Group health plan or travel insurance for international travel?

Now that vacation season is under way, it’s this time of the year when we typically get questions about health insurance coverage when traveling internationally.

A common question we receive is, “Do I need travel insurance when traveling internationally, or does my group health plan cover me for health care expenses when I travel abroad?”

The answer, typically, is that health care services provided in a foreign country (including Canada) are specifically excluded from one’s health insurance coverage, except for medical emergencies.

Medical Emergency

A “medical emergency” is a condition brought on by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, with an average knowledge of health and medicine, could reasonably expect that not getting immediate medical attention could result in:

  • Serious jeopardy to the health of the individual or, in the case of a pregnant woman, the health of the woman or her unborn child;
  • Serious impairment to bodily functions; or
  • Serious dysfunction of any bodily organ or part.

Therefore, if you were to have a medical emergency while traveling abroad the technical answer to the question above about coverage is “Yes”. However, as a practical matter you would have to jump through a number of hoops before any benefits would be paid.

Understanding the Process

Generally speaking, understand that virtually no foreign health care provider is going to accept an assignment of benefits from a U. S. – based health insurance company. Therefore, you would have to pay for services when rendered. Then, when returning to the U. S., you would need to make arrangements to have the bill translated if it is not already in English.  This is necessary so that the health insurance company’s claims office representative understands exactly what the nature of the services was.

The benefit for emergency care services received in a foreign country, if and when paid, will be based on the currency exchange rate on the date services are rendered.

Tip: Be sure to pay for any such services using a VISA, MasterCard, or AmEx card, because the benefit in doing this is that the major credit card companies will give you the most favorable daily exchange rate on your bill.

Given the above constraints, when you travel abroad you may want to consider purchasing short-term health insurance coverage designed for international travelers.

International Travel Insurance

International travel insurance is temporary accident and sickness insurance designed to cover persons (of any nationality) traveling or living outside their home country. This includes Americans traveling or living overseas, foreign nationals visiting or temporarily residing in the USA, and foreign nationals traveling away from their own home country. Coverage includes hospitalization, surgery, doctor’s office‑visits, prescription medicines, medical evacuation, and the repatriation of one’s remains (in the case of death).

Typically, each insured person is eligible to utilize the services of a worldwide assistance network, staffed 24 hours a day by multilingual coordinators. The international travel coverage experts are trained to respond to the myriad of problems an international traveler or expatriate might encounter, such as:

  • Renewing a prescription left at home
  • Replacing lost credit cards or a passport
  • Locating a nearby medical specialist
  • Locating legal representation, in the case of an auto accident
  • Critical hospitalization
  • Medical evacuation back to a hospital near the person’s home

You get a travel insurance quote or buy such coverage (with a major credit card) on our travel insurance page. Or, simply search “international medical insurance” on the web.

Have Questions?

If you have any questions about health insurance coverage while traveling outside of the United States, please feel free to direct such questions to Mary Bieker (mary.bieker@benico.com; 847-669-4800, ext. 208).

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