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What Do You Mean My Health Insurance Won’t Cover Me Outside the Country?

BLOG, PERSONAL FINANCE  |  8 Feb 2019

By Jon Aldrich

Travel Insurance

Have you traveled outside of the U.S. without travel insurance which includes a provision for medical costs? If you have and did so without incident, congratulations, you rolled the dice and may have dodged a financial nightmare. I know I have traveled with my family out of the country several times over the years without emergency medical coverage but will never do so again. I guess I had always assumed, wrongly, that my current health insurance would cover me if something happened. Think again, it very likely does not or only offers very limited coverage.  Hopefully, after you read this, you will not leave the country without travel and health insurance again or at least make sure that you already have adequate coverage in place.

I have read several stories of travelers having to pay $50,000 for a broken arm or leg, or over $250,000 for more extensive care required overseas, because they did not have emergency travel medical coverage for overseas travel. Imagine if you have a heart attack or some other serious medical emergency outside of the country. Those bills could easily get into the several hundred-thousand-dollar range and you may be on the hook for paying this out of your pocket if you are not covered.

In some parts of the world getting access to quality health care during a medical emergency can be difficult. Some hospitals will not provide treatment or allow a patient to be discharged until they have a guarantee of payment. If you do not have a specific travel insurance policy in place, these charges are going to come from your credit cards or bank accounts.

Think Medicare covers you when you leave the borders of the U.S. (wall or not)? it does not, unless you qualify under one of these 3 remote possibilities, and if you don’t fall under one of these 3 you are out of luck:

Medicare Coverage

Source: https://www.medicare.gov/Pubs/pdf/11037-medicare-coverage-outside-united-stat.pdf

Good luck qualifying under one of these scenarios. You might have better odds playing the lottery.

Your Medigap plan could provide some coverage but it is somewhat limited:

Medigap plans

Source: https://www.medicare.gov/Pubs/pdf/11037-medicare-coverage-outside-united-stat.pdf

That limit of $50,000 can be exceeded rather quickly in a major medical emergency.

If you have a Medicare Advantage plan, you would want to check with the insurance carrier to see what type of coverage is included for travel outside of the U.S. In most cases it probably is not all that much.

Countries with socialized medicine might assist with minor needs, but do not have an obligation to help. If you require major or ongoing medical care, you are going to have to come up with the cost of that yourself. These bills can run in the tens to hundreds of thousands of dollars. And if you ever need to be evacuated back to the U.S. or somewhere with better coverage, expect another $25,000 to $250,000 that you will need to come up with if not covered with a policy that includes evacuation coverage.

How about Coverage while on a Cruise Ship?

Medicare will cover medically necessary health care services needed on a cruise ship provided:

  • The doctor is allowed under certain laws to provide medical services on the cruise ship.
  • The ship is in a U.S. Port or not more than 6 hours away from a U.S. port in U.S. territorial waters when you get the services, regardless if it is an emergency or not.

If the care was needed on a cruise ship that didn’t meet these requirements, Medicare will not cover it. It is very likely your group medical plan is not going to cover these expenses either.

What about my Group Plan thorough my Employer?

Many group health insurance plans offer limited emergency medical coverage outside the U.S., but each plan is different. You may have to pay expenses out-of-pocket and file a claim for reimbursement. Care would likely be reimbursed as “out-of-network” and subject to higher deductibles and co-pays.

Group Health Insurance

https://www.consumerreports.org/health-insurance/will-health-insurance-cover-you-overseas/

You would need to check with the specifics of your individual plan to see what coverage is available. If your plan does provide coverage, be sure to confirm exactly what is provided and if medical evacuations are covered and the extent of that coverage.

So, now that you understand the risks of travelling outside the U.S. without travel insurance, what should I do if planning to travel outside the country?

Check your Credit Card Coverage:

Many of the premium cards such as the Platinum Card from American Express, or the Chase Sapphire Reserve offer travel accident insurance and evacuation insurance. Travel accident insurance is not the same as travel health insurance. Basically, accident insurance reimburses you for the loss of a limb, sight, hearing, extremity, etc. So, if you break an arm but do not lose it, there is no coverage for the medical expenses. I guess you could go and chop your arm off if you broke it to obtain coverage, but I don’t really endorse that. These premium cards and others also may offer emergency evacuation insurance which can be ungodly expensive if you need to be evacuated to another hospital or back to the U.S. for care.

The coverage for accidents and evacuation expenses from these cards can be helpful but are not a substitute for getting a true travel medical insurance policy.

Supplemental International Travel Medical Insurance

This will be coverage that can be obtained prior to embarking on a trip outside of the country. It will provide the guarantees of coverage mentioned above so that hospitals around the globe will accept you for treatment. You may still be required to pay expenses upfront and get reimbursed later, but at least you will get reimbursed and won’t have to foot the bill yourself.

The costs of this can vary depending on your age, the length of your trip and a pre-existing condition waiver.

International Travel Insurance

https://www.consumerreports.org/health-insurance/will-health-insurance-cover-you-overseas/

I have Blue Cross insurance and visited their Travel Medical & International Health Insurance carrier GeoBlue to get an idea of what coverage would cost for my wife and I for a one week trip and it came up with the following:

Voyager Choice

You can experiment with the length of your trip, the coverages, deductibles, etc. to see an estimate of what the coverage might cost. You will want to be sure that Emergency Evacuation Coverage is included, and if you have pre-existing conditions, look for a waiver for that if you can get it. You don’t have to be a member of Blue Cross to purchase, but you do need to have coverage under a primary medical plan, whether that is Medicare or another private insurance carrier.

There are also sites such as Insure My Trip  that sell almost 1,200 different plans from 30 different insurance companies and is a good place to shop for coverage that fits your need.

The bottom line is, you really should address the issue of emergency medical coverage if you are travelling outside the U.S. either on a cruise ship, by plane or donkey. It would be bad enough having a medical emergency on a vacation in a foreign land, but then to have an astronomical medical bill on top of that would really be a not so great experience. You might consider a malaria shot too.