Travel insurance and blood thinners

If you’re taking a blood thinner such as warfarin, you’ll need to declare why you’re taking it to the travel insurer to get the right cover.

Whether you’re on the blood thinner for DVT, pulmonary embolism or to prevent a stroke, we’ve compared a number of travel insurance brands to see how they cover conditions related to blood thinners, and what you need to know when getting your policy.

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Cover-More Comprehensive		Unlimited	$10,000	$25,000	$250	Includes unlimited cover for emergency medical, accommodation and transport expenses, $25,000 cover for luggage and travel documents, and $10,000 for legal expenses.	Get Quote More Info	Compare	loading Fetching your data...
Holiday Rescue Comprehensive		Unlimited	$50,000	$5,000	$100	Comprehensive travel cover that includes unlimited emergency medical with no excess, up to $5,000 for lost and stolen items, and 24/7 access to a registered nurse abroad.	More Info	Compare	loading Fetching your data...
Cover-More Annual Multi-Trip		$7,500,000	$10,000	$4,000	$250	Peace of mind as you travel the world with insurance that covers you over a 12 month period. An affordable option for those who take multiple trips over the year.	Get Quote More Info	Compare	loading Fetching your data...
Holiday Rescue Essentials		Unlimited	$50,000	$0	$100	Essentials travel insurance protects you abroad with up to $1,000,000 for personal liability, $500 for dental expenses, and more.	More Info	Compare	loading Fetching your data...
Cover-More Domestic		$1500	$10,000	$5,000	$25	Travel around New Zealand with the security of $200,000 in personal liability cover, up to $4,000 for rental vehicle excess and $10,000 in cancellation cover.	Get Quote More Info	Compare	loading Fetching your data...
Holiday Rescue Domestic		No cover	$50,000	$0	$100	Cover as you travel around New Zealand with $5,000 for rental vehicle excess, up to $1,000,000 in personal liability protection, and $5,000 in alternative travel expenses.	More Info	Compare	loading Fetching your data...

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Can I get travel insurance if I’m taking blood thinners?

If you are taking warfarin or a similar anticoagulant, your travel insurance policy, and premium that may come along with it, is dependent on the condition that you’re taking the blood thinners for.

If you’re taking it after a heart attack or a stroke:

• Most insurers will consider you if it’s been a considerable amount of time since you had your heart attack or stroke .

If you’re taking it for DVT:

If you’re taking it for pulmonary embolism:

most insurers will not cover you for any condition that is related to that drug, whether that’s the condition being treated or a condition that arises as a side effect. However, you will still be able to get insurance that covers you for other, non-related injuries or illnesses.

If you are taking a type of blood thinner called an antiplatelet, then your insurer will take a look at why you are taking the medication in the first place and base its decision on the pre-existing condition rather than the medication.

What do travel insurers say about warfarin and its use?

Taking warfarin and other anticoagulants has important implications for your travel insurance policy. Since warfarin can have a range of serious side effects and potential complications, most insurers class warfarin use as a pre-existing medical condition and can exclude it from cover.

This means that if you take warfarin or any other prescription anticoagulant, any medical claims related to that condition will not be paid if you don’t have the appropriate travel insurance policy, or if you haven’t declared your condition when buying your policy. For example, bleeding complications, strokes and haemorrhages would not be covered.

With this in mind, if you take warfarin it’s a good idea to approach a number of insurers to find out whether or not any cover will be available to you.

• What is warfarin?

  Warfarin is a commonly prescribed oral anticoagulant designed to prevent dangerous clots forming in your blood vessels. These clots can lead to a stroke or a blockage in a vein or on your lungs.

  Warfarin works by slowing down your liver’s production of vitamin K, which helps your blood to clot. The slower production means it takes longer for clots to form in your blood vessels.

  As well as preventing clots form in the first place, warfarin is also used to stop existing blood clots getting bigger (this is what happens in deep vein thrombosis) and to prevent pulmonary embolism, where parts of a clot break off and travel to the lungs.

• Why would you need a blood thinner like warfarin?

  There are a number of common medical conditions and situations where you would be prescribed warfarin or a similar anticoagulant. Here are some of the most common:

  • Atrial fibrillation (an irregular heartbeat)
  • Artificial heart valves
  • Deep vein thrombosis
  • Heart attack or ischaemic heart disease

  • Pulmonary embolism
  • Following a stroke
  • The prevention of blood clots for those with blood clotting problems

• What are some other blood-thinning medications?

  Warfarin can be found under a few different brand names but there are also other anticoagulants that are related to warfarin. In addition to that, there is a different class of blood thinners called antiplatelets.

  Here are the different medications you might come across:

  Warfarin

  Warfarin is also known under the following brand names: Coumadin, Jantoven, Marevan and Waran.

  Other oral anticoagulants

  Other oral anticoagulants include:

  • Dabigatran (brand name Pradaxa)
  • Apixaban (Eliquis)
  • Rivaroxaban (Xarelto)
  • Edoxaban (Savaysa)

  Injectable anticoagulants

  Some common injectable anticoagulants include:

  • Heparin (Fragmin, Innohep and Lovenox)
  • Fondaparinux (Arixtra).

  Antiplatelets

  Some common antiplatelets include:

  • Aspirin
  • Clopidogrel (Plavix)
  • Dipyridamole (Persantine)
  • Prasugrel (Effient)

Facts about anticoagulant blood thinners

• They don’t actually thin your blood. Although they’re referred to as blood thinners, anticoagulants don’t actually affect the thickness of your blood, they just stop it from clotting.
• They’re different to aspirin. While low-dose aspirin may be referred to as an anti-clotting medication, it works in a completely different way to an anticoagulant like warfarin. Aspirin is an antiplatelet medicine that stops certain types of blood cells binding together.
• They affect your diet. While some people believe you need to avoid green leafy vegetables when on a blood thinner, this is not true. However, because these types of veggies are rich in vitamin K, which helps your blood to clot, you’ll need to eat the same amount each week to keep your international normalised ratio (INR) stable.
• They need to be taken consistently. It’s vital that you take your blood-thinning medication at the same time every day, as prescribed by your doctor. If you forget to take a dose, contact your doctor for advice – never take a double dose.
• They increase your risk of bleeding. Nosebleeds, internal bleeding and bruises are all common side effects when taking blood-thinning medication. Any signs of blood in your urine or stools should be reported to your doctor immediately.

Do you need to travel with your prescription for blood thinners?

When travelling overseas with prescription medication, it’s better to be safe than sorry, so we advise you to take your written prescription with you and keep your medication in its original packaging. There are a couple of reasons for this:

• Drug laws differ from country to country. Blood thinners aren’t typically regulated as tightly as drugs like painkillers, but unless you are a drug law expert in each country, you’re better off having evidence that the medication is yours and that it’s for a legitimate purpose.
• New Zealand doesn’t want you selling PBS drugs. Since PBS drugs come at a discount, the New Zealand government doesn’t want you stocking up just so you can sell them overseas for profit. A valid prescription will show how much you need for your trip and what is an appropriate amount for you to take with you for personal use.

What happens if you run out/lose your blood thinners while overseas?

If you lose your prescription while overseas, you’ve got a few options.

• See a local doctor. A local doctor might be able to prescribe a local version of your blood-thinning medication. This is another example of how having your original prescription might come in handy, especially if the local doctor wants to see evidence of your condition.
• Have it sent from New Zealand. You can have your blood-thinning medication sent from New Zealand as long as it is legal in the country you’re in, is for personal use only and the amount does not violate export regulations. It will need to be accompanied by a letter from your doctor and/or a customs declaration form.

Can you fly while you’re on blood thinners?

Sitting still for long periods of time, like when you are on a plane, can increase your chances of developing a blood clot or make existing blood clots worse due to reduced circulation. Blood thinners can help reduce your risk, but it’s always a good idea to get approval with your doctor before you head off on a long flight.

Tips for flying while on blood thinners

When you’re on warfarin or another anticoagulant, you need to take your medication reliably and in a systematic way. Travelling will most likely disrupt your schedule in and of itself, making it more important than ever to pay attention to when and how you take your meds. Here are some tips to help you stay consistent:

• Have your INR* test before you go. Your INR test helps your doctor determine how much warfarin you need and this can change over time. Getting this test before you leave ensures you’re on the right dosage for the duration of your trip.
• Consider an INR monitor. With a pinprick of blood, you can do your own INR test while travelling. If you’ll be gone for a long time or if your treatment requires variable dosing, having your own INR test will let you know if your treatment is working. You can tell your doctor about any discrepancies.
• Take your record book. If you are on warfarin, you’ll have a record book to log your INR results and dosing regimen. If something happens to you, doctors will be able to see that you are taking blood thinners.
• Stay consistent. It is crucial that you take your medication at the same time every day. Take this into consideration when crossing time zones and set alarms to ensure you stay consistent.
• Take enough with you. Warfarin dosages can vary based on your INR tests, so make sure you take enough for all possibilities.
• Be consistent with your salad intake. Travelling can easily disrupt your eating habits, but it is important not to alter your intake of green leafy vegetables. These are high in vitamin K, which is what warfarin targets. It’s fine if you eat them, but not if you are inconsistent with it.
• Get your circulation going. If you’re not sure if you have a blood clot or are prone to developing them, then you need to stand up, move around and stretch periodically to decrease your chances of developing one.
• Seek help if necessary. If you have severe bruising or bleeding, get help immediately. Let doctors know you are on warfarin so they don’t prescribe anything that will conflict with it.

*Some of these tips may not apply to other anticoagulants like dabigatran, apixaban and rivaroxaban that do not require an INR test.

What is deep vein thrombosis and what are the risks when flying?

Deep vein thrombosis (DVT) is caused by blood clotting, most commonly in the large veins of the calf muscles. It occurs as a result of slow blood flow, often caused by inactivity and dehydration (which are both very common on flights).

In some cases the clots that form can break free and travel to other parts of the body, for example the heart or lungs. If those clots become trapped in the arteries of the lungs they can result in pulmonary embolism, which can be fatal.

Up to 400 people die each year in New Zealand as a result of pulmonary embolism, with a small portion of those deaths associated with flying.

Who is at risk of deep vein thrombosis?

There are a number of factors that can increase your risk of suffering from DVT when travelling, including:

Tips for flying to reduce the risk of deep vein thrombosis

Keep the following tips in mind to help reduce the risk of DVT when you fly:

• Drink plenty of fluids during flights and avoid alcohol
• Coffee and tea can also have a dehydrating effect so minimise your consumption
• Regularly massage your calves
• Wear loose clothing that will not restrict movement or blood flow
• Don’t take sleeping tablets as they lead to immobility
• Consider wearing elastic compression stockings
• Take a short walk immediately after your journey to get your blood flowing once again
• If you’re a high-risk patient, your doctor might advise you to have a heparin injection before flying
• Exercise your calf and foot muscles regularly when you fly. You can:

• While seated, bend and straighten your legs, feet and toes every half an hour
• Walk up and down the aisle once an hour (as long as the flight crew say it is safe to do so)
• Press the bottom of your feet down hard into the floor or foot rest every now and then to increase blood flow
• Don’t put bags under the seat in front of you – give yourself as much foot and leg room as possible
• Get up and stretch your legs whenever possible, including if you have a brief airport stopover

By keeping these tips in mind and remaining vigilant, you can ensure that you stay safe and healthy on even the longest of international flights – leaving you free to simply relax and enjoy your holiday.