to it in some time. Experts advise that you limit your time on the beach the first day. If you do overexpose yourself, stay out of the sun until you recover. If your exposure is followed by fever or chills, a headache, or a feeling of nausea or dizziness, see a doctor.

Sandflies (or "no-see-ums") can still be a problem in Puerto Rico but are not the menace they are in other Caribbean destinations. They appear mainly in the early evening, and even if you can't see these tiny bugs, you sure can "feel-um."

Your favorite insect repellent will protect you from them should they become a problem.

Although mosquitoes are a nuisance, they do not carry malaria in Puerto Rico. However, after a long absence, the dreaded dengue fever has returned to Puerto Rico. The disease is transmitted by the Aede mosquito, and its symptoms include fever, headaches, pain in the muscles and joints, skin blisters, and hemorrhaging. Most of its victims lack any defense against it.

Hookworm and other intestinal parasites are relatively common in the Caribbean, though you are less likely to be affected in Puerto Rico than on other islands. Hookworm can be contracted by just walking barefoot on an infected beach. Schistosomiasis (also called bilharzia), caused by a parasitic fluke, can be contracted by submerging your feet in rivers and lakes infested with a certain species of snail.

Puerto Rico has been especially hard hit by AIDS. Exercise at least the same caution in choosing your sexual partners, and in practicing safe sex, as you would at home.