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You’ve packed your bags, double-checked your passport, and triple-checked the stove (yes, it’s off). But did you forget the most important thing? Travel medical insurance, also known as travel health insurance, is essential coverage that can globetrot with you and potentially save you from owing thousands of dollars if you get sick or hurt and have to seek out-of-network medical care.
While you may have excellent healthcare coverage at home, it pays to check whether those benefits extend across the U.S. and overseas.
Let’s start with the basics
Ask, don’t assume: Does my health insurance cover travel?
First things first: Before you plan any trip, it’s wise to contact your health insurer and ask specific questions about your coverage while traveling. Ask them to refer you to written documents (or send them to you), as you’ll want to have details in writing that clarify exactly what is and isn’t covered when you travel. Although we’ll provide a general overview here, there’s no substitute for finding out exactly how your specific policy covers you when you leave your home area.
Globetrotting: Do I need international travel health insurance?
Nobody heads out on vacation planning to get sick or have an accident. But it can happen, and the resulting medical bills can be overwhelming if your health insurance doesn’t translate abroad.
Unfortunately, most U.S.-based health plans don’t cover international travel. Fortunately, international travel health insurance is widely available, inexpensive, and relatively easy to obtain.
It’s important to note that not all travel insurance plans offer equal medical coverage, so read the fine print.
Explain some general differences here briefly, that some include minimum coverage, others include transportation, etc.
What does travel medical insurance cover?
– intro sentence and then list what’s typically covered by all travel insurances, using bullet points
– In another sentence you might list what additional things are covered by more comprehensive travel insurance plans
– Perhaps also note that these plans usually don’t cover experimental or elective medical treatment abroad
What’s the best travel medical insurance plan for me?
intro sentence and then briefly list types, using bullet points . Perhaps you include
Single Trip Annual Multi Trip Stand-alone, for example… Or ditch this section if it seems repetitive to other sections.
How much is travel medical insurance?
Is there a price range you can include? Or what factors go into determining price (age, destination, etc.) Use bullet points here if it makes sense. Or ditch this section if it’s too hard to put a price range on it.
What medical conditions do I have to declare for travel medical insurance?
Ie Perhaps go into something like this from your original article: Travel medical insurance plans are not regulated by the ACA, so they can still have annual and lifetime benefit caps, they do not have to cover pre-existing conditions, and coverage is not guaranteed issue. There’s also no requirement that plans cover the ACA’s ten essential benefits.
Travel insurance plans are not regulated by the ACA, so they can still have annual and lifetime benefit caps, they do not have to cover pre-existing conditions, and coverage is not guaranteed issue. There’s also no requirement that plans cover the ACA’s ten essential benefits.
Do I need travel medical insurance if I have Medicare?
It depends on your plan. If you’re enrolled in Medicare, your Medigap plan might provide some coverage for international travel (Original Medicare doesn’t cover care outside the U.S., with very limited exceptions). If you have Medicare Advantage coverage, the plan might include some travel coverage, but this will vary considerably from one plan to another.
If you’ve got private coverage, it depends on your plan. On some plans, life or limb medical emergencies are covered, but the onus is on the patient to prove that the situation was truly an emergency, and the cost of medical evacuation back to the United States is rarely covered by standard U.S.-based health plans. Travel medical insurance plans generally do cover medication evacuations, but you’ll want to check to make sure that’s included in the travel policy you’re considering.
[hio_question question="Do I have to renew my travel medical insurance for each trip?"]Travel medical insurance is not guaranteed renewable, which means that if you need another policy after your first one ends, you’d have to reapply and go through medical underwriting again (similar to short-term insurance).
And since travel insurance is not considered minimum essential coverage, the termination of a travel policy does not trigger a special enrollment period to purchase a regular ACA-compliant health insurance plan in your home state. This is an important reason to make sure that your travel policy is purchased to supplement your regular health plan, not replace it.
In the past, regular health insurance had many of the same caveats as travel insurance. But the ACA’s reforms have made us more accustomed to guaranteed-issue coverage that doesn’t discriminate against pre-existing conditions or limit coverage for essential health benefits. So it’s important to read the fine print on any travel insurance policy you’re considering, as the nuances of the coverage may be quite different from your normal coverage.
For travel within the U.S., do I need supplemental health insurance?
If you’re traveling outside your home state, you might be traveling out of network. And if you receive non-emergency, out-of-network care, you can expect to pay. Possibly a lot. That’s why many domestic travelers sign up for supplemental health insurance in addition to their comprehensive major medical coverage.
How much you’ll owe for out-of-network care – the full bill or part – depends on the breadth of your current health insurance plan. Employer-sponsored plans (especially those offered by large employers) often have nationwide networks. But individual market plans (the kind you buy on your own, either through the exchange or directly from an insurer) typically have localized networks.
There’s a good chance your plan doesn’t cover any non-emergency, out-of-network care. A Robert Wood Johnson Foundation study in 2018 found that only 28% of individual plans offer out-of-network benefits.
Out-of-network E.R. care is a different story – one where you don’t have to pay exorbitant out-of-pocket fees. Thanks to the federal No Surprises Act, which went into effect in 2022, health insurance companies are required to cover emergency services at in-network rates. This is true regardless of your plan’s network structure (EPO, PPO, HMO, or POS) or how extensive the network is.
However, sometimes emergency medical situations result in long hospital stays with the patient too ill to return home. In these cases, the extended services might not qualify for No Surprises Act protections. (By the way, there is no standard definition of what constitutes an emergency. Insurers can and do dispute the emergency nature of medical care, even if it’s provided in an emergency room. But you have the opportunity to appeal an adverse decision that your health insurer makes.)
Types of supplemental coverage for out-of-network care in the U.S.
Some people purchase supplemental coverage to offset some of the potential costs that could be incurred if a medical situation arises while in another state.
- Accident supplements will typically reimburse a policyholder a flat dollar amount, which can be used to pay out-of-network charges or balance bills in the event of a medical claim that arises from an accident or injury.
- Critical illness plans also reimburse the policyholder a flat dollar amount, although the plan will only pay if the patient experiences a specific covered illness. These plans typically include coverage for things like heart attacks and strokes, so they can be useful for sudden scenarios that can arise while one is traveling and which necessitate emergency care.
Supplemental plans are suitable for maintaining year-round, whether or not you’re traveling.
Last word: Read all the fine print
Piper Kan and Reece Huculak-Kimmel both have stories that amount to a cautionary tale about the shortcomings of travel insurance. Both little girls were born prematurely in foreign countries, and the extensive medical bills were not covered, despite the fact that in each case the parents had purchased travel medical insurance policies and thought they were covered for any contingency.
The takeaway? It’s important to pay careful attention to the written details and exclusions of the plan you’re considering. Don’t rely on verbal confirmations of benefits. But that said, travel insurance is an excellent supplement to your regular policy, and will cover mishaps in foreign countries that would otherwise have to be paid out-of-pocket. Bon voyage!
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
