Traveling? What You Should Know About Overseas Health Claims

Posted in: Employee Benefits

The last thing most people want to spend time thinking about when planning a dream trip is health insurance.  It’s far more exciting to think about the relaxing island beach or European adventure than how you would deal with an overseas health insurance claim. However, a little preparation in advance, and a bit of research will enable you to deal far more efficiently with an emergency condition should it arise.

Before You Go

Getting right to the point — The short answer is you’re probably covered. Many major US-based health insurers extend coverage for medically necessary treatment to policy holders when traveling abroad.  However, you will likely have to pay out-of-pocket for all treatment and then have to submit for reimbursement upon your return.

Obviously, you’ll want to be sure your policy is current. And remember to take your health insurance card with you (you’d be surprised at how many people forget).  On the back of the card is the member or customer services number.  It’s a good idea to call your provider in advance of your trip and notify the company that you will be traveling outside the country.  Ask if they have preferred hospitals, physicians or other local resources at or near your destination.  Your carrier can also be a resource providing information on any diseases or other risks that you should be made aware of.  Make sure to learn how to dial your member services number from your overseas destination.  You should also ask if you are covered for an emergency medical evacuation in the event that you sustain an injury or illness that cannot be treated at your destination.

A Few Words on International Health Insurance

People often get confused between travel insurance and international health insurance. Travel insurance covers you for trip delays, cancellations, etc., while international health insurance protects you if you get sick or have an accident while you are abroad. I always advise people to purchase international health insurance.  We often work with CMI Insurance, a division of FrontierMEDEX in Towson, MD.  This inexpensive coverage buys you a lot of peace of mind. Medical treatments due to accidents and illnesses are covered as well as medical evacuation to a modern hospital if needed. FrontierMEDEX has a team of international health experts who travel to international hospitals and evaluate them using a 350 item checklist. They are looking at everything from how often the floors are disinfected to making sure the hospitals are using fresh needles for each patient. There are three levels of preferred providers in the FrontierMEDEX network based on how comprehensive the facility is and in order to be a preferred hospital, minimum standards must be met. There are also Regional Centers of Excellence and International Centers of Excellence which are the evacuation destinations and can treat virtually any illness or injury (i.e. similar to the capabilities of a major U.S. hospital like Johns Hopkins).

And, you won’t have to pay thousands of dollars out of pocket. Policies are available starting at only $1.22 per person per day depending on your age and the medical benefit you select. Purchase the insurance for the duration of the trip (maybe add a few extra days in the event an illness were to delay your departure). You’ll want to give yourself at least thirty days before departure to make sure the insurance is in force.

You’ve Arrived and Something Happens – Now What?

So, you’ve made the proper preparations and you’re ready to take off on that dream trip.  You have a smooth landing at your destination and everything is going nicely so far.  You step out of your hotel door and slip and fall, breaking your wrist. Now what?

If you have purchased an international health insurance policy it will include access to a 24/7 emergency assistance phone number.   The assistance provider will be able to tell you where the best local treating facility is located and will call ahead to schedule an appointment on your behalf.  Most international health insurance providers will be able to pay directly to a foreign hospital for in-patient care.

If you have not purchased an international health insurance policy, go to a local hospital for emergency treatment. Best case, the hospital may be able to process your claim through your insurance company.  More likely, you’ll be required to pay for treatment on the spot. This is especially true in less developed countries. Be sure you get a detailed bill for the services received—and keep all paperwork and documentation. When you return to the US, notify your health insurer when and where you were treated for an emergency condition. You’ll be asked to submit a claim form.  When the claim form is accepted, the insurer will convert the charges to US dollars, minus your deductible or co-pay, and then reimburse you.

Medical emergencies overseas can compromise your rest and relaxation, but with the right advance preparation, international health insurance, and local knowledge, you’ll be well equipped to handle these situations and to be reimbursed in a timely way. Bon voyage!