How to get and pay for the treatment you need if you get sick abroad

If you’re traveling abroad this summer, the last thing you probably want to think about is what you’ll do if you get sick or injured. But experts say 15 percent of travelers encounter some kind of medical problem on their journey, and depending on your destination, your U.S. health insurance may not be much use.

The good news is that if you have to look beyond your own health plan, there are ways to cover medical emergencies that can be surprisingly inexpensive. Here’s what you need to think about.

Key Considerations

Check your existing health plan. Coverage varies by health insurer and plan, so you must contact your carrier to get the details of your specific policy, says Cathryn Donaldson, a spokeswoman for the America’s Health Insurance Plans trade association. In most cases, Medicare does not cover you outside the U.S., while some Medicare Advantage and Medigap plans do offer worldwide emergency care.

“Most domestic health plans provide limited coverage overseas and won’t cover prescriptions abroad,” says Margaret Wilson, M.D., chief medical officer of UnitedHealthcare Global, which is part of the largest health insurer in the U.S.

Aetna, for example, generally covers its policyholders when they embark on foreign travel, but the care is reimbursed as “out-of-network,” which is typically subject to higher out-of-pocket costs.

The Centers for Disease Control and Prevention recommends that you grill your insurer about: Exclusions for injuries related to terrorist attacks, acts of war, natural disasters, adventure activities like scuba diving and mountain climbing, and exacerbations of pre-existing conditions; whether pre-authorization is needed for treatment, hospital admission, or other services; and the deductibles, copays, limits, and other policies for out-of-network services.

Consider international travel health insurance. If your examination finds gaps in your existing healthcare policy, the CDC and major carriers like Aetna, Kaiser Permanente, and UnitedHealthcare say you should consider filling the holes with a supplemental international travel health insurance plan. These plans provide secondary coverage that picks up the costs where your primary health insurance stops; some provide primary coverage.

Beware exclusions for pre-existing conditions. Travel health insurance policies typically don’t cover pre-existing conditions. But you can buy a waiver of that exclusion, and you should consider doing so if you’ve had a change in your health, treatment, or medicines in the 180 days before you buy the coverage, says Lynne Peters, director of product at InsureMyTrip.com, a broker of travel insurance, international travel health insurance, and medical evacuation insurance.

Shop wisely for travel health insurance. You and your travel itinerary are unique, so you want to have multiple health plans and carriers to choose from, to tailor coverage to your exact needs. Shop at a broker that gives you options. Two with especially large selections are InsureMyTrip (800-487-4722), which sells more than 250 policies from 28 insurance companies, and SquareMouth (800-240-0369), which offers 112 policies from 22 insurers. Use these websites’ toll-free phone numbers to get precise guidance from a human agent.

Policies tend to cost less the younger the traveler and the less comprehensive the plan. A $1 million medical insurance plan with zero deductible could cost a 35-year-old less than $15 a week, says Peters. The same medical coverage for a 65-year-old–but with a pre-existing medical condition waiver, medical evacuation, and $5,000 trip cancellation/interruption coverage–could cost $220 to more than $600 a week, according to Peters.

Be prepared to pay up front for overseas medical care. Even if you’re covered by your regular U.S. health policy and supplemental travel health insurance, you should be ready to pay up front for medical care you receive abroad. That’s because most foreign healthcare providers require payment in cash or by credit card when you receive treatment, and only some U.S. insurers have direct billing and payment relationships with healthcare providers all over the world, says Wilson.

Some international travel health plans also require that you pay up front and get reimbursed later, while others pay providers a certain amount on the spot to get you treated and admitted. The GeoBlue international travel health plans, however, have a global network of 7,100 physicians and 2,000 facilities in 190 countries, which the insurer pays directly, if you get treated there.

Of course, you can’t choose where you’ll fall ill or be injured. So you must have ready money. “Even with international coverage, consider carrying an extra credit card with a large limit to use for unanticipated medical expenses,” says Wilson. To ensure proper and prompt reimbursement by your insurers, Wilson advises that you get clear and complete copies of all bills, medical records, and discharge notes after you receive treatment.

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