Medical insurance for international travel?

[ldubs]

14 minutes ago, pris993 said:

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.  

 

Thanks Pris993.  I understood about the HMO.  My plan requires pre-approval for any out-of-network facility, but if an emergency, they waive that for obvious reasons.   I was surprised Kaiser would not do the same.   

[CPT Trips]

On 7/15/2022 at 4:12 PM, 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.  

I hope you also told your congresscritter.😉

 

[pris993]

1 hour ago, CPT Trips said:

I hope you also told your congresscritter.😉

 

The reason we pay so much here the quality of care is far superior, facilities need to recover the cost of the technology and we are still providing care to some with no insurance. I worked for a private practice surgeon for 20 years.  Saw many patients coming from out of the country for care here in USA.  These were folks who had means and did not want to wait the time it would take to get care under socialized medicine in their countries. 

 

Recently my DH had an accident and was transported to a local hospital by ambulance, a 20 minute ride.  The ambulance carrier sent a bill to our insurance for $12,000+.   Because of a contract the insurance company paid $2500 of the bill.  Our copay with insurance was $50.    The high cost of the transport is about the Ambulance company trying to cover the cost of equipment and technology on board.   

 

We take for grant the quality of care available in USA.  When medical records went electronic, I

needed to scan medical records from patient charts going back 30 years.   Reviewing medical records left me realizing the quality of care we have here is impressive.  

[CPT Trips]

My apologies to the mod for opening a can of worms. Feel free to remove my previous  post.
I will refrain from responding to the post immediately above.

[Toofarfromthesea]

15 hours ago, pris993 said:

The reason we pay so much here the quality of care is far superior, facilities need to recover the cost of the technology and we are still providing care to some with no insurance. I worked for a private practice surgeon for 20 years.  Saw many patients coming from out of the country for care here in USA.  These were folks who had means and did not want to wait the time it would take to get care under socialized medicine in their countries. 

 

Recently my DH had an accident and was transported to a local hospital by ambulance, a 20 minute ride.  The ambulance carrier sent a bill to our insurance for $12,000+.   Because of a contract the insurance company paid $2500 of the bill.  Our copay with insurance was $50.    The high cost of the transport is about the Ambulance company trying to cover the cost of equipment and technology on board.   

 

We take for grant the quality of care available in USA.  When medical records went electronic, I

needed to scan medical records from patient charts going back 30 years.   Reviewing medical records left me realizing the quality of care we have here is impressive.  

 

FWIW, after my trip to the ER in Poland, my US Drs. said that while the technology they used was older than that used in the US, what they did was perfectly correct and got to the right result.

 

 

[pris993]

6 hours ago, Toofarfromthesea said:

 

FWIW, after my trip to the ER in Poland, my US Drs. said that while the technology they used was older than that used in the US, what they did was perfectly correct and got to the right result.

 

 

Not surprised your doctor said so.  I take some prescriptions that have been around forever too, they work. They are also the least expensive.   At the same time folks are living longer because of advances in medicine and basic hygiene.  

[sanger727]

OP, you mentioned that you have an annual geoblue policy. I don’t know how much you travel, but if you are looking for a higher limit, geoblue offers up to 1 million in their per trip policies. Maybe it would work better for you to cancel the annual policy and just get policies for each trip.

[Joebucks]

On 7/14/2022 at 9:27 PM, pris993 said:

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.   

 

You mean good once you travel more than 100 miles from home? Right?

 

Anyways, sure limits can be important. However, people need to understand what you are buying. Insurance isn't just about numbers you decide are important, but also terms and exclusions. Most companies aren't going to pay out a $50k claim all willy nilly.

[6rugrats]

On 7/15/2022 at 3:26 PM, 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. 

I found Kaiser on the west coast to be pretty good.  I’ve had it four years living on the east coast and have found the care to be poor.  Switched my plan last month and left.  The only out-of-area care, non-Kaiser provider coverage Kaiser covers is emergency and urgent care.  And, I wouldn’t even seek that w/o authorization.

Edited July 18, 2022 by 6rugrats

[Flatbush Flyer]

On 7/14/2022 at 6:27 PM, pris993 said:

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.   

I’ve looked at these types of annual travel plans. The major problem with them is the aggregate claim limits fir trip interrupt/cancel are woefully inadequate if you do several long/expensive cruises per year. 

[pris993]

1 hour ago, Flatbush Flyer said:

I’ve looked at these types of annual travel plans. The major problem with them is the aggregate claim limits fir trip interrupt/cancel are woefully inadequate if you do several long/expensive cruises per year. 

Am sure you are right.  So far we have never had to use.  Figured if I did, I would buy another plan if I had other travel coming up.  

[GeezerCouple]

2 hours ago, pris993 said:

Am sure you are right.  So far we have never had to use.  Figured if I did, I would buy another plan if I had other travel coming up.  

 

We looked into annual plans back when we were just starting our serious travels.

Before it turned out that the limits wouldn't be enough for most of our single trips, we realized there was a different problem.  IF we ended up maxing out an annual policy, we may have already been past some deadlines for certain types of policies for other trips we already had planned.  If someone only plans or has deposits/paid for only one trip at a time, this wouldn't be a problem.  But in the "before days", we used to plan more than one trip at a time, sometimes several.

 

We weren't willing to run the risk that we wouldn't be able to insure an already planned future trip because of a claim on the current trip.

It may also have turned out there were other restrictions, but that alone caused us to rule out annual policies, or at least those that existed at that time.

 

The only annual policy we do choose is for MedJetAssist.  MJA does have "per-trip" coverage, but since we often travel(ed!) on more than one major trip a year, the cost of the annual policy made sense.  Also, this way we were covered for any shorter/lesser trips (at least 150 miles from home, of course), such as business trips or visits to friends/family.

 

Just make sure that the strategy you are planning would actually work for the types of travel, and the scheduling, that you tend to do.

 

GC

[cruisingguy007]

On 7/16/2022 at 5:51 PM, ldubs said:

 

Thanks Pris993.  I understood about the HMO.  My plan requires pre-approval for any out-of-network facility, but if an emergency, they waive that for obvious reasons.   I was surprised Kaiser would not do the same.   

 

If you're admitted, they do. They won't if you use out of network ER as a urgent care/routine care (non emergency care). You can use ANY facility if a member has an emergency and is admitted. They will also waive the deductible if you are admitted to a Kaiser emergency facility. I've done it both ways but they won't waive anything if you use the emergency room for non-emergencies.  

[GeezerCouple]

1 hour ago, cruisingguy007 said:

 

If you're admitted, they do. They won't if you use out of network ER as a urgent care/routine care (non emergency care). You can use ANY facility if a member has an emergency and is admitted. They will also waive the deductible if you are admitted to a Kaiser emergency facility. I've done it both ways but they won't waive anything if you use the emergency room for non-emergencies.  

 

Is this really correct?

A "medical emergency" doesn't necessarily require hospital admission, not by most understandings.

 

Think about someone with a broken arm, perhaps hanging at an odd angle (ouch 😠 ).  Surely getting medical attention isn't discretionary, something that could wait until some future appointment...  And it might need a facility with more resources (equipment and staffing) than a corner "urgent care facility".  But that doesn't mean it requires a hospital admission.
There are other "medical emergencies" that don't require hospital admission, but sometimes that isn't clear until the immediate ER treatment and some observation, to see IF hospital admission is necessary.

 

However, I do understand that an insurer - or HMO - doesn't want to pay ER-level costs if someone has a painful splinter or something similar, something that is not an emergency.

But sometimes ER diagnostics are needed to rule out something that *might* have required admission or surgery, etc.

 

??

 

GC

[Flatbush Flyer]

2 minutes ago, GeezerCouple said:

 

Is this really correct?

A "medical emergency" doesn't necessarily require hospital admission, not by most understandings.

 

Think about someone with a broken arm, perhaps hanging at an odd angle (ouch 😠 ).  Surely getting medical attention isn't discretionary, something that could wait until some future appointment...  And it might need a facility with more resources (equipment and staffing) than a corner "urgent care facility".  But that doesn't mean it requires a hospital admission.
There are other "medical emergencies" that don't require hospital admission, but sometimes that isn't clear until the immediate ER treatment and some observation, to see IF hospital admission is necessary.

 

However, I do understand that an insurer - or HMO - doesn't want to pay ER-level costs if someone has a painful splinter or something similar, something that is not an emergency.

But sometimes ER diagnostics are needed to rule out something that *might* have required admission or surgery, etc.

 

??

 

GC

There’s no one answer here. Depends in large part on the nature and disposition of the issue as well as the dictates of the policy.

For example: Some insurers have no copay for an ER visit if it ends in an admission but do have a copay if there is no admission.

[GeezerCouple]

22 minutes ago, Flatbush Flyer said:

There’s no one answer here. Depends in large part on the nature and disposition of the issue as well as the dictates of the policy.

For example: Some insurers have no copay for an ER visit if it ends in an admission but do have a copay if there is no admission.

 

Yes, our coverage used to have something like this:  IF there was an admission, no co-pay.  But if there was no admission, then there was a flat $100 co-pay for the ER services.  We figured they hoped that wouldn't hurt too much if someone genuinely thought the ER was necessary, while perhaps dissuading someone from heading to the ER for that uncomplicated splinter or such.

 

But disallowing the ER visit cost entirely if no admission resulted from it?  That really seems extreme, especially if it is indeed something that even medical professionals would consider an emergency.

 

I do "get it" if it's judged not to have been anything that could be considered a medical emergency, but otherwise... would they really want to risk encouraging seriously adverse outcomes because someone was worried about maybe paying all of the ER costs if admission didn't end up being necessary?  Someone with shortness of breath and chest pains might not go to the ER...  It *could* be something other than a heart attack, but.......

 

I just find this payment policy very odd, and wonder if that's really how it would be decided.

Does anyone have the actual wording of such coverage stating that without an admission, the ER costs are *not* covered?

GC

 

[cruisingguy007]

48 minutes ago, GeezerCouple said:

 

 Someone with shortness of breath and chest pains might not go to the ER...  It *could* be something other than a heart attack, but.......

 

 

 

This happened to me, ironically, after I switched from Kaiser to another provider. I used to live a stones throw away from a Kaiser hospital and went there, was promptly admitted and paid nothing extra even though it was out of network. Happened another time (in-network and while covered with Kaiser) and I was promptly admitted and everything waived as well. I took myself but if you call emergency services, chest pain and shortness of breath will land you in the ER 100% of the time (liability) unless you refuse to go. It also gets you VIP service once there, something a lot of uninsured folks figured out after sitting in the ER for 8-10 hours using it as primary care. Things are better now with covered California but too many still use the ER as a primary care facility.

 

That said, I doubt they did not cover anything, some plans have larger deductibles that must be met (group rates are different,depending on number of employees), though Kaiser is usually portion as you go vs no coverage until all deductibles are met (another reason it's so popular). I'm sure that story was misconstrued somehow as I doubt any member would not be covered somewhat, unless the deductible covered everything out of pocket. I think there is more to the story to be perfectly honest.