No matter how excited you are for a trip, sometimes, life happens: You’re too sick to fly or—in today’s world of the COVID-19 pandemic—you suspect you might be. So what’s an under-the-weather or cautious traveler to do?

Step 1: Judge your sickness.

Turns out, there actually are hard and fast rules for when you shouldn’t hit the skies. The Centers for Disease Control and Prevention (CDC), for example, recommends those with symptoms of COVID-19 do not travel.

Generally, you should also bag a trip if you have a fever higher than 100 degrees Fahrenheit and symptoms such as coughing or sneezing, says William Schaffner, M.D., a professor of infectious diseases at the Vanderbilt University Medical Center.

“Of all the infections that are acquired on public conveyances, I think respiratory infections are the most common,” he says. And coughing and sneezing give exhalations more energy, which means you’re more likely to spread germs or virus over a larger distance than if you simply had the sniffles.

In fact, being within just two rows of someone sick can increase your risk of coming down with whatever they have, some research finds. The longer the flight, the more likely it is that you’ll infect others.

The CDC also recommends that everyone who travels is fully vaccinated against COVID-19. “The vaccines are very, very effective in preventing infection and keeping people out of the hospital with COVID,” says Dr. Schaffner.

Additionally, the organization warns against travel if you’ve recently had surgery, a heart attack, or a stroke—these can increase your risk of blood clots and heart-related issues. In any of these instances, you have plausible reason to plead your case.

Step 2: Know the rules.

Today in the U.S., airlines essentially all across the board (minus some low-cost carriers and basic economy fares) have permanently gotten rid of change fees, says Scott Keyes, founder of Scott’s Cheap Flights. That means that usually, if you’re booked in main economy or higher, you can change your travel dates after you book without paying a penalty beyond any fare differences. (Southwest has had this policy for decades.) So while rebooking for another time isn’t the same as a refund, it is often an option if you’re too sick to fly right now.

It’s also worth noting some key policy updates in the world of flying and flexibility. Just recently, for example, United announced that passengers booked in basic economy can now upgrade to main economy (something that wasn’t allowed in the past) and thereby be able to switch a flight without having to pay a penalty. “It’s a little convoluted,” says Keyes. “But it’s one way that folks will be able to have flexibility if they are not able to travel for some reason.”

Also important to remember: If an airline ever cancels or significantly changes your flight, by law you’re eligible for a full cash refund (or you can switch to more convenient flight). So if your flight gets changed big time and you’re feeling under the weather anyway, know that flight schedule changes are actually an opportunity to either get a refund or get a much more convenient flight, says Keyes.

Step 3: Hop on the horn—with your doctor and then your airline.

If you are indeed a sick passenger and need to cancel your flight (read: you can’t change your dates), try to do so before the original scheduled departure time, says Brett Snyder, president of Cranky Concierge air travel assistance. If you don’t cancel in time, you lose the ability to use that credit toward future travel.

Generally, you are going to need a doctor’s note or a medical letter proving illness. From there, it’s worth giving your airline a call. While a full refund for being sick might be unlikely (a travel credit would be a more realistic hope), Keyes notes that “airline customer service agents are empowered to make decisions on whether they grant what you’re asking for or not.” And with the pandemic, you might have a higher chance of leniency than you would have pre-pandemic, he says.

If you don’t get what you hope for the first time around, call again, he suggests. There are thousands of airline representatives. “Don’t just assume, ‘well, I’ve got to eat the cost of the ticket.’ Take your chances and call; maybe you’ll get lucky,” Keyes says.

In fact, that advice holds for any situation you’re in with travel, whether you’re within the 24-hour cancellation time frame, don’t have a doctor’s note, or just feel stuck—it’s always worth reaching out and trying to get what you can.

Step 4: Think ahead.

Find yourself stuck with a fee? The next time you’re booking an expensive trip, consider Cancel For Any Reason (CFAR) travel insurance, which could reimburse you if you get sick.

“CFAR tends to be something people buy aspirationally,” says Keyes. “But it’s not a ‘get out of jail free card.’” It might, though, give you a 75 percent refund on a flight price if your reason for not flying is covered, for example.

“Policies vary among insurance companies and products,” says Keyes. So just be sure to read the fine print of any plan you buy to make sure you understand what you’re being insured for.

This article has been updated with new information since its original publish date. 

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