Living or traveling abroad can be an invigorating and life enriching experience, but it is not without its difficulties and dangers.
Day-to-day health care needs are not suspended when adventurers travel to new places, and medical emergencies can happen to anyone at any time. Fortunately, a little advance preparation can help travelers and expatriates protect themselves while making their most of their overseas adventures.
The best ways to find and arrange health care while living abroad can depend largely on who the insurance buyer is, why he or she is traveling and for how long. Students, for instance, can have entirely different options at their disposal than retirees. Retirees, in turn, may have an array of different options available to them based on pre-existing factors like their veteran status or enrollment in Medicaid.
Overall, most Americans living abroad arrange for health insurance coverage in one of only a handful of ways. They may rely on minimal coverage from the health insurance policies they already hold, they may purchase short or long-term travelers’ insurance or they may qualify for some form of foreign insurance offered by an employer.
Nearly all standard health insurance plans, regardless of type, contain clauses that permit policyholders to access emergency medical care wherever possible in the event that it is needed. These permissions extend to international travel, using what is referred to as the “prudent layperson standard.” Under this standard, emergency care is covered for any symptom or condition that would drive a reasonable person to seek critical care. Chest pain, broken bones and serious auto accidents are simple examples.
Some managed care plans place strict limits on what does or does not qualify as emergency care. Travelers enrolled in managed care plans should review their policies and contact their insurance company representatives before traveling, if necessary, to ensure they are clear what standards and limitations they will be operating under. Authorities and insurance experts alike encourage insurance policy holders planning to travel abroad to proactively inform their insurers ahead of time. That quick, easy step can go a long way toward preventing delays down the line if filing a claim is necessary.
Travelers must also be aware that most foreign hospitals and care providers are not equipped to process and bill their insurance companies directly. Nor are most American insurance companies set up to rapidly process and pay bills associated with the delivery of health care and medical services in other countries. As a result, travelers may need to be prepared to pay the full costs of any care they receive while traveling. They will then be able to submit their bills to their insurance companies for reimbursement. It may take months for reimbursements to be processed and distributed. Advance planning and saving for such contingencies can significantly reduce the strain of such experiences.
Some insurers will issue travelers special riders for travel. These may be generic or customized to the specific needs of different groups, such as business people, professional or amateur athletes participating in tournaments or competitions and expatriates.
Travelers who do not have pre-existing insurance or who feel their current plans are inadequate can purchase travelers’ insurance. Travelers’ insurance is available in short-term or long-term plans. Short-term plans typically cover periods of less than one year. Long-term plans cover trips of one year or longer. Travelers’ insurance policies can allow travelers to bundle other forms of insurance with their health insurance protections, such as coverage for rented vehicles, homes and equipment.
Travelers’ insurance plans vary widely. Travelers can piece together a plan that covers only certain areas they are concerned about. Alternatively, they can often select plans that match the coverage they have for themselves and their possessions while at home in the United States. The costs of such insurance will scale up or down with the types and amounts of coverage desired.
Depending on the plan, travelers’ medical insurance may:
Travelers’ insurance may be purchased for a single trip or for multiple trips taking place within the same year. Travelers who intend to live abroad for an extended period of time, whether in one place or multiple places, can purchase annual coverage that protects them for a complete year, regardless of where they go.
The cost of travelers’ insurance can be influenced by the comprehensiveness of the coverage purchased, travelers’ ages, where travelers are going and their accommodations. On average, policies tend to cost between 5 and 7 percent of a trip’s total cost.
Students traveling or living abroad for educational purposes can often secure health insurance through their colleges or universities. Students participating in exchange or immersion programs can sometimes access appropriate coverage through those programs, as well. It is important that students traveling abroad under their parents’ insurance or their own college student insurance plans verify what care will and will not be covered. Some conditions, such as asthma, may not be adequately covered outside of their plans’ network range. Prescription medications may not be readily available or covered at their usual rates overseas. Checking on these types of details in advance can be crucially important.
Military veterans may qualify for some health care and VA health insurance benefits while living abroad. The types of care available and the costs of that care will vary by country and region. Generally, veterans who live within range of military bases or other military facilities will have more access to care than those who do not. Full details are available from the Department of Veterans Affairs.
Individuals who are working overseas at the behest of their employers can generally expect that their companies will make some kind of comprehensive and appropriate health care available to them during their time abroad.
Individuals enrolled in Medicare should be aware that, as a rule, Medicare does not pay for any medical expenses incurred outside of the United States.
Travelers are not necessarily exempt from the Affordable Care Act’s individual mandate, which orders that all Americans must carry health insurance. Due to legal categorization issues, travelers’ insurance may not be considered qualifying health insurance under ACA requirements. In most cases, Americans who spend 11 months a year or more living outside of the United States are exempt from the health insurance mandate. However, travelers are strongly advised to consult with their tax professionals ahead of time to ensure that they do, in fact, qualify for an exemption before canceling their health insurance or letting it expire.Travelers who qualify for Medicaid or Medicare should also strongly consider enrolling in those plans as soon as they are eligible, even if they are not in the United States to take advantage of them. Some parts of those programs inflict penalties on late enrollees. As a result, it may be cheaper to pay for care policy holders are not using than to pay the late fees later on if they return to the United States and want to access those benefits.