Travel insurance and blood thinners
If you're taking a blood thinner such as Warfarin, find out whether it impacts your travel insurance.
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Can I get travel insurance if I’m taking blood thinners?
This depends ultimately on the reason for taking the medication, as opposed to the medication itself. Any pre-existing conditions will need to be declared to your insurance provider prior to travel. During the application process, you’ll be asked whether or not you’re taking any medication. The individual provider will then assess your eligibility for cover.
What is Warfarin?
Warfarin is a commonly prescribed anticoagulant (anti-clotting drug) designed to prevent potentially dangerous clots from forming in your blood vessels. Blood clots can lead to a stroke, or a blockage in a vein or on your lungs.
Warfarin slows your liver’s production of Vitamin K, which helps your blood to clot, so it takes longer for a clot to form in your blood vessels. This anticoagulant is also used to prevent existing blood clots from growing (which is what happens in deep vein thrombosis) and to stop parts of a pre-existing blood clot from breaking off and being transported to the lungs, which can result in pulmonary embolism.
There are several common medical conditions and scenarios in which a doctor will prescribe Warfarin, including:
- 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
Warfarin users will always need to contact their doctor before travelling to check whether they’re safe to do so.
What do travel insurers say about Warfarin and its use?
Warfarin use has significant implications for your choice of travel policy. Most travel insurers will highlight the fact that Warfarin can result in some serious side effects and potential complications. Warfarin use is therefore commonly classed as a pre-existing medical condition and sometimes excluded from cover.
What this means is that if you take Warfarin or any other blood thinning prescription medication, claims connected to any resulting medical expenses abroad, as well as any other expenses connected to your injury or illness, will not be paid. Any bleeding complications, strokes and haemorrhages won’t be covered under your travel insurance policy.
Considering this, if you take Warfarin it’s a good idea to shop around and check with a number of different providers to find out whether any will be able to offer the cover you need.
What is deep vein thrombosis and what are the risks when flying?
Deep vein thrombosis (DVT) is a condition caused by blood clotting, and most commonly occurs in the large veins in the calf muscles.
DVT is a result of slow blood flow, often caused by periods of inactivity, and is linked to dehydration. In some cases formed clots become loose and break free and travel to other parts of the body, for instance the heart or the lungs. If clots become trapped in the arteries of the lungs this can lead to pulmonary embolism, which can be fatal.
Although DVT has long been considered as a problem for those who are immobile or confined to their bed, it’s also a risk during a flight. Not only are you subjected to sitting still in a cramped space for a prolonged period of time, you will also need to battle with the dehydrating effects of flying.
Can I fly if I take a blood thinner?
Long haul flights can increase your chance of getting DVT. So if you take a blood thinner, regardless of what you take it for, it’s wise to check with your GP whether it is safe for you to fly or not.
Doctors may actually prescribe a blood thinner to someone more susceptible to DVT before a long haul flight in order to lower their risk of developing DVT.
If you’ve previously had DVT and are taking a blood thinner in order to prevent new blood clots forming, you don’t necessarily have to avoid flying but it is essential you confirm your travel plans with a doctor. Failing to do this could have serious consequences, and in some cases be fatal.
What are the risks when flying?
An overseas flight can be stress inducing in the best of scenarios, but if you’re not in your peak of health, boarding a flight can have serious implications. Whether you’re suffering simply from the common cold or a more serious pre-existing medical condition, flying can present an array of problems and side effects:
- Air pressure. Air pressure changes during a fight are usually little more than a minor annoyance for most travellers, but these have the potential to affect your heart and respiratory system. If you have a pre-existing heart or lung condition, it’s of the utmost importance to check with your GP before travelling to make sure you’re fit to fly.
- Confined space. Flying means sharing a confined space with a couple of hundred people you don’t know, all of you breathing the same air. If you or another passenger is suffering from an airborne virus or carrying harmful bacteria, coughing and sneezing can quickly spread any number of infections throughout the cabin.
- Ear and nose problems. Swallowing, yawning and sucking hard boiled sweets are all useful aids to pop your ears during flight. Travellers with nasal or allergy problems could benefit from a decongestant spray, and babies can be soothed by sucking on a breast, a bottle or a dummy while in the air.
- Pregnancy complications. Once you’ve entered the 26th week of your pregnancy, you’ll need to start being aware of any restrictions flight providers impose on international flights. Medical clearance will be required before flying if you’re expecting a multiple birth, or if you have any past pregnancy complications. Even if you have what’s considered a textbook pregnancy, it’s vital you check with your GP or midwife before you fly.
Facts about blood thinners
- They don’t actually thin your blood. Although they’re commonly referred to as blood thinners, anticoagulants don’t actually affect the thickness of your blood — they work to prevent it from clotting.
- They differ to aspirin. While aspirin is often referred to as an anti-clotting medication, it works in a completely different way to anticoagulants like Warfarin. Aspirin is an antiplatelet medicine that prevents certain types of blood cells from binding together.
- They affect your diet. Some people believe you should avoid leafy greens when taking a blood thinner, but this is simply not true. However, these types of veggies are high in Vitamin K, which is the vitamin that helps your blood to clot, so you’ll need to eat the same amount each week to stabilise your INR (International Normalised Ratio).
- They need to be taken consistently. It’s extremely important that blood-thinning medication is taken at the same time every day, as prescribed by your GP. If you miss a dose, you should contact your doctor for advice — never take a double dose.
- They actually increase your risk of bleeding. You might be under the impression that taking an anticoagulant would reduce the risk of bleeding, when in fact the opposite is true. Nosebleeds, internal bleeding and bruises are all considered common side effects for those taking blood thinning medication. If you spot any signs of blood in your urine or stools, you should report the incident/s your doctor immediately.
Who is at risk of DVT?
There are a number of scenarios in which your risk of suffering from DVT during travel are heightened. These include:
- Increased age
- Being overweight
- Smoking
- Cancer
- Being pregnant
- Using oral contraceptives
- Undergoing hormone replacement therapy
- Having had DVT or a pulmonary embolism before
- If you suffer from a blood clotting disorder, for example thrombophilia
- Being either very tall or very short
- Having a family history of DVT
- Having undergone surgery in the past two months
- Suffering from an injury to a lower limb
- Having recently suffered a severe illness, such as pneumonia or a heart attack
Tips for flying
- Drink plenty of fluids during flights — avoid alcohol no matter how tempting it can be
- Coffee and tea can have an added dehydrating effect, so minimise your consumption
- Regularly massage your calves
- Wear loose clothing that will not restrict your movement or blood flow
- Don’t take sleeping pills — 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, visit your doctor before flying
- Exercise your calf and foot muscles regularly during the flight
- While seated, bend and straighten your legs, feet and toes every half an hour
- Walk up and down the aisle once an hour provided the fasten seatbelt light is off
- 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 — allow yourself as much foot and legroom as possible
- Get up and stretch your legs whenever you can, including if you have a brief airport stopover
Bottom line
Taking blood thinners doesn’t have to scupper your travel plans. As long as you get the all clear from your doctor before you travel, and you secure the appropriate level of travel insurance, you could be flying high.
Be mindful, however, that your travel insurance premium is likely to be higher and any medical treatment that you require relating to your blood thinner is unlikely to be covered.
Shop around and compare deals to find the right cover for your needs.
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