How does my Medical Insurance relate to overseas travel for medical care?
Whether or not you are covered for overseas care all depends on what type of medical insurance you have, which carrier owns the policy and a host of other variables. Generally speaking, though, U.S. insurance plans do not typically cover care overseas. There are exceptions for emergency care but even then coverage is usually limited to stabilizing your health and evacuating you back to the States.
Things are starting to change, though. Slowly parts of the establishment are beginning to warm to the concept of Medical Travel. While much of what you hear in the media and how the conversation typically starts is around the topic of cost savings, what really gets employers and insurers interested is when they find the quality of care overseas is in some cases better than what is available here at home.
Who pays for your health care? It’s more complicated than you think.
Most individuals who have health care coverage in the United States carry benefit cards with one of a handful of names on them: Cigna, Blue Cross, United Health Care, Aetna, Humana, etc. But that doesn’t really tell you anything about who is actually footing the bill for your care. The fact is that while it is often the case that the company whose name is on your card is paying the bill, if your coverage is provided by your employer there is a better than 50{7b225fbeff640dd30b4b8b66650188099c7e8b184e2fb5b5b9f806a74d59162d} chance that the “insurance company” is actually the same company that writes your paycheck every month.
Almost 60{7b225fbeff640dd30b4b8b66650188099c7e8b184e2fb5b5b9f806a74d59162d} of employers hire one of the big-name insurance companies to manage their health insurance plans, but the employer actually pays the medical bills that come in for their employees. This is called self insurance, and it is how almost every one of the companies that you recognize from the world of business manage their health plans. So even though you are getting services from Aetna, for example, Aetna is simply negotiating discounts and processing the paperwork on behalf of their client: your employer.
In general, large insurance companies have yet to embrace the idea of allowing their clients to travel abroad for medical care. There are so many reasons for this that the topic merits its own post, but the quality of care is unlikely to be on the list even though it is the Trojan horse in which all of the other concerns reside.
If your employer is the one footing the bill, though, they have the authority and autonomy to offer you a Medical Travel benefit. Even if your card bears the name of a large insurance company that doesn’t otherwise pay for overseas coverage.
What does all this mean?
What this boils down to is that you might already be covered for overseas Medical Travel depending on what coverage you have an who is ultimately responsible for paying the bill. What’s more, in many cases if your employer does self-fund their benefit plan, if you have identified an overseas provider that you want to work with your employer can approve payment on a case-by-case basis. This is something that happens with some frequency since the cost savings are typically significant for the employer.
