8 Questions for Your Health Insurance Provider Before Traveling Abroad

 SmitBruins / Twenty20

A recent survey by travel insurance comparison site InsureMyTrip reveals that a sizeable number of Americans are unclear about whether they're covered for medical care when traveling outside the country. 

If an American citizen becomes seriously ill or injured abroad, a consular officer from the U.S. embassy or consulate can assist in locating appropriate medical services and informing your family or friends. But payment of hospital and other expenses is the patient’s responsibility.

In the InsureMyTrip survey of 800 respondents, nearly one third did not know whether their domestic medical insurance provider would cover any doctor or hospital visits outside the U.S. Twenty-nine percent believed their insurance did offer coverage, while 34 percent thought their insurance would offer no coverage.

The level of medical coverage available for trips abroad can vary widely, depending on your health care provider and plan. Major insurance providers such as Blue Cross and Blue Shield, Cigna, Aetna may provide some emergency and urgent care coverage abroad but the definition of emergency can vary. 

Traveling with grandparents? Medicare will rarely pay for inpatient hospital care, doctor visits, or ambulance services in a foreign country. Puerto Rico, the US Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the United States.  

If someone in your travel party is enrolled in Medicare, he or she may be able to purchase a Medigap policy to cover emergency care received outside the United States. This policy pays 80 percent of the billed charges for emergency care outside the U.S. after meeting a $250 yearly deductible. Medigap coverage has a lifetime limit of $50,000.

What to Ask Your Health Insurer

The only way to know for sure what your healthy insurance plan covers is to ask. Before you leave on an international trip, call your insurance provider and ask to review your certificate of coverage for explanation of benefits. Here are eight questions to ask:

  1. How can I find approved hospitals and doctors in my destination? When selecting a doctor, make sure that he or she can speak your language. 
  2. Does my insurance policy cover emergency expenses abroad such as returning me to the United States for treatment if I become seriously ill? Be aware that many insurers draw a line between "urgent care" and "emergency care." which refers specifically to life- or limb-threatening situations. 
  3. Does my insurance cover high-risk activities such as parasailing, mountain climbing, scuba diving and off-roading?
  4. Does my policy cover pre-existing conditions?
  5. Does my insurance company require pre-authorizations or second opinions before emergency treatment can begin?
  6. Does my insurance company guarantee medical payments abroad?
  7. Will my insurance company pay foreign hospitals and foreign doctors directly?
  8. Does my insurance company have a 24-hour physician-backed support center? 

If your health insurance policy provides coverage outside the United States, remember to pack your insurance policy identity card, customer service hotline number, and a claim form.  

Many health insurance companies will pay "customary and reasonable" hospital costs abroad, but the US State Department warns that very few health insurance companies will pay for a medical evacuation back to the United States, which can easily cost up to $100,000, depending on your condition and location.

If you have pre-existing medical problems, you should carry a letter from your attending physician, describing the medical condition and any prescription medications, including the generic name of prescribed drugs. Leave any medications you carry in their original containers, clearly labeled. Be sure to check with the foreign embassy of the country you are visiting or transiting en-route to make sure your medications are not considered to be illegal narcotics in that country.

For more routine medical issues on vacation, consider Dr. Phil's Doctor on Demand app, which lets you video chat with a physician for a flat $40 fee.

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