“How are you handling health care and insurance?” I’ve heard this from many friends and it is a legitimate concern even for seniors currently in good health. If you are less than 65 and do not have insurance through an employer (our case), then you are subject to the ever-changing US health insurance laws, large premiums with policies that are only useful in a small region of the US. If you are over 65, you’ll find that Medicare basically offers no coverage for any medical issue outside of the US, whether routine or emergency. Travelers need to consider what can happen when out of the country and purchase insurance to cover at least the most financially risky possibilities.
Our approach is two-fold:
Domestic Health Insurance
I now qualify for Medicare, so I chose a Medicare Advantage plan. That is great when we are around home, and will cover emergency services in the US. No coverage outside the 50 states though. Susie is on an ACA plan through the health insurance exchange, and we are in a position to control our taxable income to qualify for subsidies.
This provides coverage like normal people, with full coverage while in the St. George area, and and emergency medical coverage while somewhere else in the US.
International Coverage
We supplement normal domestic coverage with travel insurance. The purpose of travel insurance is to shield the traveler from the costs associated with lots of things that can go wrong on a trip, including non-medical problems, such as delayed or lost baggage, and delayed or cancelled flights, trip interruptions due to a variety of factors.
Even more challenging and potentially very expensive are emergency medical issues: broken bones, illness and the possibility of medical evacuation, or even repatriation of remains. The main point of medical travel insurance is to handle emergency needs close to where you have the emergency, and if needed, to transport you back to the US, where presumably your regular health insurance would begin coverage
Our foreign travel insurance consists of two parts:
1) Many credit cards offer free travel benefits when the travel expenses are purchased using the card. Our main travel credit card is the Chase Sapphire Reserve Visa card. The card provides ample benefits for lost or delayed baggage, trip cancelation and interruption, flight cancellation or delays and other annoying non-medical things that happen from time to time. There are a host of other benefits, which you can read about at the site. We found these benefits to be sufficient for all our travel needs, except for medical.
2) We add medical coverage, through one of the reputable providers, such as GeoBlue or Allianz. (we have no relationship with these companies) These companies offer comprehensive travel insurance plans. Read through the fine print of your credit card plans so you know the coverage you already have and then use that card to make travel purchases. Then choose the travel insurance plan that adds the medical coverage you need. There will still likely be some overlap with your credit card coverage for non-medical coverage. The policies apply to any trip more than 100 miles from home, so they can provide some assistance even when traveling in the US.
Plans are available to purchase for each trip, or for all trips in a calendar year. The annual program is quite cost effective if you plan to take multiple trips in a year. Do note that coverage expires if the duration of a trip exceeds a certain number of days specified by the insurer. 90 days is the maximum I have found. There are short-stay insurance programs for stays longer than 90 days but I haven’t studied or used those.
Extra Homework
Know how your policies work. Read through their documents and make some notes on the steps: Do you have to pay out of pocket first and then get reimbursed later? What situations require pre-approval for coverage? Do you have contact information at your fingertips? What documentation do you need to provide to file a claim? What are coverage limits and exclusions?
Example: I needed to visit a doctor in Malaysia due to a very sore throat. I paid the doctor directly, kept the receipt, and then a few days later started the process of filing the claim. One of the items required by the insurance company was to have the doctor fill out a form describing the medical need for the procedure. Well by the time I saw this requirement, it wasn’t practical to do. I should have had a copy of the form with me when I visited the doctor and had him fill it out during the examination. (Note: I forged the document, but filled it out with the correct information). So when picking a new policy this year, I read through the claims process carefully. Our current policy only requires proof of payment and no form from the doctor.