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Medical & Evacuation Insurances

I just want to provide some feedback based on my reading of policies and conversations with the service providers to make sure my understanding is correct. I know this is not a country specific subject but I was not able to find a more proper forum.

I selected three providers for my research: GeoBlue, Medjet and Zurich (provided through Costco). Since my regular insurance covers overseas emergency medical expenses but won't pay upfront, my focus is on whether the provider will pay the cost upfront and whether the evacuation covers transfer to the nearest medical facility in the foreign country and/or to nearest medical facility in the home country. At the risk of over-generalization, here are a summary of my findings:

GeoBlue: Will pay upfront if an in-network provider/hospital is used. If out of network, Geoblue will reimburse emergency med expenses up to what's deemed by Geoblue ordinary and necessary. Will pay transfer to the nearest medical facility in the foreign country and a medical facility in the home country if necessary and requested by the attending physician and approved by Geo.

Medjet: Hospital to hospital transfer only. Confirmed it doesn't cover transfer from where you get sick to the nearest medical facility in the foreign country. Cash advance only if the hospital requires advance payment and Medjet verified your ability to pay back and the advance must be paid back within 30 days. It doesn't expect you to pay the evacuation upfront or afterwards.

Zurich: Will not pay up upfront unless the hospital demands advance payment. In which case, it will only pay upfront $15K max. Will pay transfer to the nearest medical facility in the foreign country and a medical facility in the home country.

Based on the above, I am leaning towards Geoblue to meet our needs, but their online reviews from customers who filed claims were not so good. As a matter of fact, none of the travel insurance companies, including Travel Guard, Allianz had good reviews on Yelp. So it is hard to judge if Geo is worse than other providers.

The customer service reps I spoke to: Geoblue was the best the Medjet the worst perhaps because their products are so popular that they don't care if you buy or not. It did make me think that if they don't care before selling the service, how much better can they be when you expect them to pay? I spoke to two different people and neither of them sounded enthusiastic in assisting a potential customer.

Thank you for reading.

Posted by
69 posts

We have medical coverage overseas so I only buy medical evacuation and repatriation. I use squaremouth.com to search for insurance. The policy I just had was from Seven Corners which is underwritten by United States Fire Insurance Company. We paid $88 for two weeks for people (70,73) for medical evacuation while overseas AND medical repatriation to point of origin or primary residence. If medically necessary, it would also pay for a medical escort to travel with us. If one of us should die, it would also pay for repatriation of remains. You may want to look further using a search engine such as squaremouth or insuremytrip.

Posted by
958 posts

We purchase GeoBlue when we travel internationally. We never needed it until this past spring, when we found ourselves in need of an urgent care equivalent matter for a foot injury. Not an emergency room situation. We were in the Brittany region of France, and it took us 3 stops to get to the appropriate place to treat us. The doctor plus facility bill was the equivalent of $75 and the pharmacy cost was $25. We kept all receipts and filled the online claim form when we got home and were reimbursed within a couple of weeks.

Of course this wasn't an emergency room or hospital admission situation. My understanding is that you can reach out to GeoBlue with those types of scenarios and they will work out a direct payment with said hospital, etc. (One hopes, but who knows.) How you would know who is in network and out of network; because it took us all day to get to a medical facility that would treat us at all; so I could see during a emergency scenario that you wouldn't be trying to figure out in network or out of network (or how stressful that would be trying to get emergency care while trying to work something out with GeoBlue) because you're just trying to get medical treatment. It wasn't a fun day, but it all worked out in the end.

Anyway, once we submitted everything into the GeoBlue portal, you could see that it was in the "processing" line; then we received a check for reimbursement.

Posted by
88 posts

@IrishEyes-Thank you for the recommendation-I did look at insureyourtrip.com and squaremouth.com but the problem is that they may not have the insurance company that you want, e.g., Allianz if I remember it correctly. Ttravelstores.com has similar problems but its comparisons have more details, IMO.

There are so many options to choose from and it's impossible to read the fine prints for all the providers. I narrowed down to the three because: Medjet is specialized in med repatriations; GeoBlue is focused on medical insurance and evacuations/repatriations, and Zurich's plan is comprehensive with a competitive premium.

Posted by
88 posts

@KD-Thank you for sharing your experience with GeoBlue.

The GeoBlue rep I spoke with said once I've purchased their plan, I will have access to their in network provider list. I raised the question how practical it is in an emergency situation to locate an in-network provider? The answer was if don't/can't, then you have to pay upfront and file a claim to get reimbursed for the amount deemed necessary and ordinary by GeoBlue. If I remember it correctly, the fine print does say you may choose any provider/hospital but you may not get all the cost reimbursed if you use an out-of-network one. It works the same as the in-network/out of network provisions with medical/dental insurances back at home in the US.

Posted by
3082 posts

I wouldn’t count on GeoBlue for quality evacuation insurance. When I called earlier this year about annual insurance, the rep brought up the evac (without me asking) and said it’s nearest facility only. She didn’t think much of the evac. Since I had already planned to buy Medjet Horizon, I didn’t care. I only wanted GeoBlue for medical and it covers pre-existing conditions without buying within 15-ish days from first trip money paid. I bought annual policies from both to cover two trips.

Posted by
88 posts

@Horsewoofie-

Yes the med evac will only transfer you to the nearest hospital, but the repatriation can get you home.
Here is an excerpt from GeoBlue's policy:

"Following any covered emergency evacuation, or if deemed appropriate by Our or Our designee’s medical director in consultation with the attending physician, We will pay for one of the following:
1. A return to the Covered Person’s permanent residence, or if appropriate, to a health care facility nearer to their permanent residence. Transportation will be provided by medically equipped specialty aircraft, commercial airline, train or ambulance depending upon the medical needs and available transportation specific to each case. Transportation must be by the most direct and economical route.
2. You will be transferred back to your original location or the location from which you were evacuated via a one-way economy airfare.
If Your transportation needs to be medically supervised a qualified medical attendant will escort you. Additionally, if We and/or Our designee, determines a mode of transport other than economy class seating on a commercial aircraft is required, We or Our designee will arrange accordingly and such will be covered by by Us. Transportation shall not be considered Medically Necessary if We or Our designee’s medical director determines that the Covered Person can continue his/her trip or can use the original transportation arrangements that he/she purchased."

Posted by
3082 posts

Jeansn6, I always thought that evacuation is for the living and repatriation (of remains) is if you die.
When is your trip? Where are you going? You’ve done a lot of research. What all are you looking to cover?

Old story but the only company I had problems with was Travel Guard. I have since bought Allianz annual premium and Allianz trip specific basic twice; no claims.

Have you looked at the forum for insurance experiences? There are a lot of forum threads about insurance. Use the search feature, then narrow it down to forum, either 6 months or 1 year.

KD, thanks for sharing your GeoBlue experience. Good to know. Fortunately I haven’t had to file a claim.

Posted by
16362 posts

I have an annual health insurance policy from Allianz and an annual Medjet Assist policy for medical evacuation. (With an AARP discount.)

While I have never had to make a claim, thank goodness, I went with these two companies because of the coverage.

With GeoBlue, they have an in-network list of providers. That could mean if you wind up at an out of network facility, they aren't going to cover much.

One of the things I like about Medjet Assist is that they will get you home in a manner necessary for your medical condition. They are not supposed to pay hospital bills. They are strictly a medical evacuation policy company. You should not see a bill at all for the evacuation so you don't need to worry about it. They make all the arrangements.

If you are looking for medical payments to doctors or hospitals, you'll find that many don't take US insurance and you will have to pay and get reimbursed. However, medical costs in Europe are so much less than in the US.

I know someone who broke her leg in Paris. The cost of the hospital, xrays, getting a cast and even a set of crutches came to 600 Euros. How many thousands of dollars would that have cost in the US?

A few years ago in the UK, I had to go to the emergency room for a small injury. I was treated and the bill came to zero. No charge.

Posted by
20360 posts

I have an annual health insurance policy from Allianz and an annual
Medjet Assist policy for medical evacuation. (With an AARP discount.)

I have an annual insurance policy with Allianz as well. It’s an expat policy. To date it has paid for 100% of my doctors and procedures (the company probably pays $1500 a year on me). My private clinic files for me. No prepayment needed.

I have a Medjet policy for evacuation. Never used it thank G-d. But seems to be the gold standard for such policies.

If you are looking for medical payments to doctors or hospitals,
you'll find that many don't take US insurance, and you will have to
pay and get reimbursed.

Speaking of the country I live in, the odds of a public healthcare provider (where you end up in an accident) taking any insurance is probably ZERO. Of course pre-payment wont be required either and the final bill will be hundreds not thousands or tens of thousands. But you will be in a ward with 3 other sick people, you will need someone to bring you food and toilet paper and the staff may or may not speak English. Pain medicine? If not absolutely needed, nope (maybe the person bringing your food can buy that for you too). But the doctors and the care will be world class.

A few private clinics do take European insurance policies. Doubt any will take a US policy.

However, medical costs in Europe are so much less than in the US.

I know someone who broke her leg in Paris. The cost of the hospital,
xrays, getting a cast and even a set of crutches came to 600 Euros.
How many thousands of dollars would that have cost in the US?

But the style of care is a lot different. Be prepared for that. And it’s cheap for us because we didn’t pay into the system. The locals here pay 14% of their income in health care tax, then the income tax is on top of that.

Here is an interesting account: https://community.ricksteves.com/travel-forum/hungary/living-as-a-temporary-local-for-9-days-in-the-surgical-wing-of-a-budapest-public-hospital

Posted by
88 posts

@Frank II-
Did you purchase Allianz thru your employer or on your own? I purchased Allianz before when booking flight tickets with Delta (?).
Most state wide insurances we have here in the U.S. won't prepay the expenses even if they provide overseas coverage and that's why I am looking for one who will. So far I haven't found a "perfect" one-GeoBlue's prepayment option is limited to its in-network providers, which may not be very useful. Maybe I should take a look at Allianz, or prepare to self-pay medical expenses and get reimbursed considering European's medical expenses are less expensive.
Med evac is an entire different animal-my state wide insurance covers it but won't pre-pay. So I'd better get additional coverage.

Posted by
88 posts

@ Mr É (Ressurrected)-Which country do you live in? I thought you lived in the US?
Were you speaking of the payout ($1500) by Allianz for your trips outside of your permanent residence? If so, seemed you had good experience with Allianz.

Thank you for sharing the link. I will take a look.

Posted by
33926 posts

if you look at his name, below it is where he lives. It says "Magyarország" which is Hungarian for Hungary.

Posted by
16362 posts

Frank II-
Did you purchase Allianz thru your employer or on your own? I purchased Allianz before when booking flight tickets with Delta (?).

What employer? I've been retired for years.

I am a full time traveler so I have an annual travel insurance policy. I was with TravelGuard for awhile but switched to Allianz a few years ago. (The coverage was better.) I just renewed it a couple of weeks ago. The agent I dealt with contacts me every year via email to set up a phone appointment for renewal. This way I don't have to remember.

I don't know of any US travel insurance policy that pays up front. The medical facility would have to accept it.

As for medical evacuation, the cost of private air ambulance from Europe to the US is somewhere in the neighborhood of $100,000 and then some. With Medjet, I don't see a bill. They also offer an additional evacuation policy covering war, terrorism and natural disaster. If you're caught up, they will arrange to get you evacuated at no cost.

Posted by
20360 posts

I am only familiar with MY US policy and my European policy, US health care and Hungarian and to a lessor degree Romanian healthcare, so I won't throw out any generalizations. No illness in the US will bankrupt me. I have good insurance, always have.

Any elective or nonessential treatment will be many months faster to receive in the US vs the Hungarian system.

The comfort of care in the US exceeds the comfort of public care in Hungarh by a factor of 10.

The ability cure is about equal in both.

If I were earning the same in Hungary that I was in the US, adjusted for the cost of living here, the Hungarian public health care tax would cost me about the same as my US policy before retirement. But I would save about $5000 in out of pocket expenses that i pay on my US policy in a serious situation. If I could find a US hospital that still had 4 bed wards, didn't feed me or provide toilet paper or pain meds for comfort I might net out even.

My European policy does pay 100% but has a fairly low cap ... hence the evacuation insurance so my US Medicare will take over.

Comparing Europe to the US is nonsense because there is no European standard. There are countries here where the coverage and care might be better than the US, paid for by very high taxes, so I don't know if cheaper than the US, and there are a lot of countries here where the citizens wish they had it as good as Hungarians.

I am satisfied here, and i have a chtonic heart condition, but I know the tradeoffs vs. the US.

In an Emergency situation I think you will get necessary care in most all of Europe without a demand for cash upfront just like in the US.

As for US vs Socialized burocracy (sp) a good example might be the system in the UK. Read and maybe surprised and maybe be happy, on some counts, you aren't living there. Everything is a tradeoff.

This is a good discussion because it's a topic we in the US need to vote on from time to time and the truth vs the ideology is important. A benefit of travel if you ask questions while on the road.

Posted by
20360 posts

Jeansn6 my Alianz policy has been very good. Because of the way systems work here (Hungary) I have to visit my cardiologist and 2 other doctors every 3 months. My GP, twice a year. The visits include blood tests, abd EKGs. Then every 2 years there is a more invasive "exam". Just guessing all of that is $1500. Insurance pays nothing on medications and those are about a third less than the US, but still over $100 a month. The policy is over $200 and a bit more than my Medicare policy in the states, which I maintain as well. The evac policy is over $500 a month.

Before all of that my cost of living here is not quite half what it would be in the US. But that comes with significant tradeoffs.

Posted by
88 posts

@Hi Stan-Thank you for letting me know that reading my post was not a totally waste of your time. I've read a lot of previous discussions on this subject and felt not everybody was completely understanding what his/her plan was covering. I was surprised to learn that Medjet doesn't cover local medical emergency evacuation/transfer.
I just happened to have listened to a podcast this morning in which the speaker talked about how much more expensive healthcare in the U.S. vs. other developed countries: The US spends 17% of its GDP on healthcare compared to half of that much by other developed countries. Hospitals, doctors, drug companies, and insurance companies all blame each other for the high cost. Everybody in the US knows the healthcare is very expensive but I don't think that will change in the foreseeable future, or ever.

I didn't mean to turn this into a pollical debate/discussion.

Posted by
88 posts

@Frank II-Thank you for your reply. I need to look into Allianz's travel insurance. It was mentioned frequently in the travel insurance discussion.
You were correct that most US health insurance companies don't prepay medical expenses incurred overseas.
Medjet is what I am considering for evacuations but since it doesn't cover local emergency med evac I need one which does. I wonder if local med transfers require upfront pay by patients?

Posted by
20360 posts

jeansn6, i dont see it as a political discussion unless someone wants to start pointing fingers. Its a learning experience, part of the reason we travel.

If the podcast said its half, then the podcast was inaccurate. Its about a thrid less in Europe as a whole (11% vs 16% more or less). But for that to mean anything one would have to analize the quality and availibility of the healthcare; and what is covered and what isnt ... in the US we cover things that would be unheard of in much of Europe. I am not taking a side, i really dont know the answer. I described above what an experience in one country would be. I posted a link of a RS person who went through the process in that one country. You have to decide if you would be happy with what that one person got (technically it was good), or it you wanted to pay a third more for what you get in the US. Most people I know in the US would revolt if that was their comfort of care. But again, thats one country vs the US. Others will be better or worse. To quote what is being paid is sort of deceptive to push a idiological point of view. Its way more complex than that.

Then there are the complexities. I was surprised that those here making minimum wage (about $700 a month and by no means a living wage by the US definition of the term) still had 14% taxes taken out for medical. In the US a minimum wage earner would probably pay $0. Those that get that there are tradeoffs will vote for a better system, those that dont get that will might possibly send things down another path that is no better, but different, than the one we are on. None of this is to take a side, just to encourage travel and talking to people so that one can create informed decisions.

Posted by
612 posts

We have purchased the Allianz annual policy for medical and evacuation for the last few years. If you live in the US what policies that are available to you vary a bit state to state.
We have some medical coverage through our own policies (Medicare Advantage for my husband and private purchase for myself) so I look at this as a supplement. One benefit to the annual Allianz policy is that it also covers you 100 miles from home so it could be used as a back up for travel in the states too. All that being said though we have thankfully never had to make a claim.
A tangent here… perhaps under the category of “prepare for the worst, hope for the best”. I’ve had to make emergency room visits due to pain from advanced glaucoma and retinal issues so I look up in advance which hospital (in the closest major city) handles ophthalmology (many due not) and accepts my insurance. If you have a specific need you might think about that.

Posted by
20360 posts

Back on track, then I will shut up.

My personal preference, knowing what I learned in the local system and what I see daily on the news about the UK system.

Get a tourist health policy. One of the big ones. I like Alianz because they have paid well and because it is a Eurpean company. Many (do some research if this is of a big concern) private clinics in Europe will accept the policy ... mine does and accepts others and actually promotes that they take tourist policies. FirstMed in Budapest. Love 'em.

Get an evacuation policy with the most liberal terms of when you can elect to return to the US. My belief is that this is MedJet, but if someone does the research and proves me wrong I would love it You will need it for when you max out your tourist policy or when you have had enough of the public healthcare system.

Outside of Germany and Austria and maybe most of the Baltic states avoid the public system if you can. Most will do an excellent job of saving your life, but will do so in a manner not too reassuring or comfortable to a US citizen.

Posted by
88 posts

@ Mr É (Ressurrected)
Thank you share your perspectives about healthcare in the US and the European countries where you've lived. While we like to complain about the high cost of healthcare here in the US, it does have merits other healthcare doesn't. Also, affordability based on earnings and living standards is an important factor to compare healthcare in different countries.

Thank you for sharing your Allianz policy. It sounds a great plan. $500/month for evac sounds expensive compared to <$500/year with Medjet.

I also want to thank you again for sharing the link-It's been over a year since the original messages were post so I was able to read from the beginning to the end in one sitting. To be honest, it made me more nervous traveling internationally and rethink if I should ever travel alone. My main take-aways:
What an extraordinary woman the OP was to go thru such an ordeal and still maintain positive attitude and care about other people
How kind you and Texastravelmom were for repeatedly offering to help and for helping her and her husband when they mostly needed
How essential to have an adequate travel insurance
No matter how well we prepare, things out of our control happen so keeping calm and being positive is important.
You never know what insurance company will find to deny to pay.

Posted by
88 posts

@Mr. E-The podcast didn't say the comparison was to European countries. It said "other major nations". I took that it meant developed nations.

Posted by
20360 posts

$500/month for evac sounds expensive compared to <$500/year with
Medjet.

My Medjet is about $500 a year.

I found a chart, but I didn't do a lot of research, it showed developed Western European countries were at about 11%.

I wouldn't be afraid to travel alone. The healthcare in most of Europe is excellent, but "different" in many regards ... most of which will have no impact on the quality of emergency care. And in thr countries that also have private care, for a tourist it is excellent and affordable. I love the quality of the care I get here. But being a tourist or a resident like me isn't the same as being local.

Posted by
88 posts

@Horsewoofie-I am going to Germany in December. Looking for med evac insurance and a provider who will prepay medical expenses.

Posted by
88 posts

@Nigel-Thank you for letting me know. I was too lazy to look it up on the internet.