Insurance May Not Cover Travel : A phone call to your health care company could ultimately save money, worry and aggravation.
Your vacation is just around the corner, but you’re feeling fairly organized. Already you have booked the dog at the kennel, persuaded a neighbor to take in the mail and stopped your newspaper delivery. Add one more entry to your to-do list: a call to the health insurance company to find out if you’re sufficiently covered for traveling.
This question is most important if you’re leaving the country, but it is a good idea to check even if you are traveling domestically, health insurance experts say.
It’s a call few people think to make, said Michael Chee, spokesman for Blue Cross of California. “People do not anticipate requiring health care (while traveling) in another country. They don’t expect to get sick.” But Chee and others have heard horror stories about travelers who incurred $35,000 fees for such things as an air ambulance home only to find out later that such costs weren’t covered by insurance.
A phone call before departure--and, perhaps, the purchase of supplemental insurance--could help to avoid aggravation and expense.
“Call your insurance company or agent,” suggested Melanie Marsh, spokeswoman for the Health Insurance Assn. of America, a nonprofit trade organization representing commercial health insurance companies. “Most of the time you are covered for conditions of sudden onset, from a sprained ankle to a heart attack. But what you need to consider is ongoing medical care if you are there long enough. Your plan may or may not cover that.”
“Call your member services department,” suggested Linda Quon, a spokeswoman for Kaiser Permanente. “Ask: Do I have coverage while traveling outside the service area? Outside the country? What should I do if I have an emergency?”
Medicare generally does not pay for hospital or medical services outside the United States, according to the 1992 Medicare Handbook. (However, the U.S. territories of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Marianas are also covered.) Medicare may pay some benefits in rare cases for emergency care in Canada or Mexico, said a Medicare spokeswoman. Her advice: If you have any kind of private supplementary plan, check to see if it covers health care in a foreign country.
Travelers not comfortable with their level of coverage might consider enrolling in a supplemental short-term health policy offered by a half-dozen or so companies to fill coverage gaps.
One often-overlooked gap in coverage is medical evacuation: the cost, for example, of an air ambulance, should you need medical care not available at your destination. Such fees, according to health insurance companies, can reach $30,000 or more.
“Medical evacuation coverage might be especially important if you are going to areas with substandard medical care,” said Amy Protexter, a spokeswoman for Travel Assure, a Mutual of Omaha travel plan.
The companies selling such policies offer a range of options, including coverage for health care, assistance in finding a physician or hospital, assistance in contacting your personal physician and medical transportation abroad or home. Some also tack on benefits for baggage delay or loss, trip cancellation and legal assistance.
Costs vary depending on coverage and the length of the trip. A family of four going on a trip for 9-15 days, for example, might pay Access America $97 and get $20,000 of coverage, minus a $50 deductible per person, for family medical expenses, said company spokeswoman Beverly Terry. The plan includes unlimited costs for medical evacuation.
HealthCare Abroad, another coverage plan, charges $3 a day for trips of 10-120 days, said spokeswoman Lynne Bursenos. The coverage includes up to $100,000 in benefits after a $100 deductible. The benefits can cover doctors’ fees, hospital charges, prescription drugs, evacuation and other expenses.
Before buying, examine the coverage carefully and try not to purchase double coverage, said Sean Mooney, senior vice president and economist at the New York-based Insurance Information Institute, a nonprofit trade organization. It may sometimes be necessary to do so, however. For instance, some companies don’t offer medical evacuation coverage alone, but combine it with other benefits in a package. And some companies stipulate a limit for medical evacuation fees. If you have doubts about the reliability of the insurance company, call the state insurance department and ask if the company is licensed to do business in the state. (In California, call 415-557-9624.)
Last-minute applications for special travel insurance should not be a problem. For convenience, many companies accept credit cards and most have 800 numbers and will mail or fax a brochure outlining coverage options.
Should you decide your existing health insurance plan provides adequate protection, remember that the same limitations in effect at home probably will apply while traveling. For example, members of preferred provider organizations (PPOs) who are treated by a doctor or other health-care provider who is not approved by the PPO organization will suffer a reduction in benefits paid, just as they would at home, said Jackie Anderson, vice president of individual services for Blue Cross of California.
In addition to checking your insurance coverage and buying extra coverage, there are other measures that will help you avoid unexpected expense should a health emergency occur during your vacation:
* “Pack a couple of blank claim forms,” suggested Marsh. It will be easier, she said, than mailing correspondence back and forth once you pay out of pocket and arrive home.
HMO subscribers, unaccustomed to completing claim forms required by most traditional plans, should ask if their company has special forms for travel. Kaiser, for instance, provides “statement of emergency” forms for travelers designed to ease the reimbursement process, Quon said. For domestic travel, “We give subscribers a travel pack. It contains a brochure listing all of our facilities.”
* Take care of any routine health needs before leaving home, suggested Anderson of Blue Cross. If you need periodic blood-pressure monitoring, for example, schedule a visit before you leave.