I tend to be skeptical about travel insurance in general. Like the extended warranties the electronics store clerks try to foist upon you, in the long run it’s a losing proposition. Medical costs encountered while traveling are rarely even close to what you would pay in the U.S. (I’ve had house calls from doctors abroad that cost less than my average co-pay at home.) If you are in a major city, you can pay a relative pittance out of pocket and be set, even for a hospital stay. That’s partly why you read so much about “medical tourism” in Latin America. The economics are compelling if you’re having elective surgery or dentistry work, never mind the drug cost differences.

The key phrase above, however, is “major city.” If you’re hiking in the Andes or floating down the Amazon, you may be days from a good medical facility. In those cases, if something major comes up, you need to get airlifted out of there. That’s where medical evacuation insurance comes in. If you have paid for a membership, you simply make a call to the company and they dispatch a plane or helicopter to pick you up. You arrive at a first-rate hospital there or back home without paying the $50,000 or so this would cost normally. Think of it as buying peace of mind.

I am out of the country a lot, so I have insurance from MedJet Assist, based in the U.S. They have plans for individuals and families, with the latter being $350 for the entire year, no matter how often you travel. As a member, if you are ever hospitalized more than 150 miles away from home, MedjetAssist will send a medically equipped and staffed aircraft to pick you up.

Thankfully I haven’t had to use it, but I like knowing that if I tumble down the side of a mountain in Peru or my wife gets Dengue fever in the jungle, we’ve got backup. Without your health, all the other travel luxuries aren’t so meaningful.