What does your health insurance cover when you travel?

Whether you’re traveling to visit friends and family for the holidays or for business, it’s wise to know what your health insurance will cover if you fall ill or are injured away from home. There are several questions you should ask your insurer well before your trip so you’ll be prepared if you get sick or an emergency arises.

• Find out how your insurer defines “emergency.” Surprisingly, just what an emergency is can vary from insurer to insurer. While you may feel that your child’s fever and vomiting while you’re out of state and away from your pediatrician warrant a trip to the emergency room, your insurer may not agree, which can leave you with significant out of pocket expenses. Contact customer service and find out what does and does not fall under your coverage for emergency care.
• Do you need preauthorization or a second opinion before you receive care? For some health plans, you may not need preauthorization or a second opinion when you’re seeing a healthcare provider within the insurer’s network, but one may be required for out of network care, so find out what your plan requires and how you go about getting the needed approvals.
• Check for an in-network provider at your destination if you’re living with a chronic condition. If you or a loved one is being treated for a condition like diabetes, asthma, heart failure or COPD, use your insurer’s find a doctor tool or call the insurer to find out if there are any in-network physicians in the area where you’ll be staying in case you need care.
• Does your plan exclude coverage for injuries that result from high-risk activities? If your vacation plans include activities like scuba diving, sky diving or mountain climbing, ask if you’re covered for injuries that happen during these activities. Some insurers exclude this care.
• If you’re pregnant, ask your insurer what coverage you have for pregnancy complications if you’re outside your network. Ask your doctor or insurer for the name, credentials and contact information of an experienced OB/GYN at your destination in case you experience complications like pre-term labor, pre-eclampsia or bleeding.
• Do you have coverage overseas? If your travel will take you outside the U.S., it’s important to find out what, if any, coverage you have while abroad. Many insurers do not cover care outside the U.S. In addition, in many countries, you will be required to pay for your care upfront if you don’t have international coverage or travel health insurance. A personal health advisor can be a valuable resource, helping you find experienced, English-speaking physicians, arranging medical evacuation services and transport back to the U.S. if needed, and providing a pre-trip report about potential health risks at your destination.

It’s also smart to make sure your comprehensive medical records can be instantly accessed by any physicians or hospitals who may treat you or your family while you’re away from home. That’s especially important in an emergency.