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Health insurance covers routine and emergency medical care whether you are at home or traveling around the country. However, not all health insurance plans offer international coverage.
Even if your US-based medical insurance covers treatment abroad, you may end up paying a significant portion of your medical bills.
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Will U.S. health insurance companies cover treatment abroad?
Some U.S.-based health insurance companies cover care when traveling abroad, but not all do, and the specific medical services covered depend on your health plan and health insurance company. it’s different. So when planning to travel abroad, it’s important to ask your health insurance company what the benefits are globally.
For example, Cigna and Kaiser Permanente health insurance plans both cover emergency medical care when traveling outside the United States.
Aetna health insurance plans only cover emergency treatment in border countries such as Mexico.
Other major health insurance companies, such as UnitedHealthcare, do not offer reimbursement for emergency medical services while traveling abroad.
Does Medicare pay for treatment in other countries?
Medicare does not cover outside the United States, with three narrow exceptions:
- If you are in the United States and have a medical emergency, foreign hospitals are closer than US facilities.
- You are traveling non-stop on an itinerary through Canada on the most direct route between Alaska and another state and you have a medical emergency and a Canadian hospital is better able to treat you. closer than the nearest US hospital.
- You live in the United States, but a foreign hospital is closer to your home than the nearest US facility where you can get treatment.
Some Medicare supplemental insurance plans, known as Medigap policies, cover emergency treatment worldwide. These policies are only available to people with Original Medicare and are not available to Medicare Advantage members.
Medigap plans to help pay for emergency medical expenses for international travel include Plans C, D, E, F, G, H, I, J, M, and N. Medigap covers 80% of medically necessary emergencies outside the United States when traveling outside the United States. $250 deductible.
The Medigap plan, which covers international medical care, has a lifetime limit of $50,000 and covers only if a travel emergency in another country occurs during the first 60 days of travel.
Does U.S. medical insurance generally cover outside the U.S.?
U.S. plans that offer international coverage typically only cover emergencies and emergency medical care. Common issues that may be covered include:
- broken bone
- chest pain
- loss of consciousness
- severe pain
- difficulty breathing
Be aware of out-of-network costs for international medical bills
Even if your health insurance plan covers international medical care, it may not cover all medical expenses. International medical providers are generally considered to be out of network coverage, so you may have to pay a significant portion of the bill yourself before your insurance starts paying.
Let’s say you break your leg and need x-rays and treatment in a foreign hospital. If you visit a hospital in the network in your hometown, the plan will cover 80% of the cost, and the remaining 20% will be paid after the deductible is reached. Refunds for out-of-network cases are lower. Even if your health insurance covers international medical care, you will have to pay more, such as 50%. (If you plan to travel internationally, ask your health insurance company exactly what your deductible and reimbursement rates will be.)
What is not covered by US medical insurance when traveling abroad?
Most insurance companies only cover emergencies that require urgent medical attention while traveling abroad.
Routine care, such as checkups and non-urgent medical appointments, and routine prescription medications are not typically covered by U.S. health insurance plans when traveling abroad.
Submit a claim for medical care outside the United States
If you receive emergency medical care while traveling outside the United States, the claims process is different. Before you go to the hospital (if possible) or when you go to the hospital, contact your health insurance company to ask about the documents and procedures required to make a claim. Timeline for submitting claims. This will help make the refund process smoother.
Your insurance company representative may need to discuss your condition and proposed treatment plan with the doctor supervising your treatment. For example, if you are a member of a Kaiser Permanente plan, your insurance company must allow post-stabilization care if you need ongoing treatment.
U.S.-based health insurance companies typically cannot pay healthcare providers in other countries directly, so you must prepay for your medical expenses with your own money. Once you return to the United States, you can file a claim with your insurance company to receive a refund.
To make an international medical claim, you need to submit documents to your insurance company. The information you need to submit includes:
- Medical bills. Your insurance company will ask you to see a medical billing statement that lists the dates of treatment, the services you received, and the cost of each service.
- medical records. Medical records should include not only test results and diagnoses, but also notes about hospital admissions and conditions.
- proof of payment. You must present proof of payment for medical expenses incurred during your trip. This may include receipts from medical institutions.
- proof of travel. You may be asked to provide proof of travel, such as airline confirmations, hotel bills or passport stamps.
The amount you will be reimbursed depends on the type of medical plan you have and copayment rules such as copayments and health insurance deductions.
Be prepared to prepay for emergency medical expenses abroad
If you need medical care in another country, you will probably need to prepay. This applies to most countries, including Mexico and Canada.
In some situations, medical emergencies can be expensive. And once you get home and file your claim, it may take a while for your refund to be issued. For example, Kaiser Permanente says he will process claims after international travel within 45 days.
Your health insurance plan may not cover all necessary medical services while traveling abroad. For example, Kaiser Permanente does not always cover follow-up outpatient treatments such as suture removal or casts that may be required after initial treatment.
Why travel medical insurance is smart
It is recommended that you obtain separate travel medical insurance while traveling internationally rather than relying on your U.S. health insurance plan. If you become ill or injured while visiting a foreign country, your travel medical insurance will cover you up to your plan limit.
- take an ambulance
- hospital and doctor bills
- clinical examination
- Other medical expenses
It is also wise to consider purchasing emergency medical evacuation insurance, which will pay for transportation to the nearest suitable facility for treatment. The cost of airlift for emergency treatment can range from tens of thousands to hundreds of thousands of dollars, depending on the condition and location.
Medical evacuation insurance also covers the cost of returning home by commercial flight while you recover, as well as the costs of medical attendants and necessary medical equipment, which can also be expensive.
where to buy travel medical insurance
Purchase a stand-alone travel medical insurance plan from a travel insurance company or part of a comprehensive travel insurance policy that also provides benefits for trip cancellation, trip delay, trip interruption, lost luggage, emergency medical evacuation, and more. can also be purchased as .
The best travel insurance companies sell comprehensive coverage that includes travel medical insurance for at least $100,000 per person, but if you need more coverage, they offer coverage for $500,000 per person. There are many companies. The most generous travel insurance plans offer medical evacuation coverage of $1 million per person.
Some health insurance companies also sell travel medical insurance plans. For example, Blue Cross Blue Shield sells through GeoBlue a medical plan with international benefits that covers emergency and some non-emergency services abroad. He does not have to be a BCBS member to purchase a GeoBlue plan. GeoBlue has a network of providers outside the United States and has health plans for his single trips, multiple trips and long stays abroad.
UnitedHealthcare sells travel medical insurance as part of SafeTrip travel insurance plans. Choose from International Travel Medical Plus or International Travel Medical depending on your coverage needs. Get a quote online to see how much a SafeTrip plan will cost based on your destination and number of travelers.
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