Most of us who travel often wonder just what the benefits of Travel Medical Insurance are. In this article we will go over the most common benefits which should be in all good Travel Medical Insurance plans. Of course there are many plans available which will not have all of these benefits but we are not discussing the cheapest plans available. When you have saved for a year or more for your vacation do you really want to take a chance on having it ruined because you wanted to save a few dollars on your Travel Medical Insurance? I don’t.
Let’s start with 2 things that you normally have the option of selecting with all Travel Medical Insurance plans, the Deductible and the Policy Maximum. Remember, the lower the deductible the higher the premium. However, the difference between a deductible of 0 and 250 is usually between 10 and 11 dollars for 2 people for a 2 week trip. The highest deductible will vary but is usually somewhere around 2,500.
You should also be able to select the Policy Maximum, of course the higher the maximum the higher the premium. Normally the maximums go from 50,000 to 2,000,000. This is a very important choice as many of the other insurance benefits depend on it.
Usually I like to have a 0 deductible with a policy maximum of 500,000 to 1,000,000. Why, because if something does happen I want to use as little of my cash as possible. It’s much better to let the Travel Medical Insurance Company handle any payments. Also many of the benefits are based on the policy maximum so you want this to be sufficiently high to handle almost anything which might happen. In my opinion these are, for the price, the best options.
Before we continue with the different benefits let me mention the PPO Network. This is a network of Preferred Provider Organizations. If an illness or injury does occur remember it is always best to coordinate any treatment with the insurance provider, especially in the U.S. When I travel overseas I usually find out ahead of time who the providers are in the countries I will be visiting. Your insurance provider should have a list of the PPO Network on-line. Your insurance company should have a list of the members/facilities in their PPO Network. Always use them if possible. Also your insurance company should be available 24/7 via phone (collect) as well as on the Internet.
OK, we’re finally ready to look at the Benefits of a good Travel Medical Insurance plan. We’ll base our discussion of the benefits on a standard Travel Medical Insurance plan for 2 people with a deductible of $0, a policy maximum of $500,000 and 2 people in their mid 30s. The price for the plan should be in the range of $53 to $58 dollars for an international trip and exclude coverage in the U.S. and Canada. Not a bad deal considering all the benefits you get.
Most plans will have a Coinsurance clause which will normally have no co-pay if treatment is received outside the U.S. and Canada. If the treatment is received within the U.S. and Canada plan will pay from 80 % to 100 % of the first 5,000 of eligible expenses. The percentage depends of whether or not the treatment was received by a provider within the PPO Network or outside of the PPO Network. In some plans the Coinsurance is waived if the treatment of eligible illnesses or injuries is incurred within the PPO Network.
* URC = usual, reasonable and customary charges
Hospital Room and Board expenses are normally paid up to the Policy Maximum. Some plans will penalize you if the Hospital is not Pre-Certified.
Intensive Care URC normally paid up to Policy Maximum.
Medical Expenses usually up to Policy Maximum. However some plans will specify amounts for specific items like Physical Therapy, just read the Benefits carefully.
Outpatient Medical expenses URC up to Policy Maximum.
Local Ambulance up to Policy Maximum. Sometimes it is URC and some plans will set a limit, for example 5,000 maximum.
Prescription Drugs up to Policy Maximum. Some plans will not specifically say it covers prescription drugs but will include them in other eligible medical expenses, again read the brochure.
Emergency Room accident normally up to Policy Maximum, some plans don’t mention this separately.
Emergency Illness with In-Patient admission up to Policy Maximum, some plans don’t separate this.
Emergency Illness without in-Patient admission up to Policy Maximum sometimes requires additional deductible. Some plans don’t separate this.
Dental, acute onset of pain is normally limited to 100 whereas injury due to an accident will go to the Policy Maximum. Some plans will have a monetary limit though.
Emergency Evacuation amounts will go to 500,000 independent of the Policy Maximum others will have a lesser amount in addition to the Policy Maximum.
Emergency Reunion up to 50,000. Some plans limit it to 15,000. What is this? “When Emergency Medical Evacuation or Repatriation is ordered and the attending Physician recommends that a family member travel with You or be with you after the evacuation, the plan will arrange and pay, up to some predefined amount, for a round trip economy-class transportation, lodging and meal costs for one individual or family member of Your choice, from Your Home Country, to be at Your side while You are hospitalized.”. This definition will vary from plan to plan.
Return of Mortal Remains up to Policy Maximum. Some plans up to 50,000.
Return of Minor Children up to 50,000. Some plans limit it to 5,000. What does this mean? “When hospitalized for more than 36 hours due to a covered illness or injury and covered children under 18 years will be left unattended as a result, the plan will cover the transportation cost for the children to return home.”.
Political Evacuation up to 50,000. Some plans limit it to 10,000 others don’t cover this at all. OK, what is a political evacuation? “If after your arrival at your destination the U.S. government issues a travel warning for your destination country, the plan will coordinate your alternate departure arrangements from that country and cover the associated costs.”.
Benefit Period will go up to 6 months. What exactly is this? “If a covered illness or injury requires continuing treatment after the Policy expires, the 6 month benefit period may provide continued coverage so that there has been 6 months of continuous coverage for the injury or illness.” Some plans do not have this benefit.
Incidental Home Country Coverage for when you return to your home country for incidental visits up to cumulative 2 weeks but not if you return solely for treatment for an injury or illness incurred while traveling.
End of Trip Home Country Coverage is available as an option on some plans. The length of the additional coverage is based on the length of coverage originally purchased.
Common Carrier AD&D will normally pay 50,000 with a maximum per family usually 250,000. Some plans pay less for children under 18.
Sports & Activities will pay up to Policy Maximum for basic, non-contact sports. There will always be a list of sports excluded. Some plans do not cover this unless you purchase a Sports Rider.
ADS&D normally pays 25,000 for loss of life or 2 members and 50 % for loss of 1 member. Some plans will pay less for children under 18 and for Insureds over 69.
Terrorism up to 50,000 lifetime maximum, some plans will pay URC up to Policy Maximum. Normally it covers eligible medical claims. This is only covered in most cases if an advisory is issued by the US Government and the insured unreasonably fails or refuses to leave the country. Some plans do not cover, again be sure to read the brochure.
Identity Theft will pay up to 500. The theft of identity must occur during the period of coverage and be reported within 6 months of the termination of the coverage. Some plans do not cover this. Read the brochure for more details.
Natural Disaster up to 100 per day for 5 days. Some plans do not cover except as part of the Trip Interruption benefit. Read the brochure for details about natural disaster coverage.
Trip Interruption up to 5,000 is pretty normal. On some plans this will pay when it is caused by natural disaster.
Lost Luggage up to 50 with a 250 maximum, some plans only specify the 250 limit.
Indemnity will pay 100 per night of a required stay in a hospital. The purpose of this is to offset the costs of basic necessities not provided by some hospitals. Some plans will pay 150. Some plans only pay this to U.S. citizens.
Sudden Recurrence of Pre-Existing Condition up to 15,000 for this. Some plans will pay up to 20,000 but only 2,500 if 65+. Also, some plans will only pay if the insured is a U.S. or Canadian citizen.
All Travel Medical Insurance plans have additional Options available to add to your plan as well as other cost-free benefits.
Common Options available include: Adventure Sports rider, Enhanced AD&D rider, Citizenship Return rider and Continuing Coverage. Be sure to read the brochure for the details of the optional riders.
Cost-free benefits included in many plans:.
Online access to a service that allows you to access information and manage your account. The type of information might include benefit explanation, provider location, request an ID card, start a pre-certification, get certification documents and maybe even recommend a provider/facility.
Some plans will have Prescription discount plans, usually only for participating pharmacies in the U.S
. Some will also have a special department for your use in coordinating care and provide medical management services. The staff usually consists of qualified Doctors and nurses who are experts at assessing the need for services. Normally there are multi-lingual personnel available for you to talk to.
The company may even offer additional benefits like: prescription drug replacement, emergency travel arrangements, dispatch of a physician, translation assistance and credit card/traveler check replacement.
Well that wraps up our discussion of Travel Medical Insurance Benefits. Sorry it was so long but I really didn’t want to leave out anything crucial. I do want you to remember that every plan is at least a little different than every other plan. That’s why you need to always read the brochures that should be available when you are online shopping for a good Travel Medical Insurance plan.