Finding a Health Insurance Plan That Travels With You
By: Stephanie Brown (NY Times) October 2015
It’s easier than ever to travel to faraway places; explore remote islands; ski, climb, cycle, glide; and to do it all with your family in tow, or on your own. Should you buy travel health insurance before you set off? Or shrug and roll the dice?
The answer depends on several factors, including what you plan to do and where (are you taking a literary walk in England or heli-skiing in Chile?), your age, health, existing insurance and appetite for risk.
“Basically we recommend that people check their regular health insurance to see if there is any coverage while traveling, and consider purchasing a supplementary policy,” Dr. Phyllis Kozarsky, Travelers’ Health Consultant to the Division of Global Migration and Quarantine at the Centers for Disease Control and Prevention, said in an email.
So where to begin?
By figuring out what you already have — or don’t have. You may not realize it, but if you have insurance from a major provider, you could be covered abroad for certain medical care, like a visit to a doctor if you have a sore throat. For example, I have a Blue Cross Blue Shield PPO, which allows me to receive care from doctors and hospitals in around 200 countries. It’s a global plan, explained the representative when I called member services. So, in most cases, I would not have to pay upfront for inpatient care at BlueCard Worldwide hospitals.
Even with such coverage, there are things that your insurance is unlikely to include — things that can seriously hurt your bank account. The State Department cautions, for instance, that few insurance companies will pay for medical evacuation back to the United States, which “can easily cost $10,000 and up, depending on your location and medical condition.” The same idea applies to credit cards, which some travelers think offer protection. That protection, however, is generally inadequate when it comes to big costs, including medical evacuation.
To find out what, if anything, your insurance will cover when traveling internationally, call your provider. Here’s a checklist of what to ask about, written by the Centers for Disease Control and Prevention:
• Exclusions for treating exacerbations of pre-existing medical conditions
• The company’s policy for “out-of-network” services
• Coverage for complications of pregnancy (or for a neonate, especially if the newborn requires intensive care)
• Exclusions for high-risk activities such as sky diving, scuba diving, and mountain climbing
• Exclusions regarding psychiatric emergencies or injuries related to terrorist attacks or acts of war
• Whether preauthorization is needed for treatment, hospital admission, or other services
• Whether a second opinion is required before obtaining emergency treatment
• Whether there is a 24-hour physician-backed support center
Also, the State Department suggests asking:
• Will the insurance company pay foreign hospitals and foreign doctors directly?
Getting answers is not necessarily easy. The representative may not know or make an effort to find out. I spoke to a nice man by calling the number on the back of my Blue Cross Blue Shield member card, but his answers were vague. For instance, I asked if there is a 24-hour physician-backed support center I can call. “That’s a great question,” he said. “I imagine that that 800-number could switch you to someone at any time.”
Even when you get concrete answers, you are likely to find that not everything is covered. So I simply told the representative that I was trying to decide if I should buy supplemental insurance.
“That is a smart thing to do,” he said. “Get that as backup.”
Indeed. And in addition to supplemental insurance, consider medical evacuation insurance: air ambulance, evacuation or medical escort service coverage for overseas travelers, according to the State Department. Medical evacuation or escort service is not only crucial if you’re in a remote location, but also because the quality of care in the nearest hospital may not be adequate. (Note: The State Department says Medicare does not cover international hospital or medical costs.)
While some people don’t bother with travel health insurance, it typically costs at most a few hundred dollars, and you will save thousands should something go wrong. For a weeklong trip to Argentina I found several plans that would cover emergency medical, dental and evacuation costs for about $30 to $60. Membership in an air medical transport program that included repatriation to the hospital of my choice in the United States was about $250.
So how do you choose a provider? Again, I turned to the C.D.C. Here’s what travelers should ask about when shopping around:
• Arrangements with hospitals to guarantee payments directly
• Assistance via a 24-hour physician-backed support center (critical for medical evacuation insurance)
• Emergency medical transport to facilities that are equivalent to those in the home country or to the home country itself (repatriation)
• Any specific medical services that may apply to their circumstances, such as coverage of high-risk activities
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