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story.lead_photo.caption Taking a dream vacation to Antarctica? Travel insurance is a must. (Bai Guolong/Xinhua/Zuma Press/TNS)

You're planning a trip abroad and you've decided not to buy travel insurance. "My choice," you think and you're right. Except in certain countries where you are required to have it. And now, other countries are considering following suit. Whaaat?

Let's say you're taking your dream trip to Antarctica. You've bought or rented your gear, arranged flights and braced for the rough seas of the Drake Passage.

But you're not going anywhere if you don't have travel insurance.

It's one of several places—including Russia, Cuba, Turkey and Ecuador—where you must have travel insurance or your trip probably will be a nonstarter.

Foreign countries want you to protect yourself against disaster because they need to protect themselves financially.

This scenario sometimes plays out: You're on a trip to the place of your dreams and you have an accident. You wind up in the hospital and incur a big bill. You leave owing thousands you have no intention of paying.

You are not one of those travelers, of course, but there are enough of them that Japan, for instance, is urging all travelers to buy insurance.

"Municipal and prefectural governments across Japan are launching campaigns urging foreign visitors to buy travel insurance as a surge in unpaid medical bills puts pressure on hospital budgets," a story in The Japan Times noted.

About a fifth of "all hospitals that have treated travelers to Japan have gotten stuck with the bill," it said. "One particular hospital racked up over 10 million yen ($92,000) in unpaid fees."

Japan reportedly is mulling mandatory insurance.

Thailand, meanwhile, has legislation in the works that would ask travelers to pay "towards a fund to provide cover in the event of death up to 1 million baht," more than $32,000, according to Britain's Telegraph. The repatriation of remains is one issue, but note that this is not insurance for injury or illness.

How do you know which countries require insurance? You don't, although so far only a handful of countries mandate this. There is no comprehensive place where you can find the answer to the question of whether you'll be turned away without insurance.

But one is in the works, said Jenna Hummer, public relations director for Squaremouth, a travel insurance comparison site that is building a database. It could be ready by the end of this month, she said.

Until then, your best bet is to contact the embassy of the country you are visiting.

There's one way to be completely sure: Buy insurance, including medical evacuation insurance in case your injury or illness requires you to return home. Not only does it protect you from financial catastrophe but it also makes you trendy.

"The industry is growing like crazy," said Stan Sandberg, co-founder of TravelInsurance.com. "Sales were up (in 2018) 40.9% from 2016."

Part of that bulge is the surge of baby boomers who are traveling, often to far-flung destinations. Here's what they've discovered about being retired and on Medicare: They have the time and often the money to travel, but they will not have coverage outside the United States under Medicare, in all likelihood.

If you're not on Medicare and don't have a travel insurance policy, some foreign hospitals won't accept you. In an even more unsettling scenario, some hospitals won't accept your insurance and will ask for a credit card. (You'd have to file for reimbursement later.)

What if you're going to a risky destination? Can you get insurance?

"If there are not OFAC (Office of Foreign Assets Control) regulations, then the exclusion is most commonly due to high-risk conditions as determined by the insurer," Hummer said.

"Some policies will provide coverage with high-risk countries that most providers don't cover once again (assuming) they do not have an OFAC sanction), but they typically have a higher cost and include disclaimers that the trip and traveler must meet specific eligible travel requirements."

Among the countries that are excluded because of OFAC regulations or risk: Syria, Sudan, Nepal and Guinea, Hummer said.

Your best bet: Before you book, check with a travel insurer to see whether you can get a policy.

Surprisingly, the biggest demand is for trip cancellation insurance by "people who are looking to protect the cost of the trip," Sandberg said. The key to making a wise choice is to find out what the exclusions are, he said.

For instance, if your child plays school sports and breaks a leg before your trip to Europe, you may not be covered for trip cancellation. Coverage for preexisting conditions may depend on when you buy the policy, he added.

The time to make an insurance decision is not at the 11th hour at an airport kiosk as you're entering the country (which is how a couple of countries spring this on you) but from your desk at home or, yes, work (if circumstances permit). Don't feel pressured, but do ponder before you wander.

You and your destination will be better for it.

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