As you plan your next trip abroad make sure you know your health insurance coverage. You’ll need to do some research on your health plan if you don’t already know how it works. Fidelity Investments gives you a head start on what you need to know:
Call your health insurance company
The first step is to contact your health insurance company to verify whether your emergency medical coverage extends outside the U.S. Contact the customer service department and ask these kinds of questions:
- If I get sick or injured abroad, will my policy cover me?
- Does my insurance cover pre-existing conditions abroad?
- Will I have to pay health expenses abroad out-of-pocket and then file a claim for reimbursement?
“In most cases, you’ll get some coverage for care needed to treat an emergency, but you’ll have to pay out-of-pocket and then submit for reimbursement after you return home,” says Lisa Zamosky, author of “Healthcare, Insurance, and You: The Savvy Consumer’s Guide.”
Zamosky says insurers can and do define things differently from one another and health plans offered by the same insurer often include different benefits. You always want to make sure you understand the specifics of what your particular health plan covers, including exclusions and the definition of emergency — because it may be different than your own.
“Generally speaking, insurers define a medical emergency as one in which a reasonable layperson believes their health would be in real jeopardy without immediate medical attention — think heart attack or a serious accident,” Zamosky says.
And while most big private insurance companies do offer some type of coverage abroad, coinsurance, deductibles and other plan requirements would still apply.
Original Medicare won’t help you
Those with Original Medicare only will generally not be covered outside the U.S., although additional coverage is available. (One exception: in some cases, Medicare will cover necessary care if you are on board a ship within the territorial waters of the U.S.)
“That’s a reason why they want to get a Medigap plan. In some cases, a Medicare Advantage plan [which is different from Medigap plans] may cover urgent or emergency care outside the U.S. Medigap plans C, D, F, G, M and N will cover 80% of the cost of care outside the U.S. during the first two months of a trip,” says Lindsay Engle, a marketing specialist with Elite Insurance Partners, an insurance broker that specializes in Medicare.
What if you need to be evacuated?
Travelers should also consider emergency evacuation insurance. Such a policy prevents you from getting stuck with a whopping bill if you suffer a heart attack abroad, for instance, and need to be transported home or to another hospital. These types of evacuations are expensive and can run $100,000 or more, the Centers for Disease Control and Prevention says.
Although many health insurance companies will pay “customary and reasonable” hospital costs abroad, very few will pay for your medical evacuation back to the U.S., according to the U.S. State Department.
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