Medical Insurance? Evacuation Insurance?

What policy did you choose under " Obamacare"? Did you read the terms? Some U.S. Insurers reimburse for emergency care abroad, but then expect you to come home to receive follow-up care. It depends on your own plan. And if you are old enough to be on Medicare ( which I am not ) I believe different rules apply.

Okay, the Obama Care comment was sarcasm. The rest was legit. Well, I guess with all that is going on maybe it isn't sarcasm. I have begun frequenting doctors in Europe because of the time I spend there. For the small stuff the country I am most in has pretty decent care, good prices and real service. But the question is still what do people think about travel medical and evac insurance. Worth it? Experiences?

Depends on your risk tolerance. After one experience being with someone whose travel insurance required they be cared for in rural Egypt, I've carried a really good quality medical evacuation policy. Happily, I have not had to use it. However, of importance, it's a policy that allows me to decide whether I should be evacuated, rather than a clerk in an insurance company. The policy I have is with MedJet Assist, and I can use it within the US, as well as internationally. The peace of mind is worth the few hundred dollars it cost me each year.

My policy is with Medjet too. Not sure I read the policy as openly as you do, but its the best I thought I could find for the sole purpose of getting me out. But most of my trips are to places with fairly decent health care so I am beginning to wonder if I should worry more about on the spot expenses and less about getting out of there. Although I am spending some time in Bulgaria in a few months so .........???

Are you asking whether you should buy Medjet in addition to general travel insurance? Or are you saying you love Medjet but "go bare" on the rest of the insurance? That would be peculiar, but similar to young Americans unwisely declining to purchase medical insurance at home.

Because my mother is elderly, I like to have cancellation with pre-existing conditions covered for the bigger-ticket trips. But now that I am over 60, the price is starting to get even higher.

One reason I don't have medjet is that everytime I buy a policy from, in my case, Travelex, a somewhat lesser evacuation coverage is included. I am aware that Medjet will let you specify the destination, while many lesser policies will only take you to the nearest US hospital. And there may be some difference in how sick you have to be. I think most purchasers don't read the policy. But, then, people who are happy with their policy seldom post online, just like other subjects.

Regarding your assumption that they will evacuate you to a US hospital, read the policy really carefully. With most of them, if they judge you can be treated locally, that's where you'll be treated. Because of that clause in an evacuation policy, I was with someone who ended up being treated in Luxor, Egypt. I love Egypt, but I wouldn't want to be treated in most of their hospitals (other than, maybe, a major hospital In Cairo). Hence my decision to carry MedJet.

Regarding medical insurance - My normal U.S. health care plan that I get through my employer has always covered me overseas (although as out-of-network). So first, you need to check with your U.S. insurance carrier and see what they cover.

Regarding experience ... I have filed a claim with my insurance company for overseas medical care that I received in England and been reimbursed in accordance with the plan. Because it is out-of-network, I paid the provider and then filed the claim with my insurance carrier.

I doubt that any of Rick Steves' staff have ever purchased this type of separate insurance. Rick's general opinions about it are at http://www.ricksteves.com/travel-tips/trip-planning/travel-insurance.

Many readers and posters to the Helpline are older than the average demographic and feel that being treated at home for whatever they may encounter are worth the additional cost.

Here is my theory. First for those preaching, you probably don’t understand that some, many, most policies will pay for covered expenses no matter where you are. So the age, responsibility dribble isn’t applicable when deciding to purchase additional insurance for traveling. I suspect that getting reimbursement from a company that deals in travel medical insurance will be easier as your home company is going to want one or more of literally thousands of treatment codes when you try to get reimbursed under Obama Care.. Obama care has a code for everything even left handed Cyclops communist spider bites. That could or might be a problem if you try to file the claim yourself with Bulgarian receipts in your hnads. The evacuation service I had always hoped would get me home and in the US system quicker to make payments and reimbursements easier; and for some conditions I might prefer to be back in the US. Do I like MedJet? Don't know, have had a policy for about 7 years but never have used it. The telling is in the trial.......
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If you are not paying cash for treatment while traveling then I wonder if the travel medical insurance company will be able to get the provider paid or guaranteed to be paid in such a manner that they let you check out or leave the country?

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But treatment in some places in Europe might not be that bad. What I believe has happened is that the socialized healthcare in some places in Europe has widened the gap between the have's and the have not’s which makes good health care more accessible and less expensive for the have's.

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Possibly because providers make no money through the socialized system there are a lot of private providers. Again, possibly, little or no government interference has allowed them to work at reasonable rates. Because it is a capitalist enterprise they have to really cater to the needs and desires of the patients in order to get their business. The result that I have found in the few instances I have had to interact with the system is that the care quality is excellent, the prices reasonable and the respect and politeness far above anything in I have yet encountered in the US. But then maybe I just hit on a good country. Who knows.

So then the core question for me at least, is will the travel medical insurance carrier be able to get me released and on my way if I am treated abroad? Or with them as well will I have to pony up the cash myself and then negotiate for reimbursement?

Nigel, that is an excellent point.

James, we have had a membership with Divers Alert Network (DAN) for several years. For $55 per year (family membership) we get $100,000 of evacuation insurance if we are more than 50 miles from home. This is the only travel insurance we buy, as we generally fly on frequent flyer tickets (miles can be put back in account in case of last-minute cancellation) and avoid hotel deposits. We have the Medicare "F" supplement which will help with medical coverage overseas if needed. A frequent traveler friend of ours broke her leg in Switzerland and she and her husband were evac'ed home by DAN with no hassles. She convinced us to buy this, and so far (thankfully) we haven't needed it, but the cost is so low that we just keep it in effect year round.

Charlene, that's real helpful. Thank you. So you paid cash in Switzerland for what ever services you had there, the evac policy got you home free of charge and then you just had to seek reimbursement for the Swiss charges? (I am guessing) I have done some basic routine care in Europe and dealt with a few illnesses but never had an emergency and was trying to get a feel for how the insurance would work if I needed it. With my MedJet I buy the annual policy because I do several trips a year and the cost is about the same as buying by the trip.

*Obama care has a code for everything even left handed Cyclops communist spider bites. *

Seriously James, CPT codes have been used by insurance companies for years.

My bill from England did not have CPT codes and as I said earlier, I was reimbursed. It was not difficult to file a claim. If you are covered overseas, your company should have instruction for filing a claim. For example, BC/BS has a special form for claims for treatment overseas; it is on their website.

Laura, that’s great news that they paid without the codes. I have a supplemental policy that helps with the high deductible and they won’t accept a claim without the codes. Glad to hear that isn’t the case with out of country claims. While I agree it isn’t the central issue, it would have been an issue. The ICD 10 coding system which replaces the ICD-9 expands the number of codes from less than 20,000 to more than 60,000 codes, so yes it will be an issue. There is a copy write on the codes so you aren’t going to find legal free access to it. I am assuming your unfortunate accident was in the last couple of years so unless the Obama system changes something I have nothing to worry about. But I do believe that I am still faced with paying cash up front and that can be onerous while traveling. I think, but I am not certain, that one of the major companies that does the travel medical insurance makes some sort of claim of payment in Europe. If anyone knows about that ………

James, what I'd suggest is that you check with your specific carrier. My claim was a not in the last several years... but there was a different process for how you filed and what had to be submitted with the claim. They needed certain info on the statement such as the diagnosis and service, but it did not have to be in the form of a code.

These are still insurance companies and you still have to follow the rules so not saying that it will be simple ...

Laura, a sincere think you for your kind consideration. I feel pretty good with just the evac. insurance but I wanted to start a discussion to see if I was missing something.

I think that evacuation insurance is not something you need until you REALLY need it. Most minor lumps, bumps, bugs etc. can be treated in Europe no problem and you probably won't have too much trouble covering the costs and/or getting your insurance to cover it. However, it's when the s h i t hits the fan, is when the evacuation insurance comes in handy. When I studied in Australia, one of the students at my uni fell while hiking, and her spine was injured. She had to be transferred back to the U.S. on a gurney (which required taking out several seats from the airplane to accommodate it) and had to have a nurse accompany her, to the tune of $40,000. If you have that kind of $$$$ laying around, then the insurance might not be worth it, but in the event of a true medical catastrophe, you might be glad you had it.

Sarah, I think you are correct. And I have found in my favorite corner of Europe that the health care outside of the socialist base system is pretty outstanding as it exists to service those with means. fair prices, amazing service and high quality providers and facilities. Still for the really major things I think I will want to be at home.

We bought "comprehensive" travel insurance through Travel Guard for our trip to China in 2011 which included trip cancellation, interruption, and medical expenses among other things. I injured my knee and was seen by a doctor in a major hospital in Shanghai that was designated for "foreigners". We paid the all the expenses upfront and was reimbursed later by Travel Guard after we provided documentation. They even reimbursed me for out of pocket expenses after I returned home and incurred follow up medical expenses (they paid what my medical insurance Blue Shield did not: basically my co-payments).

We currently have Blue Shield of CA insurance (Gold Plan) and our policy will cover medical expenses while abroad, but in order to minimize our expenses, we would need to use an in-network provider if there are any available in the countries we will be visiting. However, our plan does not cover for being transported/air lifted. We have bought travel insurance again with Travel Guard for our next trip to Europe and does have coverage for medical evacuation, and they do give you a list of providers for such service, but you need to make your own arrangements and pay for it at the time of service. Also, I don't know who makes the decision on whether you get to be transported and where, etc. I still need to look into this in greater detail. You would have to file a claim in order to get reimbursed. So it seems that it would make sense to get some kind of medical evacuation arrangement/insurance beforehand as other posters have mentioned.

I don't travel anywhere outside the US without at least evacuation coverage. I haven't got $100,000 lying around to cover evacuation charges in case I break my leg. When I was in North Korea a couple months back it was a nightmare trying to find a company that issues policies there. Finally found a company affiliated with Lloyd's of London that would do it:
www.travelsafe.com

Quick question, will most medical/evacuation policies cover this rare but serious muscular disorder:

http://tinyurl.com/le2kej2

Like Charlene, I carry a Diver's Alert Network membership that includes med evac and lots of other related coverages for $35/year. I have never had to use it, so I can't speak to that. My regular medical insurance covers me while abroad for other medical expenses. Again, I have never needed it, but I would probably have to pay up front and be reimbursed. And since "Obama Care" isn't really an entity, it will depend on what the individual policies included under the Affordable Care Act cover as to whether you will be covered while abroad.

Nancy, but Obama Care does set some basic standards all the policies have to cover. I was just curious if Obama Care included something for out of country coverage in those minimum standards. Seems to be it would be more basic than some of the other mandatory inclusions. I will take a copy of the law along with me on my next 20 hour r/t transatlantic flight and read it.
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That aside, since my current private policy, come to find out, will pay for costs incurred abroad I think in my situation the travel medical insurance would be redundant without any real benefit. Either way I have to pay cash and file a claim when i get home. The evacuation insurance that I have been carrying for years now seems to be all I really need and that policy (Medjet Elite) will advance me up to $50,000.00 in country to pay bills so I can get out. They also point out that in some instances services may be withheld until proof of ability to pay is provided. I hadn't thought about that. So far no one has offered that their travel med insurance would work with the hospital in Albania if needed to get the treatment or the release.

Hmmm, this topic has been discussed seemingly countless times. Search the archives for the full range of views..

I would love to learn of an Affordable Care Act policy that is international. That is beyond the stated purpose of the Act.

After spending months trying to contact companies only to learn that there was no international coverage for the many policies I checked, I got a letter of international coverage from my old insurer. I'm keeping that letter with my medical stuff for traveling.
I don't get travel insurance any more because my credit card offers great coverage for lots of events, and I have no problem with medical care in most other countries (I love to buy my own antibiotics!)

Question: do you have to be a diver to get evacuation insurance?

No, you do not have to be a diver to join DAN. The coverages are all included with your membership. They also have additional insurance you can buy, but I don't buy that.

Thanks, Nancy. Such a clever solution!

Bruce but we have new minds and new experiences.

I personally know two people who have had to be evacuated via medical plane out of the country they were staying in. Both were relatively young...one was accidentally burned by boiling water and the other was attacked by a crazy guy on a beach wielding a knife while she was playing cards with friends. It put both them and their families into debt for a number of years. I always get medical evacuation coverage. It is a negligible expense in light of the potential costs...totally worth it and necessary in my opinion! You never know when you'll be in the wrong place at the wrong time or become unexpectedly ill.

Hi Mate, i am working for Auxilium logistics and support services, a major part of our work is the evacuation and yes it is important to have an evacuation coverage especially if you travel to high risk zone with poor medical facility, the cost of evacuating person from country like Iraq to nearest place using an air ambulance will cost something between 40 to 60 K which is too much

James,

Just something to think about and inquire.

I checked with my provider yesterday about "what if i were got get injured overthere".

what i was told was that:

• get receipts on everything
• I had to pay "out of my pocket" all expenses and will be reimbursed once i get here.
• no evac coverage in my policy

So you may want to check on who pays what if/when you're over there.

happy trails.

Ray, thanks.