Secure your health for the journey. Episode 56

Monika Rachtan
Hi, a warm welcome to you to another 'First Patient' programme. Today is, as far as I can tell, the 19th of June, which means that most of us are about to pack our bags and head off on holiday. What are some things to keep in mind, besides taking your luggage and your child on the road? We're going to be talking today. And with me are Ala, who is a travel doctor and works at Medicover Medical Centre, and with me is Magda, who is a travel insurance specialist at Mubi travel search. Hi girls! Alla, I'll start with you. Tell me, should any of us who are going on a trip think about going to a travel medicine doctor?

Alicja Sapała-Smoczyńska
This is a good idea. But just as there are many people, there are many ideas for holidays and you know that there are those destinations closer and further afield. We often go with adults, with friends, but also often with children, who are really of different ages, and I think that in fact every trip and every destination requires deeper thinking. Of course, listen, when we go to Suwałki, I think that such a visit might not be what you think of. On the other hand, if we are going to distant Asian destinations, not to mention Africa and South America, it is certainly a good idea. But what I would like to add straight away, which from my perspective and from the patient's perspective is super important, is the timing of when to go for such an appointment. I've had patients come to me and say they're flying out on Friday and it's Monday, and that, listen, it's not that uncommon. It's nice that they came at all.

Monika Rachtan
There is a time when we should plan this visit. In fact, is 5 days enough, or is it more likely to be 3 weeks or more likely to be a month?

Alicja Sapała-Smoczyńska
I think that vaccination is such an indicator here. Prescriptions can always be written overnight. However, vaccinations are something which requires us to organise a certain amount of time so that the end of vaccinations means that our organism still has time to produce enough antibodies to be safe. The kind of time I am talking about here is roughly 14 days before departure. This is the time that we have to finish vaccinating. So to sum up, when we are going away, these two, one month before is a super idea to see a travel medicine doctor.

Monika Rachtan
And are travel doctor visits reimbursed?

Alicja Sapała-Smoczyńska
No. As far as the travel doctor is concerned, you have to go there commercially. However, I would also like to point out straight away, if we have touched on this subject, that practically the majority of vaccinations that concern adults, because we are not talking about children here, who do most of their vaccinations as part of their obligation, the immunisation programme, are paid vaccinations.

Monika Rachtan
That is, such a visit will probably cost us an amount of money, plus we should more or less prepare for the cost associated with vaccinations. And tell me, exactly, why else do you go to the travel doctor? Well, because to get vaccinated. That is so kind of logical for us. But, for example, should a person with a chronic illness, say, heart failure or high blood pressure, also visit a travel medicine doctor to discuss, for example, any risks associated with flying or their illness when travelling to a foreign country? Is this also a good address to address these concerns?

Alicja Sapała-Smoczyńska
By all means, yes. This is not the only address, because let us remember that if someone has a chronic illness, they must be provided with specialist care for that chronic illness. On the other hand, we are somewhat concerned with such aspects as how to transport such a patient safely to a given destination and how to provide them with knowledge on how to proceed there. But let's not just talk about chronic illnesses, for example, say pregnancy. It is becoming increasingly common for pregnant ladies to travel as well. This is not forbidden. On the other hand, it is the kind of condition that obviously requires more attention and a little from a medical perspective. It is, for example, increasingly common in our society that chronic diseases affect people who start travelling, but also pregnant people.

Monika Rachtan
In Poland, we have such a thing as the European Insurance Card, and this is one of the ways to act if something happens to us during this trip, but we also know that it does not cover all benefits and that it is worth insuring against such a trip. Do patients ask you about insurance? Do they talk to you at all, or does it make sense? How do you choose this insurance?

Alicja Sapała-Smoczyńska
Listen, if they are not talking, I am raising the issue myself anyway because let us remember the EHIC, which you mentioned here, that this is a European card. A large proportion of my patients, I think, my colleagues who work as travel doctors, consult people going far, far outside Europe. There, this card doesn't apply, so it's just a percentage of people who need expertise and medical care abroad. So if even the patient doesn't come up with the idea of asking for insurance on his or her own, I also talk about it myself. I'm not going to give away my secret here, because every doctor has a pattern to their visit that they make. And I, if I am seeing a patient for the first time or the last time, because it depends on what plans we have before a particular departure, I also have these points that I would like to tick off in my head so that I can also make a note of it, firstly in the medical records, and secondly, so that I know that he or she has obtained this knowledge from me. And that insurance, the requirement for insurance, for me is a kind of bond here if we are talking about such trips that are far-reaching or risky.
Monika Rachtan
When we think about insurance just for travelling, I think we most often imagine skiing, a broken leg, well, and that I'll get some money back in Poland afterwards. But actually these insurances cover many other events and many other circumstances. Oh no Magda, I would like to ask you, what can we insure ourselves against when we go on holiday?

Magda Dybowska
In fact, medical costs are the basic insurance cover that we think of, but the very concept of medical costs is not just about what we are covered for if something happens to us. It is also a number of additional elements which, at first glance, are not so obvious to us, such as, for example, that if something happens to us, and we have, as we discussed, children with us, and these children may be left unattended, because something may happen to an adult, then, for example, the insurance also provides additional options, such as providing care for these children, providing transport or, if we are travelling alone, calling an accompanying person to join us, and this is included in the scope of assistance, which is an inseparable supplement to medical costs. In addition to this, we can take out personal accident insurance. So, this is another thing which is also a very important element of insurance when it comes to the costs of treatment itself, when it comes to our health. In addition to this, I always recommend third-party and baggage insurance.

Monika Rachtan
What does liability insurance cover? What do you have in mind here?

Magda Dybowska
Liability insurance is all those risks that actually come to mind the least if we are thinking of going away. Because nowadays, for example, city scooters have become very fashionable, and they are also in every city, be it European or worldwide. And we all use them, we use them a lot, unfortunately incautiously, and you don't have to look far to find out, because even among my close friends there have been some such collisions, be it with bicycles or scooters. I am leaving aside some more extreme accidents, but let's focus on this. If we on such an electric scooter run into someone, and there is such a collision.

Monika Rachtan
Not even on holiday, well in everyday life we see that such collisions happen.

Magda Dybowska
Where on holiday, however, we are less careful, or more likely to consume alcohol and accidentally run into someone, a trivial situation can lead to a really big accident. He or she could fall over, maybe hit his or her head on a kerb or maybe break an arm. We can be held liable to pay a pension to such a person for the rest of their life, for example.

Monika Rachtan
And that then ruins our finances for the rest of our lives. Because this pension, if, let's say, we're on holiday in some country, let's say Italy, can be completely different than in Poland. And secondly, paying someone, let's say, our second pension for the rest of our lives is a situation none of us wants to allow.

Magda Dybowska
It is not even just a question of paying it, because sometimes it really is millions of zlotys, millions of euros, because we have to pay for the treatment of such a person, often for their inability to work and their lost benefits. And of course, in extreme cases, as I mentioned, it is the pension.

Monika Rachtan
But to visualise with some example some profession where just these costs can be so very high or something and some situation you remember from your practice comes to mind.

Magda Dybowska
This is not specifically mine, but I have also heard it from insurers. It was a situation, we are on holiday, but it was actually a winter situation where a skier accidentally drove into a ski instructor. And here, in fact, the costs, it was in Italy and the costs are then enormous, because he loses the possibility of practising his profession. Still I, from my experience, when it comes to travelling in Italy, the courts and the Italian police are very sympathetic to their citizens, less sympathetic to tourists and from what I remember, yes. From what I remember, the compensation was 3 billion euros awarded by the court. After the appeal, it came down to one billion euros. This is money that we cannot even imagine having to pay back to someone overnight over a holiday.

Monika Rachtan
Even selling a house, a car and a kidney here may not be enough, so we can see that it is actually worth using these insurances. And if you are travelling with children, what benefits would you look out for in terms of medical care? What is worth buying in such insurances? What can happen to us when we travel when it comes to children?

Alicja Sapała-Smoczyńska
The first thing is that children are a bag of people of different ages, and now depending on what kind of kid, at what age, we are travelling with, it is quite important to be able to deal with a paediatrician. If we are travelling with, say, a 13-year-old, it seems that an internal medicine doctor, a family medicine doctor in the countries to which we travel, is able to deal with such a person. However, the situation is completely different when we travel with a year-old or a year-and-a-half-year-old child, who requires a paediatric approach. I always draw parents' attention to the possibility of paediatric care.

Monika Rachtan
That is, we do not call our paediatrician who has stayed in Poland.

Alicja Sapała-Smoczyńska
Sometimes we call, but he is not able to do much here. We also don't have, even talking about European countries, it's hard for us to write a medicine because we don't have the possibility to fill a prescription in another country. So you know that for advice, telephone advice can also contribute a lot. But if you need to examine a child in person, you need the hands of a doctor and you need access to a paediatrician, not a doctor. This is a very important issue in the younger age group. The second issue is, unfortunately, hospitalisation. Let's give children probably the simplest thing we can think of, which is diarrhoea.

Monika Rachtan
And the risk of dehydration, right?

Alicja Sapała-Smoczyńska
Yes, with adults it is completely different, because, as you probably know, we can convince ourselves that if we have to drink, we have to drink, even if we don't want to drink. However, anyone who has had a three-year-old knows that a three-year-old cannot be persuaded to do anything they are not absolutely sure they want to do. So here, too, the risk of dehydration is definitely higher.

Monika Rachtan
And then there's probably when you're travelling to a country where it's hot, you've got diarrhoea 32 degrees, a child who won't take a bidon in his mouth, and unfortunately a spoon can't squeeze through his mouth.

Alicja Sapała-Smoczyńska
In such a case, yes, and in such a case you may need hospitalisation, which, as my colleague here knows, also involves perhaps not billions of euros, but huge sums of money.

Magda Dybowska
Here, too, if I may add, it is worth considering, if we are leaving with a child concerning the EHIC card, that we should always have this insurance when leaving with a child, because, especially with children, the risk, as you mentioned, is much higher, because we have a whole bag of children of different ages and we also have such a huge ball of energy and a lot can happen with children. And here it should be remembered that the EHIC card does not cover all those benefits that we are used to having covered in Poland. Health care systems in different countries work differently and apart from the fact that we often have to contribute to these costs, where we think that if I have the EHIC card, all the benefits that we have in Poland, whether it is a general practitioner or a paediatrician, we have it covered. However, this is not quite the case, because we get to see a doctor on the same conditions as citizens of a given country, which means that if we end up with our child, whether dehydrated or with a broken arm, in an ED in another country, we will have to wait in a queue just like citizens of the country in question. Only after such a broader interview with the general practitioner will he or she continue to refer us. And with travel insurance we have the comfort of calling a helpline, which is also our first line of contact, whether we don't speak the language or we have such a barrier. We call the helpline in our own language and we get a huge amount of support straight away about where to direct ourselves. Then we don't have to go to these public facilities even in Europe, but we can already use private care, which a public hospital can be much further away. And with this child, it is possible that we need to get help right away as soon as possible, without looking at how far away the facility is. Whether the facility is public or private, time is of the essence and it is then worth using insurance, because it covers both the costs and the time, when it is really important.

Monika Rachtan
But I think that here, too, in terms of the comfort of being on holiday, because we can assume that it is not going to be some matter of life and death at all, it may be a broken tooth in a child that will require the intervention of a doctor, but absolutely these holidays can still be fun, successful, and none of us wants to sit in the ED for 12 14 hours. I say that from the Polish reality, he just goes comfortably to a private practice where he gets water. He can communicate all the information in English, most often there are no obstacles here, and it is limited to such a short visit, a few dozen minutes, and not to the whole procedure, which we do not know yet. We do not know the language. That's why it seems to me that this comfort and the ability to call a helpline, dial a number and speak to a consultant and then go directly to the doctor is what we want on holiday.

Magda Dybowska
And another thing is that insurers usually cover all these damages for us out-of-pocket. And if there is an incident where we try to get to a doctor on our own and we go to a state facility, we can apply to the National Health Service for reimbursement on our return. However, all this paperwork and these procedures are very complicated and lengthy. So when it comes to the comfort of the trip itself, this insurance sometimes costs as much as, say, new shoes, which everyone likes to buy somewhere before the trip to look nice. We'll buy ourselves a blouse, a backpack, trousers, whatever everyone likes to add to their luggage. It is better to forgo this purchase in favour of insurance, because it will really give us much more comfort and we will look much better in it than in the photo in these new clothes.

Monika Rachtan
But that's in addition to being a travel medicine doctor, you're also a paediatrician. What stories do you recall? Because you probably have parents coming back from holidays, they tell you about different situations that happened to them on the trip.

Alicja Sapała-Smoczyńska
Yes, or they write to me while they are still in the process. I mean, yes, I still wanted to take a moment to respond to what you were saying, because these costs are indeed sometimes a surprise. I have patients who like to go to faraway countries, but not that far away, so here we are talking about the Middle East. And during one trip with their two children, they unfortunately had to end up just in the ED, where they were supplied. They spent about 24 hours there and it cost them about £10,000. They had insurance, but as it turned out that didn't cover it out-of-pocket. So, you know, to take out 10,000 zloty while still being on holiday, which obviously some amount of money went to us and we were prepared to do that. And just to take out 10,000 zloty and pay, I think that's quite a challenge for most of us. And I also remember how they were very surprised that, having insurance, they were faced with this unpleasantness. That turned out well later, of course, because they were billed correctly. But I think it's the holidays that are such a time when we want to be joyful and hassle-free.

Alicja Sapała-Smoczyńska
Somewhere in a country we are not in, we don't feel like we are at home, we feel like tourists. This is always a difficulty. Children in general, on the other hand, I think this is a river topic. What can they do? What can they come up with, what kind of pet can they pet when their mum turns her head, or how to fraternise with a stray dog in Thailand. I've had stories like that too, so generally children I wouldn't want to belittle adults.

Monika Rachtan
Especially on holiday, who are looser, who consume more alcohol, different things can happen here too.

Alicja Sapała-Smoczyńska
Yes, definitely. On the other hand, I think the added complication, if I can call it that in trips, is just the presence of children.

Monika Rachtan
I would also say that the mCitizen application allows us to check what risks await us in a given country, and it is worth looking there when we go on holiday. But talking to a travel doctor is a very important element. And this insurance we're talking about, but, well, we have different insurances, they cover different things. The contract is 20 pages long. We're going on holiday, we buy on Friday, we're flying out on Saturday. How do we get that covered so we buy right? Because it seems to me that stories like Al was talking about happen to most travellers, that they've just bought something but they didn't quite know what.

Magda Dybowska
Yes, here too, in the beginning when she mentioned going to the doctor, people leave it to the last minute. It's the same thing with insurance. And I also see that very often we leave it to the last minute. So my first suggestion would be that we don't leave it to the last minute though, because then we're just doing it already so that we have it. Better late than never, so better at the airport. But always keep in mind that if you do it earlier, 3 4 days in advance, then you have time to read the terms and conditions in peace. I also encourage you to compare these insurances, because it is not only the price that plays a role here, but if you look through the insurance comparison website, you will see many of the little nuances that may be important to you, because there are insurances that cover some of the little things that may be important to you. Whereas in the other insurance it will not be there. And it is then worthwhile, without overpaying, to choose the insurance that is tailored to our needs.

Monika Rachtan
Tailor-made.

Magda Dybowska
And if we start doing this early and with our heads, we have time to prepare well for this trip and adjust the insurance as we need it. And what you said on the mCitizen app, I also encourage you to always take a look at what the medical care is like in the country we're going to. Because we can also adjust to what insurance costs we should buy, that is, the guaranteed sums, because this is, above all, when it comes to medical costs, such a basis.

Monika Rachtan
What sums could these be? Because I think it is difficult for someone who receives healthcare in Poland at the National Health Fund to imagine how much, for example, an operation on a broken arm with dislocation might cost in Switzerland.

Magda Dybowska
Oh a lot, it can cost, in fact also depending on the case what kind of displacement it is, but it can be 15,000 Swiss francs, it can be even more.

Monika Rachtan
What amounts should we think about when we look at these treatment costs? Should we be aiming for it to be 50,000 zloty, euros, or is it more like 200,000 zloty as a standard? How do you look at these offers that insurers are offering.

Alicja Sapała-Smoczyńska
I.e. depending on where we are going, this definitely needs to be checked, because there are countries where this care, even though we are not that far from home, is extremely expensive, if we look, for example, at trips to the United States, where these are also very frequent trips, there, frankly speaking, I recommend insurance above one million zlotys.

Monika Rachtan
And there is also such insurance?

Magda Dybowska
They are, and this million is the minimum, because in fact you can insure yourself for more than 40 million, and in fact that is, then we can say that we feel safe, because I have just seen an example of a broken arm operation, where it was the cost of 150 thousand dollars for an operation on a broken arm with displacement. The States are such an extreme case, but so are the Emirates and the surrounding areas, which are also very expensive. Australia, Japan, Canada, somewhere like that, where, in fact, because air transport is so developed, we travel more and more willingly and more often, but also, in fact, the close countries that we go to, because we often forget that if something happens to us, there are still issues of that, we go to the mountains and it could be, for example, our Slovak border. We are very close, but if we add to this the cost of rescue, the cost of transport back home, then these costs rise again. So I always propose, and even if my friends ask me, I am always in favour of the minimum medical costs of 400 or 500 thousand zlotys even in Europe, and the further away we go, the higher the costs should be, and above all they should be adjusted to the country we are going to and the activities we are planning to do. For example, rafting, which is much riskier, but which is also very tempting for us, because it is a cool attraction, but the risk is much higher and to this we have to add, if something happens to us during rafting, the cost of rescue, the cost of pulling us out of the canyon in which we are swimming, plus transport and additional medical costs.

Monika Rachtan
Well, yes that means these costs can be very high. And what you said, not only the cost of the treatment itself in a particular place, but, for example, the cost of transporting a patient who has had something happen, has been treated in a particular country where they have been, and then has to be transported to Poland, but it is often the case that such things have happened on holiday.

Alicja Sapała-Smoczyńska
This is not very common. However, another point of comment on what you said is that you mentioned those countries where these prices - I am not at all familiar with prices - are the highest for these operations and these medical services. These are also the countries you mentioned. I think this could probably be broken down further. If you look at the map, there are countries where we have good accessibility to care, and there are countries that are really much worse in terms of the patient's accessibility to care, which is, for example, the number of kilometres we have to travel to get to a centre that is able to help us. And it doesn't have to be terribly specialised services. I'm talking here about countries in far eastern Asia, when we move away from the big urban centres, just deviate and go to these beautiful areas. But there it is actually much more dangerous and epidemiological, and more dangerous in relation to if we even do something trivial. It's where to look for that help, and I think that's where it's also important, that this issue of getting the patient to a place where that doctor is able to help them, yes, to do a trivial CRP test, to examine the throat, to do a throat swab, not to mention specialist operations for a broken, broken arm. This is also important, because, as I mentioned before, countries like the United States are pretty much, they are obviously vast and different, but they are quite epidemiologically safe, as we think in the realities of travel medicine. On the other hand, let us remember that Africa and such Central America, which used to be virtually untouchable for us Poles, is now an increasingly frequent destination, and I think of such places that it really is also worth remembering that this insurance must be tailored to where we are going.

Monika Rachtan
I will come back to these very transport costs, as we are talking. For a while we talked about such more trivial situations, when we have just had a broken arm, when we have a sore throat, when we have a broken tooth. But sometimes there are dramatic situations on holiday. And this insurance, the fact that we have it, we are just insured for transport. This makes it possible, for example, not to ruin the budget of our whole family, because I'm talking about extreme situations, which are probably also specified in these insurance contracts. What are these situations?

Magda Dybowska
These are extreme situations, as you mentioned, and sometimes, if something serious happens to us, the doctors on the spot, in consultation with the insurance company, decide what is best to do with the patient, colloquially speaking. Will treatment on site be better for him? Would it be better and cheaper to transport him or her to the country, and this usually already involves specialist air transport. Depending on what needs to be on board that plane, these costs, these costs can vary. However, when it comes to transport from America, Asia or Africa, on average it is estimated at around 250 thousand PLN and this is the cost of transport alone. On top of that, there are all the treatments that we have on the spot and all the treatments that we still have after our return, and often, unfortunately, not to mention the most tragic situations, when it is simply the transport of the body after some serious accident to the country. And, unfortunately, it is the case that we often end up simply seeing scraps being created for this type of situation, whether for treatment, for transport or for transporting the body, which is, of course, very sad and the only thing we can do at the moment.

Magda Dybowska
None of us thinks about the unpleasant consequences when we go on holiday, but we will have fun, but we should keep in the back of our minds that we are not only protecting ourselves, but also our loved ones. Because in a situation where the situation is dramatic, our loved ones and our family will do everything to get the money. And we must also remember not to leave them in the plight of those who remain here in Poland while we are away having a great time. But we also need to make sure that we have enough security so that no one has to sell the proverbial kidney, which we also mentioned at the beginning, or the house, because these are huge costs.

Monika Rachtan
If we are insuring ourselves against such important things, against such difficult situations, please tell me how much a day such travel insurance might cost?

Alicja Sapała-Smoczyńska
Insurance prices vary. They also vary depending on the destination, because insurers estimate the risk differently, and in fact the basic insurance usually includes only medical expenses and some low NNW. It starts from as little as £4 per day. Sometimes it may be 3.60, but these are such low packages, where reaching such good high insurance amounts and full insurance with luggage, where we also have protected our electronic equipment, which we often take with us, the things we have already mentioned, and this and this already in high amounts, NNW medical costs and such very extended packages amount to about 14 PLN per day, so still going for a week or two, it really pays off to use this, because these insurance amounts are incomparably high.

Monika Rachtan
The cost of one night's accommodation, right? You could compare it exactly to that sum. All right, but could we try to throw some figures around here? Such as Croatia. All Poles go to Croatia. Let's say I go for 10 days. How much can such insurance cost me?

Magda Dybowska
Depending, as I say, on what kind of coverage we want, it may be for 10 days, it may be 40 zlotys, it may be 300 zlotys, but I always recommend somewhere in the middle ones, at least as far as Croatia is concerned. We should oscillate in these middle prices, because there we will usually already find more complete coverage.

Monika Rachtan
Well, yes, so in a comparison site we are primarily comparing price, meaning we are looking at what we can afford and how much we can pay for it. But we're also comparing those other things that you said, which are extremely important. But one very interesting thing. We were talking about these scooters and you said that we can ride a scooter under the influence of alcohol. If I'm riding my scooter under the influence of alcohol, I've had two beers and I have some sort of mishap, is that covered by insurance as well? Can I then also claim for medical expenses? Well, if we do something under the influence of alcohol, or sometimes it happens that we do not induce anyone to use psychoactive substances. But if we are under the influence of such substances, will this compensation also be paid to us?

Magda Dybowska
Here, just so that I am not misunderstood, I must also correct this. Insurers offer an alcohol clause, because here we can go straight to that whole clause. First and foremost, they offer cover for medical expenses, because these are all the unfortunate accidents that can happen to us when we get too carried away. On the other hand, we need to be careful when it comes to all these other third-party claims, because in third-party liability, as far as alcohol is concerned, it is often excluded unless the situation was not related to alcohol consumption or was not entirely our fault. Here it is always worth reading up. Psychoactive situations are completely excluded from insurance cover, as is alcohol poisoning when we consume alcohol from some untested source or some similar substance.

Monika Rachtan
That is, it is something to watch out for. Proven places we don't buy from local vendors. This is popular in places like Croatia, Albania. There, people sell alcohol on stalls. And I know that there are people who reach for such alcohol, so it is worth bearing in mind here too.

Magda Dybowska
Because it seems cool to us, attractive, local, that we can try something from the host, but I wouldn't exactly recommend it. But coming back to the alcohol clause, I would also like to correct that it is not the case that if we get on the scooter under the influence of alcohol, the insurance will compensate us. It is usually worth reading whether insurers cover damages from third party liability and what are the limits of alcohol consumption, because it is also usually the case that we are covered, but up to the limit which is allowed in a given country, when this condition is not yet so high.

Monika Rachtan
Sure, so let's remember to be responsible on holiday first and foremost. Even though we're buying insurance, it's still a good idea to use that common sense. And tell me, we have something like an exclusion clause in insurance contracts. What do you pay attention to? What points, what buzzwords? What might be relevant?

Magda Dybowska
I would generally recommend always checking for yourself what the exclusions of cover are, because they tend to be tailored to each of the components of the insurance, so medical expenses will have its own, third party liability will have its own, accident insurance will have its own. Somewhere in there we always have to search for ourselves, even just. Of course, I encourage you to still find the time to review the contract, the terms and conditions of insurance in its entirety. However, these exclusions are particularly important, because we sometimes have the feeling that the insurer is bad, that we bought insurance and it does not want to pay out, and we often do not pay attention to the fact that these exclusions of protection have already been described and it is worth looking into them, because it is, for example, driving when we are not authorised.

Monika Rachtan
And also these entitlements look different in different countries, because in Poland, for example, our driving licence can be valid for certain vehicles, and in another country, for example, you need to have a local driving licence which allows you to drive a vehicle, so it is very important to have this knowledge.

Magda Dybowska
Yes, yes, I would also like to say here, regarding these exclusions, that often it is precisely, it is stimulants, that is, these psychoactive substances, on top of that it is also driving under the influence of alcohol, because if we have, for example, a traffic accident, but we are under the influence of alcohol, we can get a complete refusal to pay the benefit, because it is strictly our fault.

Monika Rachtan
Sure, sure. And as I say, we encourage responsibility. And tell me how is it with pregnant women? Because Ala mentioned that it can happen that we still go on holiday when we're pregnant and various complications can arise, well, but for example if we give birth on holiday, are these common situations?

Alicja Sapała-Smoczyńska
Not because, let's remember, carriers don't want to carry women with advanced pregnancies, so usually if they are normal pregnancies. I take into account that women with abnormal, managed pregnancies do not take such long-distance holidays, it is indeed a normal pregnancy. It usually ends on time in Poland. However, in order to fly far away on an aeroplane, you cannot be above the thirtieth week, 30-32.

Monika Rachtan
But a car, a holiday, Croatia is a tempting option after all. One last holiday for two.

Alicja Sapała-Smoczyńska
Yes, definitely yes. But I think they are not frequent. I do not know the statistics, but I think it is not common. It is definitely more common to go on holiday while pregnant than it used to be.

Monika Rachtan
What does it look like? Exactly, Magda from the insurers' side?

Magda Dybowska
As with the carriers, after the 30nd 32nd week of pregnancy, we may already be refused compensation, as this may also be due to the fact that, firstly, this probability is already high and the costs of giving birth in a private hospital are also a bit of a conscious decision to leave in such a state. As far as premature birth is concerned, this is covered by insurance, but it is also always worth checking. I would also encourage pregnant women, even if they are travelling with us, to check whether there are any exclusions. I am not going to give specific companies, specific examples, but in various insurers, this may be provided for in the T&C, so it is worth reading. These are special situations when we should take special care of our health and mental comfort on holiday.

Monika Rachtan
And when we take out insurance, it's a bit like going to the doctor that it's worth telling the truth. In that interview, when the insurer asks us, how old are you, what do you suffer from? And this is very important information that we give even before we take out an insurance contract. Tell me why it's not worth lying in these questionnaires?

Magda Dybowska
First and foremost, this is a question about chronic diseases, which carry a much higher risk. Knowing that we have such diseases, we should always indicate this in the form, always on the website these forms are very short. We actually have a question about chronic diseases. We have a question about the activities we will be doing. And here I can also encourage you to really answer these questions honestly. And if, for example, we weren't planning an activity, but it comes to us in the course. You can take out insurance, but there is also a time limit, so you need to pay attention to this. But if we think about extreme adventures or diving, or rather professional sports, we plan in advance, but if we go to work abroad, then the insurance will be more expensive, but if we honestly say what we are going to do, then we can expect the insurance company to be honest and that the insurance will actually work if something happens to us.

Monika Rachtan
Today, we talk a lot about illnesses and such events which are connected with our health, but simply, on holiday, someone may steal a suitcase, and do insurances also protect us from such situations, or do they not protect us, but compensate us for such situations?

Magda Dybowska
If we choose insurance that includes luggage protection. I would also encourage you to always check for yourself, because nowadays we have increasingly expensive equipment, even if it is electronic, and we have different coverage options, which is also shown in the comparison sites. We have the opportunity to check what level of cover this baggage includes for electronic equipment, whether we will be reimbursed for this baggage if it is stolen, under what conditions? Because this is also another exclusion. How should this baggage be protected? When can we be sure that we have properly secured the baggage? Because if we leave it somewhere and someone comes along, it is partly our fault too, so we should always report this too. When it comes to insuring your luggage, it's also always worth taking a photo of what you're packing. Then it's much easier for us to apply for a refund and prove that we actually took such things with us.

Monika Rachtan
Ala tell me apart from packing dresses, hats and other things to help us have a nice holiday, what other first aid kit should we maybe pack with us?

Alicja Sapała-Smoczyńska
Yes, and before I move on to the first aid kit, I also wanted to refer a little bit to what you were saying, because a tablet is a tablet, a laptop is a laptop, but what if someone steals the medicines that we have in the case? This is very important. People who have chronic illnesses, they are not healthy, non-diseased, non-medicated people, for example, either a high blood pressure disease, or diabetes, or a person who has, who has had anaphylactic shock in the past.

Alicja Sapała-Smoczyńska
A person who needs to have adrenaline with them. These are situations that really require action here and now. When we have a person with a chronic illness who comes to see a travel medicine doctor, I also always and my colleagues always ask if you have enough medication that you can take with you so that you don't have to go and get a prescription, charge your EHIC, charge your time, charge your insurer.

Monika Rachtan
Do you add medicines if something is missing or do you refer to the PCP?

Alicja Sapała-Smoczyńska
No no, of course I can do that too. But what is important from the patient's perspective is that when planning a holiday, more or less knowing how long we are going to be away, how much we will be away from Poland, that we have these medicines with us. And we can talk here about adrenaline, but we can also talk, for example, about hypothyroidism, which is quite a common disease and many people, again mainly women, need to, need to have these medicines with them and going for a fortnight without them can be very inconvenient for them. So that's what's super important. Whereas the first aid kit itself actually, in my opinion, is made up of two parts, that is the things that I can give you straight away to whatever destination you are going to. But of course, there are some destinations where you need to add some medicines. Most of these are drugs or substances that we can buy for ourselves without a prescription, but we need to know about it. That is, for example, fever medicines for children and for adults. You know that everything starts at one o'clock in the morning always and at that one o'clock in the morning you have to wake up and send someone to the nearest pharmacy, which may be far away. I remember being in Rhodes myself and the child of a paediatrician.

Monika Rachtan
A shoemaker walks without shoes.

Alicja Sapała-Smoczyńska
The paediatrician's child got quite a strong allergic reaction and started scratching all over her body. It made it impossible to sleep. So then I said to my husband listen, pack up and go to the pharmacy. It turned out that we were somewhere in Rhodes. The nearest pharmacy was in Rhodes town, which took him half a night or so to convince the pharmacist to sell this over-the-counter medicine yet and get home. So situations like this really can happen even to people who theoretically should be able to provide this for themselves. And that was a trivial story. Of course, I was prepared for all other things. On the other hand, such situations do indeed happen. The second thing is the allergy medication I have already mentioned here. I am not just talking about allergy sufferers here. There are simply insects in countries that we are not used to, that our body is not used to, and not everyone has malaria and not everyone transmits dengue fever, but some just cause ordinary bites, which our body reacts to quite differently.

Monika Rachtan
He's never been in touch, has he?

Alicja Sapała-Smoczyńska
He has never been in contact, so such a medicine may not be in kilos, but an allergy medicine is also good to have with you. This too is available without a prescription. Another quite important thing is disinfectant medication. Remember that in countries where it is very warm and we are in contact with very salty water, wounds heal much worse. And it is important that this disinfection is carried out correctly, for example not with grandma's hydrogen peroxide, but with preparations that are designed for this purpose. However, of course, the more athletic the trip, the more backpacker the trip, the longer the trip, the broader the first aid kit.

Monika Rachtan
Magda when we buy medicines abroad, does the insurance also cover the cost of these medicines?

Magda Dybowska
Yes.

Monika Rachtan
Just one important thing to remember. You have to take the receipt, because without it you won't get anything done. But listen, we know how it is. We've planned the trip, we've packed a suitcase, we've taken a first aid kit, we've taken insurance.

Alicja Sapała-Smoczyńska
If there's anything I can say here, because I've said it, it's probably yes, but only those medications that are prescribed to us by our doctor. It is not the case that we can go and buy a whole net of medicines and walk out and it will be reimbursed, it is in those situations where these medicines are prescribed to us for a specific insurance claim.

Monika Rachtan
And just like that we already have our suitcase packed, we have our first aid kit packed, we have bought insurance. On Tuesday we have a 12 o'clock flight, but on Monday at 11 o'clock our daughter Kasia develops a 40-degree fever, vomits, grabs her ear and we already know that the holiday will be ruined. Can we also take out travel insurance in this case?

Magda Dybowska
This is where a different insurance product comes in, because these are trip cancellation insurances, but we have to remember to buy these trip cancellation insurances well in advance, and usually we buy these insurances when we buy our trip. If we are organising a trip on our own, it is at the moment of booking accommodation or some travel where we buy tickets, because there is such a thing that we have a specific moment to buy this insurance, and depending on the insurance company, there are many reasons for resignation. From the fact that our child or our partner falls ill, through situations such as losing our job and simply having to give up the trip for purely practical reasons, such as not wanting to spend the money on holidays because we need it for current expenses, to the time when we find a new job. And these reasons for resignation are numerous. These products are very differently structured, so I think it's a good idea to compare such insurance.

Monika Rachtan
We, when we are on holiday and need to contact the insurance company because something bad has happened, we reach for the phone. We do the standard thing, we dial the number. Then the phone bill arrives and it turns out that the call cost more than our holiday. How do we deal with such a situation? Because when we read the contract, we don't pay any attention to these costs, but then they come up and they are an additional burden on the holiday.

Magda Dybowska
Unfortunately, there are, here I can suggest such a solution. I don't know if this works with every insurer, as not every T&C specifies whether costs are covered. However, we now have a nice option. I don't want to recommend specific apps anymore, but an internet connection. If we can make a call while we are on WiFi, then we can use this connection to call the hotline free of charge. If we make the call on our own, well, in Europe, we know that these costs will not be high or there will be no costs at all. If we call from further destinations, unfortunately we may be charged for these costs. I personally, when we had such a situation recently, I also tried to contact a person close to me, my sister, who was in Poland. And up to a certain point there was contact with the insurer. Unfortunately, it still comes to the point where we have to call in person, so I recommend trying to still call through this Internet connection, if we have the time, because sometimes, unfortunately, we don't have the time to call the insurer at all, because the accident is so urgent that we need help here and now, and then we use this kind of help, like an ambulance, an ambulance.

Magda Dybowska
Then we don't look at the time and we don't call. However, if we have the opportunity, we always use it. Here I would like to add that when it comes to reporting a claim and calling the insurer in general. This should be, unless the situation is life-threatening, the first thing we do. Because if we start acting on our own, choose our own medical facility, get ourselves some help and then go to the insurer for reimbursement, we may also be refused. So our first step, unless, as I say, the situation is life-threatening, should be to contact the insurer so that they can direct us on what to do next.

Monika Rachtan
Girls, it's June. As I said, probably most of us are going on holiday, but as many as three tips for our viewers on what they should do before they go?

Alicja Sapała-Smoczyńska
A visit to the travel doctor, if they haven't already, or they are not already aware of it because they have had it before, that's for sure. The second thing is insurance, which means checking those things that are important to us and buying that insurance. The third is probably to have fun already.

Monika Rachtan
Magda and you what do I recommend when it comes to insurance? How do you choose well?

Magda Dybowska
I, above all, recommend using a comparison engine. Of course, I recommend Mubi. As far as what else I always recommend is that we be prepared for this damage. Of course, let's have fun and not think all the time that we have this damage, but let's have our insurer's number and our policy number ready, because if something happens to us, that will be the first question we have to ask ourselves, where to call and our insurance number to give, so that we can be located right away.

Monika Rachtan
My dear friends, I hope your holidays this year are going well. I would like to remind you that the "Po Pierwsze Pacjent" programme does not have a summer break because we care about health education all year round, so I invite you to watch the next episodes of our programme. I invite you to subscribe to my channel. Thank you very much today. Thank you Alu. Thank you Magda for being a guest in my studio. This was the programme "Po Pierwsze Pacjent", and my name is Monika Rachtan and I thank you very much for your attention.