Your vacation is coming up; it's all so exciting you can hardly sit still. Passports found and checked, flights booked, hotel reservations made, clothes packed, arrangements made for friends to feed the dog.

Is there anything you have forgotten? What about travel insurance?

Oh sure, travel insurance … do you really need that? You've never lost a bag and you have a good feeling about things. There is no need for travel insurance.

WRONG! There is a very definite need for travel insurance.

Travel insurance covers many eventualities. If your flight is cancelled and you are stranded or if your bag is missing and you don't have even a toothbrush, the insurance will help to defray your expenses.

These, however, are not the most important or expensive eventualities that are covered. The most important is healthcare insurance for the time you are out of the country.

Canadians are more negligent about purchasing this type of insurance than are Americans or Europeans. Because the Provincial Health plans, with all their faults, are always there for Canadians they do not think too much about health insurance. The concept of the "uninsured patient" is not part of the Canadian experience. Neither is the phenomenon of patients being turned away from hospitals because they have no travel insurance. But if you are taken ill or injured in a foreign country and you do not have travel insurance, as an uninsured patient you may have trouble getting care.

Robert Jackson was looking forward to his visit to South East Asia. He spent several months planning his trip. He read the history of the countries that he would visit and created a demanding schedule for himself. He was planning to travel to the less visited areas in Northern Thailand and visit as many of the holy sites as he could cram into his schedule.

He was not planning on visiting the Intensive Care Unit of the Bangkok Hospital Medical Center. He was not planning on spending over forty-eight hours unconscious. He was not planning on multiple surgeries. He was not planning on intensive rehabilitation.

In spite of the fact that he was not too agile and had not ridden a motor-bike in over ten years, he decided to rent a motor bike and ride around the back roads of Thailand. A truck that he was following too closely braked suddenly. Robert flew through the air and landed on his face in the road.

Fortunately he was transported into the city quickly and brought to the Bangkok Hospital Medical Center, a tertiary care JCI Accredited facility. Since he was unconscious, he admitted to the Neurological Intensive Care Unit. His family was contacted and consent for treatment obtained. They didn't know if Robert had any health insurance and were reluctant to guarantee payment for the care. In spite of this he received excellent care and, after multiple surgeries for his facial fractures and skin grafting to other wounds, he is now on his way to full recovery.

Robert was obliged to take out a considerable bank loan to cover his care.

Melanie Albert was working as a volunteer in a children's care home in Cambodia. After eating a very spicy dinner one evening she started to have abdominal pain. Thinking it was indigestion she initially ignored the pain but by the following morning realized that this might be something more serious than an upset stomach. Naively thinking that her home country would cover her medical expenses while out of the country, she had not obtained any insurance when she left Canada. After being seen in a clinic she was flown to Bangkok and admitted to the Bangkok Hospital Medical Center. A diagnosis of appendicitis was made and she had an operation on the same day. Her family came out from Canada and were able to have funds transferred to cover the cost of her care.

She was particularly fortunate as she had been able to get to Bangkok on a commercial flight. If she had needed to have a special air-ambulance the cost would have been enormous. One of the features that is always included in travel insurance is evacuation insurance, which covers the cost of transportation to a good medical center close to your accident or to where you were taken ill. It also covers the expense of getting you home after treatment has reached that point that you are ready to travel.

Another Canadian man needed to be transported back to Canada after surgery and intensive care treatment for a collapsed lung which happened quite spontaneously and without warning. As he was taking anti-coagulants and there was the possibility that he might need extra oxygen on the flight, he needed a nurse and a doctor to travel with him. He was flown from Bangkok to Hong Kong and from there to Toronto. He traveled Business Class with his two attendants. Luckily he had good coverage for this very expensive journey.

These three patients were all fit young people with no previous medical illnesses who had no reason to believe that they would need hospital care during their vacation. That is the whole point about insurance it is there to help you when the unexpected happens.

Travel insurance is surprisingly inexpensive and for a young person may be as little as US$40 for a three-week vacation. I would suggest that you purchase this before you leave your home country. The Information Center that the insurer provides can be very useful and they will be able to direct you to the best medical facility wherever you are in the world.

Whatever insurance you have, keep the details of the policy and call center number with you, on your person, at all times.

I hope you have a wonderful trip and do not need any medical services, but it is best to plan for all eventualities.

Dr. Michael Moreton is a Canadian physician. He is the International Medical Coordinator at the Bangkok Hospital Medical Center, Thailand.