NerdWallet: What if I test positive for COVID-19 when I’m traveling abroad?

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Middle school science teacher Stefanie Guggenheim was set to fly home to Illinois from a weeklong family vacation through Spain — a last hurrah before the school year would start.

As all passengers must do before entering the U.S. from abroad, she and her family took a rapid COVID-19 test in Barcelona the day before their flight in August. Her dad’s test came back negative. Her sister’s test came back negative. Hers was positive.

“The lady issuing our tests gave them their clearance forms,” says Guggenheim, who was vaccinated at the time. “She looked at me and simply said, ‘10 days.’ I was in shock.”

That evening wasn’t the last hurrah in Spain she expected. Instead, she rushed to reschedule her flight while her family purchased supplies to get her through the unanticipated quarantine. And the next day, her family returned to the U.S., leaving 27-year-old Guggenheim alone in a hotel room with no human interaction for 10 days, aside from the knock on the door from someone delivering food.

What followed was a crash course in what happens if you test positive for COVID-19 while traveling abroad.

What happens when you test positive

The cost of getting COVID-19 abroad — and the process of dealing with it — can vary by country, and often even by region.

Guggenheim lucked out (as much as one could when testing positive) because she was in Barcelona, which operates specific “health hotels” for people required to self-isolate. The Spanish government covered the cost of her hotel, which was a small room with a twin bed and mini balcony overlooking the street below. If she had needed to foot the bill, a 10-day stay could have easily cost her more than $800, according to a NerdWallet analysis of a dozen hotel stays at budget properties in Barcelona (and that doesn’t even account for the cost of food).

Also see: Google Flights lets travelers see their carbon footprint — but can you trust it?

Similarly, traveler Rollie Peterkin, who tested positive back in January 2021, had a similar fortuitous moment. Peterkin, who was bound for Turkey with a stopover in the U.S., tested positive the day before he was set to depart Costa Rica.

Costa Rica requires unvaccinated tourists to purchase travel insurance. While he has since been vaccinated, he was not at the time. And so — while Peterkin typically never purchases travel insurance — he forked over roughly $30 for it.

But he wasn’t sure what would get reimbursed (if anything), so Peterkin said he still tried to keep costs down rather than order nice meals and stay at luxury hotels during his quarantine. While he submitted about $2,000 worth of receipts, he said he was thankful to get a $1,000 check back from his insurance company, eventually.

Here are some of the challenges that Guggenheim and Peterkin encountered given their extended stays:

Lodging

Because the government covered room and board, Guggenheim’s stay in Spain had few expenses aside from the hotel’s laundry service.

Lodging was more challenging for Peterkin, who was staying at a hostel. The hostel owner asked him to leave after learning about the positive test, so Peterkin scrambled to find lodging that would accept him and ultimately found a vacation rental. With no laundry detergent, he defaulted to doing laundry in the sink with dish soap.

What to expect: Obviously costs will vary by location, but it isn’t unreasonable to expect to pay at least $100 a night at budget hotels if you have to extend your stay. This could be upward of $1,000 over the course of 10 nights.

Read: Carnival to restart more cruises from U.S. ports in January and February, expects 100% capacity use in the spring

Food

Guggenheim, who is vegan, said she was impressed that her hotel even provided meat-free meals. Guggenheim said she doesn’t recall the food quality because by day three of quarantine, she lost her sense of smell.

Given that he was in a vacation rental, Peterkin relied on a food delivery service. He typically ordered just two meals a day to reduce delivery fees.

What to expect: It’s not unreasonable to expect to pay $15-$20 per delivered meal while you’re in quarantine. So you’ll need to factor in several hundred dollars for food.

Entertainment

Guggenheim anticipated a work-free vacation and didn’t bring a laptop. But given her impending lonely quarantine, her family purchased her a laptop at the Apple Store in Barcelona so she could prepare for her upcoming school year. Aside from that, the extent of her entertainment entailed a stray cat wandering through her hotel’s hallway.

Peterkin, who works remotely as a writer and podcaster, said he remained relatively productive, albeit bored.

“Aside from that, I was just busting out push-ups to keep myself occupied,” he says.

What to expect: While buying a laptop might seem extreme, you’ll want to at least think about what you might be doing to kill time if you’re abroad but unable to get out and about. Will you need to be able to work from your hotel room? Do you have a book or electronics with you that can get you through the quarantine time?

Flights

Both Guggenheim and Peterkin rescheduled their initial flights. Most airlines have added flexible change and cancellation policies since the pandemic. Both said that they didn’t have to pay change fees, though they both owed the difference in their original airfare versus the last-minute, more expensive airfare.

Peterkin’s situation was tricky because while his final destination was Turkey, he had a stopover in the U.S., but he booked the flights separately. His insurance covered the airfare from Costa Rica to the U.S., but he owed the fare difference for the rescheduled flight onward to Turkey.

What to expect: Rebooking a flight can be expensive, because you’re usually on the hook for the difference in fare price, which is often going to be higher when you’re rebooking close to your new post-quarantine departure date as opposed to that original flight you likely booked well ahead of time. This cost could easily be several hundred dollars.

Medical expenses

Guggenheim said her symptoms — which largely set in mid-quarantine — were mild, which she attributes to being vaccinated. Peterkin said he was asymptomatic. But for travelers with serious cases, unanticipated hospital bills can be expensive.

Additionally, both needed clearance to return to the U.S. For Guggenheim, that entailed a visit to a doctor, who wrote a note stating she was fully recovered.

Peterkin’s ticket to the U.S. was a negative test result. Because tests in the area cost $90, he waited 10 days despite being asymptomatic to better guarantee a negative test — thus ensuring he wouldn’t lose $90 on a second positive test.

What to expect: This can be a huge variable depending on how sick (or not) you get. Anything from paying for a COVID-19 test to extended hospital costs could be necessary depending on the country you’re in.

How to prepare for the possibility of getting COVID abroad

“I know the vaccine is not necessarily there to rid you of the illness, but rather to keep your symptoms mild,” Guggenheim says. “Still, I was shocked that I tested positive and my family tested negative.”

Guggenheim said she was aware of possibly getting sick. “But you never think it’s going to happen to you until it does,” she says.

In anticipation that you might test positive, here’s how to prepare:

Understand your existing medical insurance and consider purchasing trip insurance

U.S.-based medical insurance providers typically don’t cover medical treatment when you’re abroad, so always check with your insurer whether it offers coverage for international travel. If it doesn’t, consider purchasing travel medical insurance. While it typically won’t cover routine expenses, it can cover emergency medical expenses, whether it’s breaking your leg on a ski trip or ending up in the hospital with COVID-19.

Pay with certain travel credit cards

Some travel credit cards offer myriad trip insurance benefits including trip cancellation, medical treatment and medical evacuation coverage. While it’s typically a perk on premium travel credit cards (which also often have annual fees north of $500), holding one of these cards can be well worth it should you test positive.

Also see: 90,000 U.S. adult deaths from COVID-19 over the summer could have been prevented if victims had been vaccinated, study finds

It’s common for these cards to reimburse expenses of up to at least $5,000 to $20,000, as long as the original purchase was made on the same card. Rather than purchase a separate trip insurance policy, you might have sufficient coverage from your credit card’s travel insurance. Terms vary by card, but often they can reimburse you if someone else in your travel party tests positive (even if you don’t).

Book with airlines and hotels that have flexible policies

Yet even relying on insurance can be frustrating. You’ll typically still need to pay upfront costs and submit receipts for reimbursement. Peterkin said it took about a dozen phone calls and many months before his insurer sent his $1,000 check.

To avoid requiring reimbursement for a missed flight or a canceled hotel room on the next leg of your trip, book with travel providers with flexible change and cancellation policies. While airline and hotel cancellation policies have improved, not all are that generous. For example, many basic economy fares are unchangeable, so what seems like cheap airfare could end up being a sunk cost.

Is international travel a good idea given the risk of testing positive for COVID-19?

It depends on who you ask. Guggenheim says that in hindsight, she wishes she had opted for a domestic vacation.

“Don’t travel outside your own country if you want to recover in your own bed,” she says. “The delta variant is alive and well. Our vaccines are helpful and I’m thankful I didn’t get very sick, but they’re not a cure.”

On the other hand, Peterkin didn’t let quarantine in Costa Rica stop him. Since then, he’s been to more than a dozen countries, and even received his first AstraZeneca vaccine in Montenegro and the second dose in Romania.

“I’m just happy to be able to travel,” he says. “Getting money back from my trip insurance was icing on the cake.”

That said, Peterkin hasn’t purchased trip insurance since the Costa Rica excursion.

“I probably should get it,” he says. “I guess I’m a little bit reckless.”

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Sally French writes for NerdWallet. Email: sfrench@nerdwallet.com. Twitter: @SAFmedia.