This is part of a series of South Florida Sun Sentinel articles exploring maternal health care.

It is 2 a.m. when Brianca Spence slips behind the wheel of her car. The drive to the nearest hospital can stretch as long as an hour, and feel like an eternity when she’s rushing to guide an expecting mother through childbirth.

As labor unfolds, Spence will translate the harsh demands of a nurse on duty into calming guidance. She will encourage the woman to ask for pain medication when she needs it or suggest a position change to speed up labor. And, when the mother eventually returns home with a new baby, Spence will be her pillar of support, encouraging her to stick with breastfeeding, or go for her postpartum doctor’s visit.

Babies born early, ill, or dead: Florida spends millions on prevention. Why isn’t it getting better?

In this maternity care desert on the western fringes of Palm Beach County, Spence’s mission as a doula is to advocate for mother and baby before, during and after childbirth. If she does her job well, she will play a vital role in keeping more Black mothers and babies alive.

With Florida’s infant mortality rate stubbornly higher than the national average and Black babies in the state dying at more than double the rate of white non-Hispanic babies, doulas represent a potential pathway to address the problem.

Doula training has ramped up in the state, the result of a confluence of factors that are making the option more available to women — particularly women of color — who may benefit most from having an advocate through the process. Doulas are non-medical, trained labor assistants or coaches who provide physical and emotional support during pregnancy, childbirth and recovery. A doula will speak up for a mother when a doctor dismisses her concerns. She will ensure a woman’s birth plan is followed as much as possible. And, she will pick up on signs of complications or postpartum depression that could have been overlooked.

There’s no legal training requirement for doulas in Florida, although most have completed certification programs.

Midwife Jamarah Amani, left, talks to Rebekah Antoine, 33, of North Miami Beach during a prenatal visit in February at the Southern Birth Justice Network in Miami. Antoine, who was pregnant with her fourth child, has since given birth to a healthy baby boy. (Carline Jean/South Florida Sun Sentinel)

To become a doula, Spence participated in the first cohort in 2022 to graduate from a training program through Healthy Mothers, Healthy Babies Palm Beach County. The program was specifically designed to drive down death rates for Black mothers and babies. Spence then joined Florida’s Doula Network, an Orlando-headquartered company that provides health plans with credentialed doulas. In Florida, The Doula Network contracts with Medicaid plans to cover doula services and typically pays the doulas a flat fee for prenatal, childbirth and postpartum support. “Each plan has a different amount that they pay,” Spence said. A private-pay client typically pays a doula a higher rate, she said.

Spence balances her doula role with a full time job at Lake Okeechobee Rural Health Network and her responsibilities as a mother of three young children. She gave birth to her children in a birthing center using a midwife and wants other mothers to have a good birth experience, too.

“I just want to be that support for women in my community,” she said. “The most important thing I do is teach them to speak up and what to speak up for. You don’t get that with a traditional prenatal provider.”

Steep cost of long-term preemie care takes heavy toll on overburdened families

In the past, doula care often has been unaffordable to low-income Black women who have higher risk of birth-related complications. If self-paid, a birth doula can cost $1,200 to $4,000, depending on whether pre- and post-birth visits are included.

As of 2019, many Medicaid enrollees in Florida’s managed care plans have access to the doula benefit. Florida is one of only 13 states that allows Medicaid plans to cover doula services, as an optional benefit. Some Florida plans offer it only to high-risk mothers while others make it more widely available.

For national insurer Elevance Health, Florida is one of the biggest markets for doula services in its Medicaid plans.

“We recognize that the Black community is really embracing doulas as an opportunity for change, and so we’re trying to put ourselves in that space to be able to help support that,” said Dr. Tiffany Inglis, national medical director at Elevance Health.

Inglis said her company began its foray into doula coverage by educating doctors, nurses and midwives in its network on the value they bring to the care team.

“We made it clear we don’t want doulas to replace doctors, nurses and midwives. We want them to be part of the care team so that we can sort of remove that burden to find social support (for a mother) from a clinical team that’s not trained for it,” Inglis said.

Ashly Hinds, 30, of Coconut Grove, is surrounded by midwives as she breastfeeds her 2-month-old son, Travis Small Jr., during a post-care visit at the Southern Birth Justice Network in Miami. (Carline Jean/South Florida Sun Sentinel)

Spence, for example, not only accompanies mothers to prenatal and postpartum visits, but she also connects them to community resources for food, diapers, transportation, or mental health counseling.

Inglis said Elevance looks to its doctors to promote doula usage among patients and tracking results.  “The plans are putting doulas in communities where they know we have larger populations of Black moms because we are seeing such a good impact from it and we are seeing such a good uptake of it,” Inglis said.

Rebekah Antoine, a doula and community programs director with Miami’s Southern Birth Justice Network, said the doula benefit through Medicaid is a public health intervention and has the potential to reduce not only Florida’s infant mortality rate but also its maternal mortality and morbidity rates.

She wants to see Florida take the next step.

“There needs to be more funding going to community-based organizations to train new doulas to serve within their communities.” Antoine said. “There needs to be more education to let Medicaid recipients know the benefit is available. Midwives and doulas should be an option suggested to a pregnant person when they enroll.”

Just because you have a benefit doesn’t mean that you know how to sign up and how it works. Connecting the patients to the doulas is a missing link, she said.

Antoine would like to see state health officials foster more partnerships between doulas and providers such as Federally Qualified Health Clinics located in communities of color, particularly the underserved Haitian community.

“Doulas and midwives are an important part of the collaboration for making quality maternal care more accessible,” she said.

Midwife Jamarah Amani, left, comforts Ashly Hinds, 30, of Coconut Grove during a post-birth care visit at the Southern Birth Justice Network in Miami. (Carline Jean/South Florida Sun Sentinel)

In Tallahassee, the services that doulas provide to the minority communities have caught the attention of Florida Sen. Rosalind Osgood, D-Tamarac.

Osgood wants to propose doula legislation similar to a law recently passed in Virginia, which mandates that health insurers who cover obstetrical services also provide coverage for state-certified doulas. She wants plans to set a higher rate for reimbursement. Doulas often complain of low reimbursement rates.

“I would like to see doulas paid consistently by healthcare providers for their advocacy and support of babies and mothers doing childbearing,” Osgood said. “Once we get some kind of criteria for certification, it makes it easier to allocate government dollars for those services and ensure doulas get paid fairly for their services.”

The state of Florida now connects pregnant women with doulas as a new initiative of the Florida Association of Healthy Start Coalitions.

Medicaid plans have provided funding to Healthy Start to train doulas using the G.R.O.W. Doula model. Sixteen of the 32 Healthy Start offices in Florida are working to complete the certification of the trained doulas and connect them with pregnant women.

Healthy Start’s Cathy Timuta asked the state in its 2024 session for more money to expand the Florida Health Start doula program to improve the disparities in birth outcomes for women of color.

“Healthy Start is launching a doula program through contracts with some of the health plans for the Medicaid population. However, we are in need of funding for the pregnant mothers who are not eligible for Medicaid which represent about 50% of births in Florida,” she wrote in a funding request for 2024-25.

Steep cost of long-term preemie care takes heavy toll on overburdened families

So far, the state has not approved the funding request.

However, in Miami, a Black Maternal and Infant Health Equity Collaborative has formed to train and certify 65 doulas and incorporate them into the obstetric care teams at Jackson Health, Miami-Dade’s large public hospital system.

“We have trained 29 doulas so far as well as training hospital staff to create a more doula-friendly environment,” said Loreen Chant, executive director of the Health Foundation of South Florida, which has provided funding for the Jackson Doula Pilot Project.

But doulas aren’t medical providers and won’t solve the problem of dwindling maternal care in some neighborhoods. About 19% of Florida’s counties are maternal care deserts, particularly concerning for Black women who face death rates related to pregnancy that are over three times those for white women.

Midwives are stepping in to fill the gaps and provide what they call “more culturally sensitive care.”

In a small office building in North Miami, Jamarah Amani runs a midwife clinic through a nonprofit called Southern Birth Justice Network. The space is calming, as is Amani’s voice as she sees Ashly Hinds for her first visit after giving birth. She asks the new mother about her success with breastfeeding, her mental health, her sex life.

Amani explains that midwives play a vital role in obstetric care.

“There’s different reasons that people come to us,” Amani said. “Sometimes it’s because they don’t trust the hospital. Sometimes it is because of previous birth trauma, or maybe they’re undocumented and they don’t want to be caught up in the system. But they do know when they come, that they’re going to get a more individualized, holistic, family-centered approach.”

Hinds, 30, of Coconut Grove said she is aware of the disparities facing mothers of color and didn’t feel comfortable with a hospital birth. She sought Amani to deliver her baby in her home. “For me it’s cultural,” Hinds said. “My grandmother was born at home with a midwife. What’s my normal might not be everyone else’s, and that’s OK.”

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The U.S. Centers for Disease Control and Prevention has found Black women are three times more likely to die from a pregnancy-related cause than white women. Midwives like Amani see more interest in her profession with greater attention to these statistics.

A recent analysis highlighted by The Commonwealth Fund found that a midwife workforce, integrated into health care delivery systems, could potentially avert as much as 39% of neonatal deaths and 26% of stillbirths.

In Florida, midwives need a license to practice but they typically don’t see high-risk patients.

Community midwives work outside of hospitals, delivering babies in birthing centers or at homes. Some Florida hospitals like Jackson Health in Miami or UF Health in North Florida offer team-based care that includes nurse midwives as part of their staff.

Florida’s new Live Healthy bill championed by Kathleen Passidomo eases the restrictions on independent midwives, making it easier for them to practice at birthing centers. The bill also allows “advanced birth centers” to provide cesarean section deliveries for women considered low-risk pregnancies. Until now, birth centers have been prohibited from providing cesarean sections, surgical procedures previously done only in hospitals.

Some insurers including Medicaid cover the cost of midwives, but reimbursement rates vary, and often are low. Typical midwives spend at least 45 minutes with a patient each visit, a different approach than most obstetricians..

“Many traditional providers will spend very little time with their patients because they just need the volume,” Amani said.

Florida has 853 certified nurse midwives, according to the national certification board, and 169 student midwives.

Johanne Ulysse, 31, who is in training to be a midwife, talks about her experience with giving birth to her son. Ulysse is doing her internship at the Southern Birth Justice Network in Miami. Ulysse said when her baby went into distress at 41 weeks, she had an emergency C-section. “I thought, there has to be a better way.” (Carline Jean/South Florida Sun Sentinel)

One of those student midwives is 32-year-old Johanne Ulysse. The Coral Springs mom is studying to become a midwife after a bad birth experience. Ulysse said when her baby went into distress at 41 weeks, she had an emergency C-section. “I thought, there has to be a better way.” The baby survived, but Ulysee knows the statistics — about 1,300 babies a year in Florida do not survive their first year.

“Midwives will talk about the patient’s personal life, health, diet … a lot of things that culminate and make a healthy pregnant person,” Ulysse said. “I think that if more Black women knew you don’t have to go to a doctor. You can have a midwife who will listen to you and give you more in-depth care. I think that it would be revolutionary.”

Jennie Joseph, founder of Orlando’s Commonsense Childbirth, became the first Black person in the U.S. in 2020 to privately own a nationally accredited midwifery school. She says Florida should offer universal healthcare to cover all women who want access to midwifery care, or doula care, or other maternal health providers.

As opposed to an OB-GYN she will take anyone who needs maternal care, regardless of their insurance status, and help them through the difficult process of applying to Medicaid, which few physicians in Florida want to accept, she said.

“Once you get to our clinic or make a phone call to our clinic, the answer is always going to be ‘Yes, we will see you.’”

After years of feeling dismissed in hospitals or provider offices, many Florida women are working to find prenatal caregivers who look like them, speak their language and listen to their concerns.

Belle Glade, a town with a significant population of women who are Hispanic, Black and Haitian, has only two prenatal care providers, and the nearest hospital with labor and delivery is 30 to 45 minutes away.

In her doula role, Spence feels like she is the safety net in her diverse community.

“When I looked at the stats and numbers and the community here, I saw mothers and babies in rural areas are dying more and the people who could make a difference don’t know or understand why,” Spence said. “Doulas might not be the end-all-be-all, but it’s a step in the right direction.”

Cindy Krischer Goodman, health reporter for the South Florida Sun Sentinel, reported this article while participating in the USC Annenberg Center for Health Journalism’s 2023 Data Fellowship, which provided training, mentoring, and funding to support this project. She can be reached at cgoodman@sunsentinel.com.

BORN TO DIE: FLORIDA’S INFANT MORTALITY CRISIS

PART 1: Babies are dying in Florida at a rate higher than the national average. Despite a declining birth rate, and millions of dollars spent on maternity programs, research, and outreach, the rate of babies who die before their first birthday remains unchanged. Florida’s tightening restrictions on access to abortion raise the risk even more, with the increasing likelihood that unhealthy and disadvantaged mothers will have no choice but to give birth to children who might die in their first year. So far, little the state is doing is leading to significant improvement in infant mortality, even while many of these deaths may be preventable. SunSentinel.com/InfantMortality

PART 2: For the last five years, Florida has seen an increase in premature births, a product of our poor health system and an increase in the number of women with health complications because of that system. The result is millions of dollars of public money are being spent to keep the premature babies alive in NICUs and support their ongoing medical issues. Not only does this drain public funds, but it keeps the families at near-poverty levels. The final segment in the “Born to Die” series looks at the families coping with a generation of children in need of costly medical care, education and development support. SunSentinel.com/LongtermCare

PART 3: Where does Florida spend its money when it comes to ensuring the health of babies, whether unborn or newly born? Data shows that despite funding and resources, the rate of babies dying before the age of 1 remains above the national average and hasn’t improved much in a decade. Florida spends $150 million a year on this issue. We examine where the money goes, how results are measured, and where money could be better spent to keep more babies alive and healthy.

Kristin Jones | KFF Health News (TNS)

More than 60 years ago, policymakers in Colorado embraced the idea that early intervention could prevent child abuse and save lives. The state’s requirement that certain professionals tell officials when they suspect a child has been abused or neglected was among the first mandatory reporting laws in the nation.

Since then, mandatory reporting laws have expanded nationally to include more types of maltreatment — including neglect, which now accounts for most reports — and have increased the number of professions required to report. In some states, all adults are required to report what they suspect may be abuse or neglect.

But now there are efforts in Colorado and other states to roll back these laws, saying the result has been too many unfounded reports, and that they disproportionately harm families that are poor, Black, or Indigenous, or have members with disabilities.

“There’s a long, depressing history based on the approach that our primary response to a struggling family is reporting,” said Mical Raz, a physician and historian at the University of Rochester in New York. “There’s now a wealth of evidence that demonstrates that more reporting is not associated with better outcomes for children.”

Stephanie Villafuerte, Colorado’s child protection ombudsman, oversees a task force to reexamine the state’s mandatory reporting laws. She said the group is seeking to balance a need to report legitimate cases of abuse and neglect with a desire to weed out inappropriate reports.

“This is designed to help individuals who are disproportionately impacted,” Villafuerte said. “I’m hoping it’s the combination of these efforts that could make a difference.”

Some critics worry that changes to the law could result in missed cases of abuse. Medical and child care workers on the task force have expressed concern about legal liability. While it’s rare for people to be criminally charged for failure to report, they can also face civil liability or professional repercussions, including threats to their licenses.

Being reported to child protective services is becoming increasingly common. More than 1 in 3 children in the United States will be the subject of a child abuse and neglect investigation by the time they turn 18, according to the most frequently cited estimate, a 2017 study funded by the Department of Health and Human Services’ Children’s Bureau.

Black and Native American families, poor families, and parents or children with disabilities experience even more oversight. Research has found that, among these groups, parents are more likely to lose parental rights and children are more likely to wind up in foster care.

In an overwhelming majority of investigations, no abuse or neglect is substantiated. Nonetheless, researchers who study how these investigations affect families describe them as terrifying and isolating.

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In Colorado, the number of child abuse and neglect reports has increased 42% in the past decade and reached a record 117,762 last year, according to state data. Roughly 100,000 other calls to the hotline weren’t counted as reports because they were requests for information or were about matters like child support or adult protection, said officials from the Colorado Department of Human Services.

The increase in reports can be traced to a policy of encouraging a broad array of professionals — including school and medical staff, therapists, coaches, clergy members, firefighters, veterinarians, dentists, and social workers — to call a hotline whenever they have a concern.

These calls don’t reflect a surge in mistreatment. More than two-thirds of the reports received by agencies in Colorado don’t meet the threshold for investigation. Of the children whose cases are assessed, 21% are found to have experienced abuse or neglect. The actual number of substantiated cases has not risen over the past decade.

While studies do not demonstrate that mandatory reporting laws keep children safe, the Colorado task force reported in January, there is evidence of harm. “Mandatory reporting disproportionately impacts families of color” — initiating contact between child protection services and families who routinely do not present concerns of abuse or neglect, the task force said.

The task force said it is analyzing whether better screening might mitigate “the disproportionate impact of mandatory reporting on under-resourced communities, communities of color and persons with disabilities.”

The task force pointed out that the only way to report concerns about a child is with a formal report to a hotline. Yet many of those calls are not to report abuse at all but rather attempts to connect children and families with resources like food or housing assistance.

Hotline callers may mean to help, but the families who are the subjects of mistaken reports of abuse and neglect rarely see it that way.

That includes Meighen Lovelace, a rural Colorado resident who asked KFF Health News not to disclose their hometown for fear of attracting unwanted attention from local officials. For Lovelace’s daughter, who is neurodivergent and has physical disabilities, the reports started when she entered preschool at age 4 in 2015. The teachers and medical providers making the reports frequently suggested that the county human services agency could assist Lovelace’s family. But the investigations that followed were invasive and traumatic.

“Our biggest looming fear is, ‘Are you going to take our children away?’” said Lovelace, who is an advocate for the Colorado Cross-Disability Coalition, an organization that lobbies for the civil rights of people with disabilities. “We’re afraid to ask for help. It’s keeping us from entering services because of the fear of child welfare.”

State and county human services officials said they could not comment on specific cases.

The Colorado task force plans to suggest clarifying the definitions of abuse and neglect under the state’s mandatory reporting statute. Mandatory reporters should not “make a report solely due to a family/child’s race, class or gender,” nor because of inadequate housing, furnishings, income or clothing. Also, there should not be a report based solely on the “disability status of the minor, parent or guardian,” according to the group’s draft recommendation.

The task force plans to recommend additional training for mandatory reporters, help for professionals who are deciding whether to make a call, and an alternative phone number, or “warmline,” for cases in which callers believe a family needs material assistance, rather than surveillance.

Critics say such changes could leave more children vulnerable to unreported abuse.

“I’m concerned about adding systems such as the warmline, that kids who are in real danger are going to slip through the cracks and not be helped,” said Hollynd Hoskins, an attorney who represents victims of child abuse. Hoskins has sued professionals who fail to report their suspicions.

The Colorado task force includes health and education officials, prosecutors, victim advocates, county child welfare representatives and attorneys, as well as five people who have experience in the child welfare system. It intends to finalize its recommendations by early next year in the hope that state legislators will consider policy changes in 2025. Implementation of any new laws could take several years.

Colorado is one of several states — including New York and California — that have recently considered changes to restrain, rather than expand, reporting of abuse. In New York City, teachers are being trained to think twice before making a report, while New York state introduced a warmline to help connect families with resources like housing and child care. In California, a state task force aimed at shifting “mandated reporting to community supporting” is planning recommendations similar to Colorado’s.

Among those advocating for change are people with experience in the child welfare system. They include Maleeka Jihad, who leads the Denver-based MJCF Coalition, which advocates for the abolition of mandatory reporting along with the rest of the child welfare system, citing its damage to Black, Native American, and Latino communities.

“Mandatory reporting is another form of keeping us policed and surveillanced by whiteness,” said Jihad, who as a child was taken from the care of a loving parent and placed temporarily into the foster system. Reform isn’t enough, she said. “We know what we need, and it’s usually funding and resources.”

Some of these resources — like affordable housing and child care — don’t exist at a level sufficient for all the Colorado families that need them, Jihad said.

Other services are out there, but it’s a matter of finding them. Lovelace said the reports ebbed after the family got the help it needed, in the form of a Medicaid waiver that paid for specialized care for their daughter’s disabilities. Their daughter is now in seventh grade and doing well.

None of the caseworkers who visited the family ever mentioned the waiver, Lovelace said. “I really think they didn’t know about it.”

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Ted Rossman | Bankrate.com (TNS)

“Revenge travel” has been a big theme the past couple of years as Americans have been raring to go here, there and everywhere after hunkering down during the COVID-19 pandemic. As a result, the Transportation Security Administration screened a record-high 858.5 million passengers in 2023.

But it hasn’t been a smooth ride for travelers. In fact, if you flew in 2022 or 2023, there was a one-in-five chance your flight was delayed, according to the Bureau of Transportation Statistics.

Cancellations were an especially big problem in 2022, when the airline industry had a tough time ramping back up after the pandemic. That year, 2.7% of flights were scrapped entirely, often due to staffing and/or equipment shortages. Last year, however, the cancellation rate was a mere 1.3%. Higher prices — not cancellations or delays — were travelers’ biggest concern last summer and last holiday season, according to Bankrate research.

Still, there can be hidden costs associated with delays, cancellations and other travel snafus. For instance, my family flew from New Jersey to California last month, and both of our flights were delayed about two hours. With two young kids in tow, our nerves were strained more than our wallets, though we still ended up spending a bit extra on food (which isn’t cheap when even a basic airport sandwich seems to cost at least $15).

I’ve had a few other travel experiences in recent years which made me wish I had paid with a credit card with strong travel insurance benefits. These perks wouldn’t have kicked in for my two-hour delay, but they definitely could have helped me out the time my flight from Chicago to New York was diverted to Virginia in the middle of the night and the airline basically just left us there. Or the two times in 2022 when airlines canceled our flights the night before they were scheduled to leave (seemingly due to operational issues) and couldn’t rebook us for several days — or when I came down with COVID and had to cancel a trip last fall.

Credit cards with strong travel insurance benefits

Not all travel insurance benefits cover the same situations, but here are a few of the most common credit card travel insurance policy perks:

—Trip delay reimbursement

—Trip cancellation or interruption insurance

—Baggage delay protection

—Lost or damaged baggage protection

—Medical evaluation

—Travel accident insurance

—Auto rental collision insurance

The Chase Sapphire PreferredⓇ Card is a great example. For a fairly modest $95 annual fee, it offers a lot of travel insurance (among other perks). In my estimation, its trip cancellation/interruption benefit (up to $10,000 per person and $20,000 per trip) should have applied to both of my 2022 flight cancellations. I ended up getting those refunded by the airlines and booked new flights on different carriers (since the original carriers couldn’t accommodate us until nearly a week later), but that cost extra.

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If I had paid for my original airline tickets with this card, I believe that Chase would have reimbursed me for the difference between my canceled flights and my new bookings (although I would have had to request that refund through a claims administrator). But there’s a chance my request would not have been approved, perhaps if the company argued I should have taken the airline up on its offer to fly a few days later, rather than rebooking myself more immediately at a higher cost on a different airline.

These programs aren’t always easy to navigate; a coworker needed to be very persistent and had to submit several rounds of documentation to win a reimbursement claim involving the Chase Sapphire ReserveⓇ and a trip disrupted by a hurricane. I wish it were easier to utilize, but this coverage can still be very valuable.

For a heftier annual fee ($550), the Sapphire Reserve offers better trip delay insurance, triggering after six hours or an overnight delay, while the Sapphire Preferred triggers after 12 hours or an overnight delay. Both the Sapphire Preferred and the Sapphire Reserve offer the same primary rental car insurance, trip delay insurance (up to $500 per ticket), delayed baggage insurance, emergency medical coverage and more.

Both cards would have been useful the time I got stranded in Virginia (I ended up renting a car and driving about five hours to get home; my company paid for that since it was a business trip, but if it had been a personal trip, I likely could have gotten a reimbursement from a travel card with good trip cancellation/interruption protections).

The Platinum CardⓇ from American Express and the Capital One Venture X Rewards Credit Card also made our list of the best credit cards for travel insurance.

It’s also worth asking what the airline, hotel or rental car agency can do for you if you need to cancel. I lost out on a prepaid rental reservation in 2020 when I was afraid to travel in the early days of the pandemic. But in 2023, when I had COVID and needed to cancel a hotel stay, the hotel generously refunded my supposedly non-refundable reservation. Perhaps it made a difference that I was actually sick that time instead of worried about potentially getting sick, but it never hurts to ask.

The bottom line

Many airlines and hotel chains have relaxed their change and cancellation policies in recent years. So if you do encounter an unexpected issue, it’s a good rule of thumb to start with the travel supplier, and then pull in your credit card company as a backup.

For this reason, I think it only makes sense to pay for travel insurance if you have a particularly complicated or expensive itinerary (especially an international trip). Often, that coverage is comparable to what you may already qualify for between your credit cards and the travel suppliers’ policies.

Paying with a credit card that has strong travel insurance benefits can provide additional assistance without adding to the cost.

(For Capital One products listed on this page, some of the above benefits are provided by Visa® or Mastercard® and may vary by product. See the respective Guide to Benefits for details, as terms and exclusions apply.)

(Visit Bankrate online at bankrate.com.)

©2024 Bankrate.com. Distributed by Tribune Content Agency, LLC.