For any U.S. resident considering a move abroad, this is an important consideration. Health insurance coverage usually falls into two major categories: coverage while traveling and coverage if you reside outside of the U.S. Many U.S. carriers have some sort of coverage for emergency care while traveling. You will need to check with your specific carrier for your plan to understand the benefit.
The most important factors to consider for traveling coverage are:
- What is covered?
- How much will they pay? (in full or a percentage of the costs)
- What is the maximum benefit?
- Do they pay direct to the health care provider or do you have to pay and get reimbursed?
- What documents do you need to claim reimbursement?
- How long can you be out of the U.S. for the benefit to still be in effect?
- Which countries do they cover?
If your insurance carrier does not provide travel coverage, you can buy a travel policy from a variety of vendors. AssistCard offers coverage around the world and has a policy that includes repatriation to the U.S. for major problems.
Regarding coverage if you live outside of the U.S., the short answer is: probably not. Most U.S. health insurers don’t cover treatment if you become a resident outside the U.S. Neither, of course, does Medicare. But the long answer is more nuanced…so it’s worth asking your health insurance company about it if you’re thinking of moving abroad.
Here are the details…
If you are an eligible Blue Cross Blue Shield member, you can use their online website access to find doctors and hospitals outside of the United States, Puerto Rico, and U.S. Virgin Islands through Blue Cross/Blue Shield Global. They even have an app for both Apple and Android devices that you can download to your phone. With the Blue Cross Blue Shield Global Core mobile app, you will have convenient access to doctors, hospitals, and resources around the world for anything from emergency needs, to finding the local equivalent for a prescription, to translating your symptoms, to finding the right doctor abroad.
Blue Cross Blue Shield has a specific program called GeoBlue. You do not have to be currently enrolled in a Blue Cross/Blue Shield medical plan to purchase a GeoBlue individual plan. You can get policies for long-term coverage for living abroad and short-term travel coverage plans for both single and multi-trips.
Other major U.S. health insurance companies, including Aetna, Cigna, and United Healthcare offer separate international health plans. However, in general, their U.S.-based plans do not cover you overseas.
That being said, insurance companies are just as aware as consumers are that U.S. medical costs are high. So, in the last several years, some health insurers began to cover a few medical procedures when they were performed abroad. This is not general coverage, of course. It is coverage under strictly limited circumstances, in countries where medical care is as good as in the U.S., but much less costly.
In addition, consider the following conditions:
Applies to a procedure that the insurance company normally covers, and one that the specific policy holder qualifies for.
Also, they are procedures that can be scheduled in advance, such as knee or hip replacements. That’s because the insurer will pre-approve the procedure—and its cost—before agreeing to cover it abroad. Information the policy holder must provide could include the name of the hospital and/or the doctor, as well as a cost breakdown for the procedure and related care.
If your employer has a self-insured health plan which is more flexible in benefit design, they may be more receptive to having certain procedures performed outside of the U.S.
Fortunately, medical tourism—the term for going abroad for less expensive medical treatment—is a thriving business in many countries in Latin America and Asia. Hospitals that cater to medical tourists are accustomed to providing cost estimates for procedures. And they often have entire staffs to handle transportation and accommodation for medical tourists. So, satisfying an insurance company’s queries doesn’t normally pose a challenge.
But even if your U.S. insurer does cover medical-tourism procedures, such as that hip replacement, it’s a far cry from covering all your health-care needs. If you move abroad full-time, therefore, you may well need to consider another option for health insurance. In some countries you may be able to access an excellent nationalized health service. Or you may opt for a local private insurance policy.
The downside of getting a new private policy abroad, of course, is that pre-existing conditions likely won’t be covered (that’s standard procedure among most private health insurers worldwide). But the upside is that the new policy’s cost may well be much lower than what you pay now…and in many countries abroad, even paying out of pocket for health care is very affordable.
However, if you plan to live abroad part-time, or spend significant time abroad checking out destinations before making a final move, consider holding onto your U.S. health insurance. You’ll need it when you’re back in the U.S. And who knows? If your company covers some medical procedures abroad, you may consider a little medical tourism yourself.
As previously mentioned, Medicare does not pay for services rendered outside of the U.S. The bigger question is whether to maintain your coverage if you decide to move overseas. You should consult with an advisor for your particular situation, but in general, keeping your Medicare is a good idea. You never know if you will decide to move back to the U.S. in the future if your circumstances change.
Maintaining Medicare Part A is a no-brainer. Usually Part A has no monthly premium and it can be very expensive to purchase later. Although Part B has increasing monthly premiums, there are several reasons to keep the coverage after you move overseas. One of those is that you will be able to have coverage the day you return to the U.S., to visit or live again, and avoid reapplication costs, penalties, and time.
If you’re a Veteran who lives overseas, you are still entitled to the benefits and services you earned through your military service. Your VA health benefits are payable regardless of your place of residence. For eligible Veterans living or traveling abroad, VA offers medical services through the Foreign Medical Program (FMP). Through this program, FMP will pay for health care services, medications, and durable medical equipment associated with a service-connected condition and/or aggravated condition.
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