When Travel Insurance Fills The Medical Emergency Breach

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Travel agents hear it all the time from clients: “I already have health insurance.” But what most travelers don’t know is that their personal health insurance policy leaves huge gaps that only traditional travel insurance plans can fill.

“Many travelers don’t know that most health insurance and Medicare plans won’t cover them outside of the U.S. or if they require medical evacuation,” said insuranceQuotes.com Senior Analyst, Laura Adams. InsuranceQuotes.com offers consumers and others online comparisons from the country’s top insurance companies.

“The image a lot of consumers have is that personal medical insurance blends over to emergency medical,” said Bob Chambers, CSA Insurance VP of Operations. “But that’s just not true.”

“People traveling domestically should check if their health plan offers a national or local network of hospitals and health care providers, and confirm what level of coverage is available at out-of-network facilities,” said Brian McGuire, vice president of business development, UnitedHealthcare Global.

“Original Medicare in nearly all cases applies to the United States only and does not extend overseas or across the border (other than in cases in the Northern U.S. where the nearest hospital is in Canada),” McGuire said. “Some Medicare Advantage and Medicare supplement plans offer worldwide emergency coverage for foreign travel, although some have restrictions and lifetime limits.”

These deficits in coverage could impact the most benign vacation plans. The Centers for Disease Control reports that 3%–11% of all medical conditions reported on a cruise ship are urgent or an emergency. If you were to be airlifted to the nearest hospital, medical transportation alone could exceed $100,000.

“Without even realizing it, people put their health and finances at risk while traveling without the proper coverage,” said Amanda Winkle, vice president of international sales at International Medical Group (IMG).

Allianz Global Assistance recommends that cruise ship clients purchase at least $25,000 in emergency medical and dental coverage, and $500,000 in emergency medical transportation coverage.

Timing is Everything

Adams at insuranceQuotes also cautions agents and consumers to think about the timing of payment for emergency medical care. Most travelers are used to paying a small co-pay on their personal health insurance plan. But outside of your network, and certainly outside of the United States, payment might be required up front.

“If you get sick in Canada, South America, Mexico, they’re typically going to see you. How they’re going to get paid is another matter,” Adams said.

“Even with international coverage, travelers should consider carrying an extra credit card with a large limit to use for unanticipated medical expenses,” McGuire suggested. “Foreign hospitals will typically want upfront payment, rather than billing the health plan.”

He urged travelers to “get clear and complete copies of all bills, medical records and discharge notes for reimbursement from your health plan. Some global health plans do provide direct payments to foreign hospitals and care providers, eliminating a potential inconvenience and providing peace of mind.”

Ideally, travelers shouldn’t have to worry about medical payments on vacation, Adams said, especially when they’re already putting thousands of dollars on their credit cards. “You want to have the health provider pay directly.”

Denise Buckland, senior vice president of operations at International Medical Group (IMG), noted how “the high costs of medical care and evacuations can make it very difficult for an ill person to arrange to receive the level of medical care that they need while they’re away from home.

“Around the globe, patients may be asked to surrender their passports and provide a monetary deposit prior to the delivery of even the most critical lifesaving care. This ostensibly provides assurance to the hospital or provider that the patient will not be able to leave without securing payment for the services they render,” Buckland said. The patient’s passport is returned to them only after the hospital and affiliated providers are paid in full.

“Uninsured consumers, or those who have a plan that will not cover the cost of an evacuation at the time of service (i.e., a reimbursement policy), can find themselves appealing to friends and family to help split the expense,” Buckland said. “They also risk predatory business practices from local air ambulance providers who we have seen inflate the charge for an air ambulance by 300% or more.”

“We see some of our biggest claims and payouts are when someone has to be evacuated,” Chambers at CSA said. “If you break your leg in Kuala Lumpur, they’ll say, ‘you’re out of network, you’ll need to pay out of pocket, and we’ll see what we’ll reimburse you for when you get home.’ “

International Assistance A Big Benefit

“A huge benefit that someone gets with travel insurance is everything that goes into emergency transportation, the insurance company will make the arrangements for the customer,” Chambers said.

“Global insurance companies can provide foreign-language translation, direct you to appropriate facilities or support evacuation to alternative facilities, and can work with local health care providers to coordinate and monitor care,” McGuire at UnitedHealthcare said.

If a traveler doesn’t purchase insurance, McGuire said, but needs emergency medical services, a smartphone or other internet-connected device might be able to provide some assistance in helping diagnose their symptoms and finding a local medical facility.

McGuire pointed out how “many health plans now offer telemedicine and mobile apps to support their customers’ health needs.” The Health4Me app, available to anyone free of charge on iPhone or Android devices. It enables users to identify nearby health care providers, hospitals, pharmacies and urgent care facilities, as well as compare quality and cost information for common medical services.

Other apps enable members to access a digital ID card and connect with a registered nurse 24/7.