The Offshore Voyaging Reference Site

When Injury Strikes

Well it’s June again, so it’s time for us to pull out our medical kit, discard the out of date items and order up their replacements—more expense! Happily we’ve never had to use anything from the kit yet, but we know it’s only a matter of time before we do, so even though we complain about shelling out once again, we know it makes sense.

How do we know that? Bitter experience. Those of you who follow Attainable Adventure will know that we were planning to cross the Atlantic last autumn, but may also be aware that we didn’t make it in the end. What happened? We craned out to antifoul and change anodes, only to find that a long running fault with our centreboard finally needed sorting out once and for all. As time was tight and no assistance was available, we threw ourselves into sorting this out only for yours truly to suffer an injury that required a return to the UK, an operation and months of convalescence. And so our plan went out of the window (as plans are inclined to do), and we’re still here.

Look After Yourselves

But it could have been worse – it might have happened somewhere far more remote, and where leaving the boat to fend for herself might have been far more problematical. Regular readers will know that all of us at AAC take health matters very seriously – John has endorsed the training he and Phyllis underwent, whilst we have commented on what to carry. Lou recently went on an excellent wilderness medical training course in the UK that impressed her. But there’s only so much you can do yourself.

Which is why many people carry additional travel or health insurance, although some policies combine the two, or elements thereof. Pantaenius offer a popular health insurance policy targeted at long term liveaboard crews, whilst others such as World Nomads have adventure type policies that cover adventure sports including offshore cruising. Naturally it pays to examine this type of policy very carefully indeed, to ensure it could meet your needs, not least because there are often differences in what is available to clients from different countries.

It’s also true that if your needs are less long-term than ours, you may find some coverage available via conventional travel insurance, or even via your VISA credit card if you use it for your travel.

National health support

For those of us from the European Union, we are lucky to have the backstop of our national health services, and there is a reciprocal arrangement between most countries that allows citizens from one country to reclaim medical costs incurred in another participating country. But repatriation costs and the like are not included, so if you need (or prefer) to get home, you’ll need to factor that in. It’s also the case that in the current difficult financial climate, some levels of service are becoming less available in some of the participating countries, as part of cost-cutting regimes. In my case, the standard remedial operation available within our National Health Service was inadequate for my future requirements, so I had to go private and pay for a more sophisticated and stronger long-term repair.

For US citizens it’s different again, related to the level of health care insurance that is carried—and it’s not cheap.

Is it worth it?

All in all, I’d estimate the overall cost of my injury at over $10,000 in direct costs (flights, hotels, consultations, surgery and support, including medicines). Suitable health insurance would cost something like $1,500 per year, so the premiums taken over the last four years would be less than the cost of the one serious injury I’ve had to pay for, so it may have paid me to carry health insurance.

So now, nearly recovered, and with a clean slate, maybe it’s time to look at those policies again. Does lightning strike in the same place twice? We’re just as committed to carrying on, and are slowly gearing ourselves up to think of the next legs, after the disappointment of this last winter. We still believe that self defense is the best method, but at the same time we now know that disaster can strike far closer to home, and (at the very least) can upset your plans.

What do you think – have you been in the same situation? Do you have any experience of long-term health care insurance for cruising, and have you had to use it? Do please leave a comment.

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Dick Stevenson

Colin, An important and complex subject. Please note that those of us who go to areas which may not have broad and deep health facilities might consider a Divers Alert Network (DAN) evacuation policy. It is designed initially for scuba accidents in remote locales, but is offered to non-scuba people also. Essentially, it will evacuate you from an area where facilities are limited to an area where treatment for you is possible. Their Drs. oversee the diagnosis and determine where and how you will go. (You do not have choice: ie you may go to Germany for a complex leg break that occurs on a small Greek Island, but even if a US citizen, will likely not go to the US.) We know of people who have benefited greatly from this service. If memory serves we pay under $50 per year for both of us. Those interested, please confirm my description of the service for yourself as it has been a number of years since I reviewed things in any depth. Dick Stevenson, s/v Alchemy, Stornaway, Lewis Island, Scotland


Hi Dick

Thanks for the tip on DAN – an outfit I’ve never heard of, but that sounds like a really viable option – something we’ll certainly look in to, especially after reading some of the comments below.

Kind regards


John Franklin

One of the problems is the cost and difficulty of obtaining cover once one reaches 70 years of age. After 70, rates immediately double and many insurers won’t even look at you once you reach 75. For cruising, we have found the Pantaenius cover to be the best, especially now they have dumped AUL as their underwriters. But even their policy is restricted to principally marine activities. Last year Jenny and I drove 25,000 km through West Africa from the UK to South Africa and felt that we really must have medical repatriation cover in the event of a severe accident in the boondocks. Being non-marine, Pantaenius wouldn’t cover us. Most “travel” insurance policies are geared to 30 to 60 day trips, typically “package” holidays, and we wanted 5 months cover for 17 countries, most of which the brokers had never heard of; once one mentioned the Congo or Angola they ran a mile! Also I was over 70. After months of searching we only found one company which would cover us (but at some cost) and that was IHI-BUPA out of Denmark. Five months medical-only insurance for the two of us (one 63 and one 71) cost GBP 1,500 ($2,2500).
John & Jenny Franklin
s/v Al SAhaheen, Mahone Bay, Nova Scotia


Hi John

I’ve read elsewhere of the difficulties of obtaining health insurance when over 70, unless you’re prepared to pay a fortune!

The Pantaenius policy seems a practical option, but as you point out, seems only related to cruising, which is a real limitation if you travel (as we do) and are arguably at more risk than when at sea! . I think they are now underwritten by Allianz, but am also told that this triggered a substantial increase in the premium.

Lou is looking at BUPA as an option for us, although it may be more suited to her work (in very remote areas) than crusing – we’ll see, but thanks for the tip.

Kind regards



We also have DAN emergency evacuation/repatriation insurance. It comes with your membership which at, $55 per year for a family membership is a good deal. We are divers, but, they also insure non-divers as well. Never had to use it but have heard good things.

Although we’ve never had to use it we also carry a worldwide(including U.S. and Canada) long-term medical insurance policy from (International Medical Group) through our insurance broker It costs about $200 monthly for both of us for global coverage with a $5,000 deductible. Even though we don’t really need it at the moment, we’re still paying so that if we develop a condition we can still get insurance and also, if you join up with them before 65 and stay for ten years they will insure you even after age 75. This company also has a specific marine policy, but, I think it’s aimed more at commercial mariners.


Hi Ann

Another vote for DAN – has to be worth looking in to.

Good point about the age related insurance too, which sounds like a suitable (and sensible) attitude on the part of the insurers. We’re still a way off that age yet, but there’s no doubt that it makes sense to think ahead in this regard.

Best wishes



We also, heartily endorse DAN insurance program. We have had a DAN family membership, including the basic evacuation/repatriation insurance, for years. In 2006, while cruising in Greece, we had a head-on automobile collision. Although DAN does not pay medical costs they do cover evacuation to an appropriate medical facility or repatriation to home. Even more importantly, they coordinate care and provide translation services etc.
When our son attempted to call the Greek hospital where Rebecca was in the ICU, they denied that she was even a patient. DAN, with their translators, straightened out the confusion and then arranged an airplane with specialists to evacuate her to an excellent hospital in Frankfurt, thereby saving her life. Not only did DAN pay for this evacuation, but they also paid for our children to fly to Greece and Germany and back home and for Rebecca’s and my flights [business class] back to Washington, after she was finally released from the German hospital.

Our DAN membership is the best investment we have ever made. Their insurance covers you anytime you are more than 50 miles! from home.



Hi Sid

Thanks for a great endorsement of DAN – as I’m sure we’ve all found at one time or another insurers are often delighted to take your premiums, but balk at paying out when it’s their turn to dig into their pockets.

Best wishes


Scott Kuhner

Kitty and I also carry DAN insurance. However, we also carry a well stocked medicine kit. Two years ago, (before we had Diver Dan Insurance) we were in Wardrick Wells, the Exuma Park in the Bahamas, when I tripped over a root while walking on a path, fell and broke my arm. We could have chartered a plane to come and take me to Nassau for over $3,000 each person each way. Or, we could wait for two days when the park warden would be able to take us to Staniel Cay where we could get a flight for only $100/person. Luckily, we had some strong pain killer in our medicine kit that I took and was able to bear the pain until we could take the kind offer of the park warden. Moral of the story is 1) always carry evacuation insurance and 2) always keep a well stocked medicine kit on board.


Hi Scott

I couldn’t agree more on the need to carry a well stocked medicine kit – ours is very comprehensive, and should enable us to deal with many emergencies, backed up by our training and the excellent Ship Captains Medical Guide.

And the more I hear of the benefits of DAN, the more I think it sounds like a good idea to carry insurance!

Best wishes


John Franklin

Just a word of caution on DAN, I think (and this needs to be confirmed) that they will only insure US nationals or US Residents.


DAN operates in Western Europe as well as in the US. I believe the membership fee, which includes basic insurance, are a bit higher in Europe, but still a great bargain.



Yes, U.S. health insurance is an expensive and inefficient mess. That’s because the U.S. Congress still has not adopted President Harry Truman’s November, 1945 request that Congress enact universal health insurance financed thorough social security payments—including insurance for supplemental income to defray non-medical costs of illness or injury.


I’ve been doing a lot of research on this subject prior to our departure cruising and I’m finding a lot of cruisers in Mexico simply don’t buy insurance because the healthcare in Mexico is less expensive to pay full price than the premiums and deductibles for a policy. They are, to a person, completely impressed with the quality and availability of care. Anyone else with first-hand experience?

S/V Kintala


Hi Deb

Yes, we do.

Last year in Morocco Lou had a wisdom tooth problem flare up badly, which demanded immediate action. We were directed to a local dentist who was US trained in a spotless and ultra modern surgery. The work, including X rays, inspection, extraction and medication came to 100 Euros.

So in the right circumstances, this can definitely be a good way to go!

Best wishes


Catherine VK4GH

DAN Insurance also has a division for residents of the Asia-Pacific Region. After a quick read it seems that the top cover only covers you for 3 months away from your country of residence, and does not cover you for accidents in your own country. We used the DAN insurance for proof of health insurance cover for a visa (I don’t think they looked too hard). Even so, I would also definitely recommend it.

Carolyn Shearlock

Another consideration for US residents . . . and this may change with all the new healthcare laws going into effect, but something to check into.

When we left cruising, we had good inexpensive health insurance from the company where Dave had retired from. Several years later, they filed for bankruptcy and we lost it. By opting for other US coverage that began immediately when the previous coverage lapsed, there were several programs that HAD to accept us. If you have a gap in coverage, there are none (this may be changing).

So even if you think you don’t need US health insurance while you’re out cruising, think long and hard about whether you EVER might want to live back in the US and thus need US health insurance. For us, we thought that it was likely that if either of us had a serious medical problem, we might very well want to come back to the US for care (depending on the problem, it might be a permanent move). So we kept US coverage the whole time we were out of the US . . . and we were very glad that we had when Dave developed some problems that the local doctors just couldn’t diagnose.

We also had DAN insurance as medical evacuation coverage — that would not have been covered by our regular health insurance. Luckily we never needed it, but we’ve had several friends who have and they’ve all spoken very highly of how DAN handled everything.

John Harries

Hi Carolyn,

That’s a really good point. When we were still residents of Bermuda before moving to Canada, we maintained a very expensive private health care policy for years just because we did not want to get caught in the preexisting condition trap. Now that we are Canadian residents, at least we know that we will always be covered as long as we can crawl back across the Canadian border.


As fellow Canadians we were thinking along the same lines, but then read about various cruisers, who, when they got a diagnosis in a foreign country were told they were unable to fly which means getting back to Canada wasn’t an option. Also, in Ontario at least, there is a three month waiting period for coverage if you’ve been out of the country for > six months. So, for now, we’re taking the hit of paying the premiums for global coverage. Expensive but worry-free (maybe another story if we ever had to make a claim though).


John Harries

Hi Ann,

Good point. We too carry insurance when out of Canada for just the reasons you state. The nice thing is that because the insurance company knows that in the event of sickness or accident all they have to do is stabilize us and get us back to Canada, the premium is a small fraction of what is was when we lived in Bermuda. Of course there is that small matter of Canadian taxes!

Simon Wirth

I’m not certain, as I didn’t look into it, but I know that Rega provides repatriation services for their members.
But it may be that this is only an options for people living in Switzerland, as their main buisness is aire rescue in Switzerland.
Maybe someone knows more about their polycies?


Hello everyone,

I’m curious what the latest opinions are about DAN. Do people here still endorse it as warmly as they did in 2012?

Being Norwegian I have to opt for DAN Europe. I looked closely at their offering, and the evacuation/repatriation insurance everyone here raved about is not a part of the membership; you have to buy a traveling insurance to get it.

Having said that, their traveling insurance looks really good, and is a tempting alternative to other, a lot more expensive, traveling and health insurance offerings I’ve seen. I would have to pay €380 for a traveling insurance valid for 365 days with DAN Europe.

This looks like a stellar deal, but am I missing something important? If anyone here uses this and can throw in their 5-cents it would be highly appreciated 🙂

Best regards,