I read a recent promotional piece published by a travel website and it sparked this week’s blog posting. I am about to embark on a vacation and thought about my insurance protection outside of the U.S. All American insurance programs, except the bare bones policies, cover domestic emergency care – and most cover emergent care for illness that you experience outside of your home market. While there has been a recent trend of health plans combatting egregious claims for otherwise uncovered care (which we wrote about on the blog), most states and health plans do apply “prudent person rules” to determine care eligibility. If a “prudent person” would seek care for the condition, the policy benefits will apply.
When traveling to other countries, U.S.-based commercial contracts will generally use this care standard as well. And the care would be reimbursed in the same manner as U.S. emergency care. When submitting a claim, it is important that a detailed explanation of benefits be provided and not just a paid bill. This will need to be translated into English and converted to U.S. dollars as of the date services were rendered. Importantly, Medicare does not pay for care outside the United States, but some Medicare supplement policies do provide limited protection for these costs. Note that most health insurance outside the U.S. does not provide any protection outside the home country.
What’s not covered is emergency medical air transport – and these expenses can be extraordinary. Coverage would be available through travel insurance policies, although these will only provide for transport to the nearest appropriate facility and not to the home country. If you have travel coverage through your employer, it is important to keep the customer service phone number on hand. In addition to the coverage terms you should understand whether the plan covers business travel only, extends to personal excursions in connection with a business trip, or provides care whether or not the trip is business-related.
Perhaps more important is knowing how to access care in your travel destination. I try to search Google prior to visiting a new location to see how care works in that country, and generally a hotel can provide assistance in care management in a foreign city. A new valuable and convenient resource – telemedicine – is available should you need medical advice while traveling. It’s a good idea to pre-register with your telemedicine vendor before your trip, which makes the process of accessing care easier.
Hopefully no one will have the need for care while traveling, but with vacation season coming up it is something to think about.