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You’ve packed your bags, double-checked your passport, and triple-checked the stove (yes, it’s off). But did you forget the most important thing? Travel medical insurance, also known as travel health insurance, is essential coverage that can globetrot with you and potentially save you from owing thousands of dollars if you get sick or hurt and have to seek out-of-network medical care.
While you may have excellent healthcare coverage at home, it pays to check whether those benefits extend across the U.S. and overseas.
Let’s start with the basics:
Ask, don’t assume: Does my health insurance cover travel?
First things first: Before you plan any trip, it's wise to contact your health insurer and ask specific questions about your coverage while traveling. Ask them to refer you to written documents (or send them to you), as you'll want to have details in writing that clarify exactly what is and isn't covered when you travel.
Although we'll provide a general overview here, there's no substitute for finding out exactly how your specific policy covers you when you leave your home area.
Globetrotting: Do I need international travel health insurance?
The short answer: Probably. Nobody heads on an international vacation planning to get sick or have an accident. But it can happen, and the resulting medical bills can be overwhelming if your health insurance doesn’t translate abroad.
Unfortunately, most U.S.-based health plans don’t cover international travel. And depending on where you’re traveling, you may need to provide proof of medical insurance to get into the country. About 60 countries require tourists to have a minimum level of travel insurance.
Fortunately, international travel health insurance is widely available, inexpensive, and relatively easy to obtain.
It’s important to note that policies can vary significantly, so read the fine print and pay close attention to the small details. For example, travel insurance policies will differ in terms of the total amount they’ll pay and whether they’ll cover recurrences of pre-existing conditions, injuries sustained during certain types of activities, and medical evacuation.
What does travel medical insurance cover?
Basic travel medical insurance will cover at least some of the cost of unexpected medical emergencies during your trip abroad. Examples of covered scenarios include broken bones, heart attacks and stroke, and the policies often include accidental death and dismemberment coverage.
More comprehensive travel policies (including additional riders added to a basic policy) will include coverage for expenses like medical evacuation, extended accommodations if you’re unable to return home due to your health, treatment for extreme sports” injuries (e.g. injuries sustained during activities such as scuba diving, mountain climbing, paragliding, skiing, etc.), and even repatriation of remains in a worst-case scenario.
Some policies cover COVID and others don’t, so you’ll want to be sure you understand how that works for the policy you’re considering.
Travel medical policies generally will not cover routine or expected medical costs, unless you purchase a policy designed specifically for expats who plan to live (rather than just travel) abroad.
Note that most travel policies work on a reimbursement basis. You pay for care up front and submit the receipts to the insurer. Reimbursement amounts depend on the specifics of your policy, including the deductible and the benefit cap.
What’s the best travel medical insurance plan for me?
The best travel medical insurance policy will depend on your budget, your risk tolerance, and specific needs you might have while on vacation.
For example, if you're planning to spend the trip relaxing with a book by the pool, your coverage needs won’t be the same as a person who plans to spend their vacation white-water rafting and skydiving. (If you’re in that latter group, make sure you buy a policy that covers injuries sustained during such activities.
Are you a frequent traveler? Consider whether it makes sense to buy an annual (multi-trip) policy or a single-trip policy. Multi-trip/annual policies will provide coverage for any trips you take during a 365-day period.
How much is travel medical insurance?
Rule of thumb: Expect the cost of travel medical insurance to equal 4% to 10% of the total cost of your trip. (5% to 6% is common.) For example, if your trip costs $5,000, a travel insurance policy could cost $200 to $500.
The exact price will depend on several factors, including:
- How much coverage you buy. (A policy with higher benefit caps will cost more.)
- The deductible you choose. (The lower the deductible, the more the plan will cost.)
- The specific benefits the policy provides, either directly or via add-on riders for things like sports/adventure coverage, medical evacuation coverage, coverage for non-medical situations such as lost luggage, trip interruption/cancellation, etc.
- Your age. (The older you are, the higher the premiums will be, and there are generally lower benefit caps available for applicants who are older than a certain age – often 65 or 70.)
- The duration of the trip. (The longer the trip, the more the coverage will cost.)
What medical conditions do I have to declare for travel medical insurance?
Do you have a pre-existing medical condition? Travel medical insurance plans are not regulated by the ACA, so they do not have to cover pre-existing conditions, they can still have annual and lifetime benefit caps, and coverage is not guaranteed issue. They also aren’t required to cover the ACA’s ten essential benefits.
Depending on the policy and your age, you may be asked about your medical history. If you fail to disclose something on the application and then incur medical costs while on your trip, don’t be surprised if your claim is denied.
Remember, if you file a claim, the insurer can then look at your medical records to confirm the expense is not related to a pre-existing condition. (Some policies will cover acute recurrence of a pre-existing condition, so if this is your concern, be sure to confirm coverage before signing onto a policy.)
Do I need travel medical insurance if I have Medicare?
Whether you need travel medical insurance depends on your Medicare plan:
- Original Medicare doesn’t cover care outside the U.S. (with very limited exceptions).
- Your Medigap plan might provide some coverage for international travel.
- If you have Medicare Advantage, the plan might include some travel coverage, but this varies from plan to plan.
- If you have private supplemental coverage from an employer, it depends on your plan. Some policies include life-or-limb medical emergencies, but the onus is on the patient to prove that the situation was truly an emergency, and the cost of medical evacuation back to the United States is rarely covered by standard U.S.-based health plans. (Travel medical insurance plans generally do cover medical evacuations, but you’ll want to check to make sure that’s included in the travel policy you’re considering.)
For more information, check out this Medicare enrollee’s guide to travel coverage.
Do I have to renew my travel medical insurance for each trip?
Travel medical insurance is not guaranteed renewable, which means that if you need another policy after your first one ends, you must reapply and go through medical underwriting again (similar to short-term insurance).
If you are planning multiple treks this year, consider purchasing an annual/multi-trip travel insurance policy. It definitely will save you time from filling out applications, and maybe save you some money, too.
U.S. travel: Do I need supplemental health insurance?
If you’re traveling domestically but outside your home state, you might be traveling out of network. Your comprehensive major medical coverage will cover out-of-network care in emergency situations, and you won’t be billed more than your in-network cost-sharing.
If you receive non-emergency care while you’re traveling, the amount you’ll owe will depend on the breadth of your current health insurance plan. Employer-sponsored plans (especially those offered by large employers) often have nationwide networks.
But individual-market plans (the kind you buy on your own, either through an exchange or directly from an insurer) typically have localized networks. If you have one of these plans, there’s a good chance it doesn’t cover any non-emergency, out-of-network care. A Robert Wood Johnson Foundation study in 2018 found that only 28% of individual plans offer out-of-network benefits.
Out-of-network E.R. care is a different story – one where you don’t have to pay exorbitant out-of-pocket fees. Thanks to the federal No Surprises Act, which went into effect in 2022, health insurance companies are required to cover emergency services at in-network rates. This is true regardless of your plan’s network structure (EPO, PPO, HMO, or POS) or how extensive the network is.
However, sometimes emergency medical situations result in long hospital stays with the patient too ill to return home. In these cases, the extended services might not qualify for No Surprises Act protections. (By the way, there is no standard definition of what constitutes an emergency. Insurers can and do dispute the emergency nature of medical care, even if it’s provided in an emergency room. But you have the opportunity to appeal an adverse decision that your health insurer makes.)
Types of supplemental coverage for out-of-network care in the U.S.
Some people purchase supplemental coverage to offset some of the potential costs that could be incurred if a medical situation arises while in another state.
- Accident supplements will typically reimburse a policyholder a flat-dollar amount, which can be used to pay out-of-network charges or balance bills in the event of a medical claim that arises from an accident or injury.
- Critical illness plans also reimburse the policyholder a flat-dollar amount, although the plan will only pay if the patient experiences a specific covered illness. These plans typically include coverage for things like heart attacks and strokes, so they can be useful for sudden scenarios that can arise while one is traveling and which necessitate emergency care.
Supplemental plans are suitable for maintaining year-round, whether or not you’re traveling. But they cannot serve as your only coverage, so you do also need to maintain comprehensive major medical coverage.
Last word: Read all the fine print
Piper Kan and Reece Huculak-Kimmel both have stories that amount to a cautionary tale about the shortcomings of travel insurance. Both little girls were born prematurely in foreign countries, and the extensive medical bills were not covered, despite the fact that in each case the parents had purchased travel medical insurance policies and thought they were covered for any contingency.
The takeaway? It’s important to pay careful attention to the written details and exclusions of the plan you’re considering. Don’t rely on verbal confirmations of benefits. But that said, travel insurance is an excellent supplement to your regular policy, and will cover mishaps in foreign countries that would otherwise have to be paid out-of-pocket. Bon voyage!
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
