Medical insurance for international travel?

[Fishboy1947]

I posted this here instead of the insurance forum because I want to see what people are actually doing. Plus the insurance forum gets less traffic 

 

I am over 70, so individual trip policies have become expensive. I have traditional Medicare with a supplement. The supplement provides $50,000 lifetime out of country coverage.

 

GeoBlue’s annual policy only provides $100,000 medical coverage for people over 70. The same seems to be true with most travel policies.

 

How much is enough when traveling internationally, Europe in particular? Where do you get additional coverage?

[navybankerteacher]

You also should consider repatriation coverage in addition to straight medical - you should look at a reasonable minimum of $50,000 to get home.

[Hlitner]

As a 70+ cruiser (who also has Geoblue) I really like the fact that the OP is concerned that $100,000 is simply not enough medical.  Consider that most cruise line insurance policies only provide $10-$20,000 of medical :(.

 

I do not have a good answer for the OP despite having spent most of my adult life in the medical insurance (government) industry.  While I am personally comfortable with $100,000 I also understand that there are plenty of situations when it would not be adequate.   I do believe that Geoblue sells single trip policies with coverage up to $1,000,000 and there are other options in the market.  Although we normally carry their annual Trekker policy, during the winter of 2021 we had a lot of concern about COVID when heading to Mexico (our winter home).    For that one trip we actually did purchase one of their million dollar policies.  

 

My advice to folks is that each person/couple must do what is right for them...which means dealing with your own risk tolerance and financial situation.  The fact that you even ask the question about $100,000 tells me you have some discomfort with that max.  Perhaps you might want to talk to a decent trip insurance broker (who deals with multiple companies) and get some advice.  If you follow the Travel/Insurance blog here on CC you should already be aware of at least one popular broker.  It costs nothing (but time) to make a phone call.

 

Hank

[pris993]

We have a Travel Guard Business Traveler annual policy.  It covers accident and sickness medical $50,000, repatriation $50,000 pp.  Annual policy is only $518 for 2.  Good anywhere in the world.   

Good for travel 100 miles away from home.   

 

With Covid, I have added a premium coverage offered by the cruise ship in this case Princess which also has medical and covers trip cancellation.   This is per trip. 

 

Through preplanning for final arrangements, we have purchased coverage for repatriation of remains from anywhere in the world for rest of our life for onetime fee of $500 pp.  

 

We have two types of medical coverage: one person has MedicareAdvantage, which is not good outside USA; the other has Medicare and a supplemental which does have cover outside USA.   We are 90/75, in good health. 

[Fishboy1947]

4 hours ago, Hlitner said:

As a 70+ cruiser (who also has Geoblue) I really like the fact that the OP is concerned that $100,000 is simply not enough medical.  Consider that most cruise line insurance policies only provide $10-$20,000 of medical :(.

 

I do not have a good answer for the OP despite having spent most of my adult life in the medical insurance (government) industry.  While I am personally comfortable with $100,000 I also understand that there are plenty of situations when it would not be adequate.   I do believe that Geoblue sells single trip policies with coverage up to $1,000,000 and there are other options in the market.  Although we normally carry their annual Trekker policy, during the winter of 2021 we had a lot of concern about COVID when heading to Mexico (our winter home).    For that one trip we actually did purchase one of their million dollar policies.  

 

My advice to folks is that each person/couple must do what is right for them...which means dealing with your own risk tolerance and financial situation.  The fact that you even ask the question about $100,000 tells me you have some discomfort with that max.  Perhaps you might want to talk to a decent trip insurance broker (who deals with multiple companies) and get some advice.  If you follow the Travel/Insurance blog here on CC you should already be aware of at least one popular broker.  It costs nothing (but time) to make a phone call.

 

Hank

Talked with broker and recommendation was $100,000. They said $80,000 was the highest claim that they had seen.

 

I have seen other insurance and financial sites recommend $50,000 or $100,000.

 

It’s good to see what seasoned travelers think. I value the opinions of many posters here, including you.

[Hlitner]

That is interesting.  I have long posted that $100,000 was my personal minimum, but your post got me thinking that we have been talking about $100,000 for over twenty years and perhaps some think that is no longer adequate.  When I worked in the business we did pay out much higher amounts than $100,000, but I do not recall anything nearly that high for emergency care.  Our biggest payments had to do with long term chronic issues and a few very expensive multi-organ transplants that would not be something of concern for emergency/urgent care.

 

Hank

[Flatbush Flyer]

1 hour ago, Fishboy1947 said:

Talked with broker and recommendation was $100,000. They said $80,000 was the highest claim that they had seen.

 

I have seen other insurance and financial sites recommend $50,000 or $100,000.

 

It’s good to see what seasoned travelers think. I value the opinions of many posters here, including you.

FWIW: There are “seasoned” travelers here and then there are insurance agents who are specialized in travel and licensed in, at least, your home state with whom you should talk (and not just with one of them). Their informed recommendations are based on significant/current  knowledge of the industry and real data - not just anecdotal evidence and/or second hand info. Most importantly, there are way too many unique variables tied to you to make any kind of “one size fits all” suggestion.

[6rugrats]

We are all healthy until we are not.  For me, $100,000 is not enough coverage.  Agree, contact insuremytrip.com or tripinsurancestore.com to discuss your needs with an agent.

[Markanddonna]

In many parts of the world, including Europe, medical care costs much less than in the USA. So, I can see that $100,000 might be adequate. Like others have said, we can't insure against every possible catastrophe. 

 

If I were a foreign travelers coming to the USA, I would be much more inclined to have a policy over $100,000.

[Flatbush Flyer]

3 hours ago, 6rugrats said:

We are all healthy until we are not.  For me, $100,000 is not enough coverage.  Agree, contact insuremytrip.com or tripinsurancestore.com to discuss your needs with an agent.

You have said the magic words: “For me”

 

Besides the existing condition of the traveler(s) health, there are so many other factors to consider in choosing a correct travel insurance policy (particularly a comprehensive one, i.e., trip + medical). Among the factors, a most important one is what existing insurance coverages you have that may allow travel related claims. After all, many travel insurance policies are “secondary payers” anyway. So, familiarity with your regular health insurance, homeowners insurance and even Credit Card coverage   (often woefully restrictive and inadequate) should be a first step in the research.

 

BTW: I am amazed at how many fellow geezers are unaware that Medicare is useless outside the US (or it’s immediate borders in certain instances). We are then bombarded daily by TV ads for Medicare Part C deals that can be equally worthless for foreign travel. And, sadly, many insurance buyers neither read the fine print or would understand it if they did.

 

Second step in insurance research is understanding that certain terms like PreExistingCondition (PEC) have different meanings in insurance vs healthcare. And, no, Medevac is NOT that first responder helicopter making a “field rescue” from a cruise ship.

 

A good travel insurance broker (e.g., InsureMyTrip.com) licensed agent can walk you through the process of choosing the right protection for YOUR specific needs, preferences and means. A 30 minute phone call can save  you many $$$.

 

FWIW: we are extremely fortunate to be CalPERS retirees with what is arguably among the best employer provided health insurance in the US (as Geezers, we now have Medicare supplements that include international coverage which can be coordinated with GeoBlue where applicable). Because our intercontinental travel is extensive, we add a MedJet annual policy.

But, we still add a relatively inexpensive comprehensive travel policy - primarily for the Trip Cancel/Interrupt coverage which is hard to find as a free-standing policy needed for longer/expensive cruises (e.g., multiple annual 1-2 months intercontinental trips on premium lines) costing far more than the claim limits on credit cards and/or cumulative limits on annual comprehensive travel policies. And insurance companies know this which is one of the reasons why the difference in cost of a comprehensive policy vs a medical only travel policy is relatively low. 
 

Yes, it is definitely a “first world problem.” But, it’s a problem nonetheless. 
 

So, do the preliminary research and then talk with multiple licensed experts before deciding how to proceed. Your decision, based on your circumstances may be to rely on your existing coverages and “self-insure” for missing pieces (if practical and possible). But, don’t be “pennywise and pound foolish” when it comes to adding appropriate coverage. After all, “no one needs insurance until they need insurance.”

[Hlitner]

FF, I think it is wise to correct something in your post about Medicare.  There are some Medicare Part C (Advantage) Plans that do provide some coverage outside of the USA for both emergency and urgent care.   In fact, we are covered by one of those policies (an Aetna plan).  That being said, I do not rely on that coverage (GeoBlue is primary for us when outside the USA).

 

But Medicare A and B are not very helpful outside the USA.  There are two very rare exceptions (if within 6 hours of a Port) and if transiting Canada on the way to or from Alaska.   And that 6 hour rule makes very little sense since it speaks of time and not distance.   Back in my working days I once had a long discussion with a Medicare colleague about that 6 hour rule and we was unable to give me good answers (this guy was a HHS middle management expert).

 

If you want some fun here is the hypothetical.  Say you are on a cruise ship 100 NM off Port Everglades.  That ship is heading towards the USA at 10 knots (which means it is 10 hours from Port).  But that ship is capable of cruising at 20 knots which means it would then be 5 hours from the port.  If somebody needs medical care are they covered by Medicare?   I was in the business and have no clue and neither did anyone I queried at Medicare including that middle management friend.   That was over 17 years ago (the 6 hour rule has been around for a very long time) and I still cannot find any written interpretation (which should be published as a Regulation).  

 

Hank

[Flatbush Flyer]

13 minutes ago, Hlitner said:

FF, I think it is wise to correct something in your post about Medicare.  There are some Medicare Part C (Advantage) Plans that do provide some coverage outside of the USA for both emergency and urgent care.

...which is why I said “can.” My point, which assume you’ll agree with, is that a lot of folks don’t pay attention to the specifics of what they’re buying.

[ldubs]

1 hour ago, Hlitner said:

FF, I think it is wise to correct something in your post about Medicare.  There are some Medicare Part C (Advantage) Plans that do provide some coverage outside of the USA for both emergency and urgent care.  

 

Hank

 

And, I've heard even inpatient care.   But most seem to be limited to emergency/urgent visits. And getting back to your "in-network area" is not covered.

[cruisingguy007]

I look for a million. Travel insurance is mostly for medical and worst case scenarios for me, think major injury, hospitalization and medical evacuation by air, those can add up like you wouldn't believe. If it happens beyond the angels in the sky (US Coast guard) reach/jurisdiction, it'll all but certainly be many multiples of a 100K. Some insurance plans will cover you for catastrophic when traveling but if they don't a million is a nice round number.      

 

[cruisingguy007]

15 minutes ago, ldubs said:

 

And, I've heard even inpatient care.   But most seem to be limited to emergency/urgent visits. And getting back to your "in-network area" is not covered.

 

Stabilization and getting you returned stateside, some even to your chosen geographic area is covered by many insurance plans. Kaiser does and they are a very large provider.   

[ldubs]

2 minutes ago, cruisingguy007 said:

 

Stabilization and getting you returned stateside, some even to your chosen geographic area is covered by many insurance plans. Kaiser does and they are a very large provider.   

 

Couple friends have Kaiser. That was the carrier I was thinking of when I posted.   They had a pretty bad rap 25+ years ago.  Now I hear all good things about them.   It would mean a change in doctors/specialists, which would be a bummer, but I think I'm going to take a look at them when the next open enrollment comes around. 

[Toofarfromthesea]

6 hours ago, Markanddonna said:

In many parts of the world, including Europe, medical care costs much less than in the USA. So, I can see that $100,000 might be adequate. Like others have said, we can't insure against every possible catastrophe. 

 

If I were a foreign travelers coming to the USA, I would be much more inclined to have a policy over $100,000.

 

This is very true.  A few years back I slipped on an icy hotel balcony in Krakow and completely tore the quad tendons in my left knee.  This led to a trip to the emergency room in Poland.  I saw a Dr. (who spoke English) who examined me.  Then I had an X-ray.  Then I had an ultrasound.  Then the Dr. came back and explained the result.  Then he put me in a large plaster splint to immobilize the knee for the trip home.

 

When we were done we were directed to the cashier window.  We asked how much we owed and they said 260.  Dollars we asked?  Nope, zloties, the Polish currency.  Which at that time was about $70 US.  We didn't even bother to file anything with Geoblue.

 

After I got home I delighted in telling the PA and surgeon who did the repair that story.  

[ontheweb]

35 minutes ago, Toofarfromthesea said:

 

This is very true.  A few years back I slipped on an icy hotel balcony in Krakow and completely tore the quad tendons in my left knee.  This led to a trip to the emergency room in Poland.  I saw a Dr. (who spoke English) who examined me.  Then I had an X-ray.  Then I had an ultrasound.  Then the Dr. came back and explained the result.  Then he put me in a large plaster splint to immobilize the knee for the trip home.

 

When we were done we were directed to the cashier window.  We asked how much we owed and they said 260.  Dollars we asked?  Nope, zloties, the Polish currency.  Which at that time was about $70 US.  We didn't even bother to file anything with Geoblue.

 

After I got home I delighted in telling the PA and surgeon who did the repair that story.  

But, can you imagine the opposite? What if this happened to a Polish person (or really a person of any other nationality) in the US? How do you think they would react to the bill from the emergency room?

[davecttr]

59 minutes ago, ontheweb said:

But, can you imagine the opposite? What if this happened to a Polish person (or really a person of any other nationality) in the US? How do you think they would react to the bill from the emergency room?

I would think we would have adequate travel insurance to cover the cost. My current policy has a medical expense limit of £10 million. I have several medical conditions so the 14 night single trip policy is costing me £200 but that is OK  as the cruise cost  is over £2000 to the Canaries including flights and transfers etc. If I decide to continue cruising I will seek an annual policy.

[cruisingguy007]

3 hours ago, ldubs said:

 

Couple friends have Kaiser. That was the carrier I was thinking of when I posted.   They had a pretty bad rap 25+ years ago.  Now I hear all good things about them.   It would mean a change in doctors/specialists, which would be a bummer, but I think I'm going to take a look at them when the next open enrollment comes around. 

 

It's not bad at all, I've had it on and off for decades and it offers great coverage but it's not as good as Sutter Health/Palo Alto Medical if you're in the bay area. Kaiser has broader coverage and cheaper rates but Sutter/PA Medical is hands down my favorite for bay area local care vs Kaiser broad based. Sutter/PA Medical have more premier doctors, quicker/better services and top surgeons affiliated with the network. You do pay more but I think it's totally worth it. I had to leave behind my doctor when we switched to Kaiser but she ended up moving closer to me in Danville so I'm considering switching back but we are happy with the kids pediatrician with Kaiser now so it's a catch 22. Kaiser is worth a look though for sure, the international travel coverage is a nice feature to be sure.   

[pris993]

5 hours ago, ldubs said:

 

Couple friends have Kaiser. That was the carrier I was thinking of when I posted.   They had a pretty bad rap 25+ years ago.  Now I hear all good things about them.   It would mean a change in doctors/specialists, which would be a bummer, but I think I'm going to take a look at them when the next open enrollment comes around. 

Interesting, my DH has Kaiser Advantage coverage which includes his Medicare.  Coverage is great at home but I would not count on it traveling outside the State of California.  I have gotten a copy of Kaiser information package for travel, basically it requires prior approval before any treatment outside a Kaiser facility.   Had a friend who had Kaiser, one of her kids hit another kid in the eye while family was in Las Vegas.  She took child to ER just to be safe.  She was surprised Kaiser would not cover the visit and she had to pay visit cost of $1800.   One has to be careful with Kaiser.  I have not looked at Kaiser guidance for travel for a number of years, but basically Kaiser is an HMO.  HMO limit coverage outside network.  

[ldubs]

3 hours ago, pris993 said:

Interesting, my DH has Kaiser Advantage coverage which includes his Medicare.  Coverage is great at home but I would not count on it traveling outside the State of California.  I have gotten a copy of Kaiser information package for travel, basically it requires prior approval before any treatment outside a Kaiser facility.   Had a friend who had Kaiser, one of her kids hit another kid in the eye while family was in Las Vegas.  She took child to ER just to be safe.  She was surprised Kaiser would not cover the visit and she had to pay visit cost of $1800.   One has to be careful with Kaiser.  I have not looked at Kaiser guidance for travel for a number of years, but basically Kaiser is an HMO.  HMO limit coverage outside network.  

 

Because your friend had Kaiser does not mean coverage extends to someone else's child who isn't an insured on that policy, even if your friend's child was responsible.   I doubt there is any health insurance policy that would provide coverage under those circumstances.   

[pris993]

19 hours ago, ldubs said:

 

Because your friend had Kaiser does not mean coverage extends to someone else's child who isn't an insured on that policy, even if your friend's child was responsible.   I doubt there is any health insurance policy that would provide coverage under those circumstances.   

Obviously, my comment was unclear.  The friend who had Kaiser had 3 kids, one of her kids hit a brother or sister.   Parent had Kaiser, they were in Los Vegas, went to ER, Kaiser did not cover, she ended up with the $1800 bill, from a non Kaiser facility in Los Vegas.  Family lived in California.   From what I have read because my DH has Kaiser, when traveling  if one seeks treatment at a non Kaiser facility they need to contact Kaiser for approval.  Don't believe family did so, because they thought it was emergency.  

 

 

[ldubs]

16 minutes ago, pris993 said:

Obviously, my comment was unclear.  The friend who had Kaiser had 3 kids, one of her kids hit a brother or sister.   Parent had Kaiser, they were in Los Vegas, went to ER, Kaiser did not cover, she ended up with the $1800 bill, from a non Kaiser facility in Los Vegas.  Family lived in California.   From what I have read because my DH has Kaiser, when traveling  if one seeks treatment at a non Kaiser facility they need to contact Kaiser for approval.  Don't believe family did so, because they thought it was emergency.  

 

 

 

More likely I misunderstood.   Seems Kaiser should cover since it was an emergency visit.   Failure to get pre-approval doesn't seem like a good reason to decline to me.  

 

My health insurer will cover emergency visits while out of the country (or out of my service area where there is no in-network facility).  They say they will cover follow-up inpatient stays with prior approval.  I've asked under what circumstances they would give that approval.  I'm still waiting for a response. 

Edited July 17, 2022 by ldubs

[pris993]

4 minutes ago, ldubs said:

 

More likely I misunderstood.   Seems Kaiser should cover since it was an emergency visit.   Failure to get pre-approval doesn't seem like a good reason to decline to me.  

 

My health insurer will cover emergency visits while out of the country (or out of my service area where there is no in-network facility).  They say they will cover follow-up inpatient stays with prior approval.  I've asked under what circumstances they would give that approval.  I'm still waiting for a response. 

I am speaking about Kaiser only.  I have not reviewed Kaiser traveler info package recently.  Did obtain a copy of their guidelines from the business office a few years ago.  What I read is prior approval is necessary for treatment at a non-Kaiser facility.  This makes sense to me because Kaiser is an HMO.   HMO (Health Management Organization) health plans generally require prior approval or a referral.  

 

I have a Federal BCBS plan, it is a PPO type plan.  This plan does provide coverage outside the country like yours.  I have even had a payment for treatment for an ear infection while on a ship on a TA a few years back.