Travel Medical Coverage

Coverage for medical expenses if you get sick or injured while traveling.

 

According to the CDC, accidents are the leading cause of medical treatment and they are the single largest cause of death while traveling. Travel Medical coverage is the second most popular type of travel insurance, right behind trip cancellation and trip interruption plans.  Keep in mind that for most people traveling abroad, their own health insurance coverage may be limited, such as people who are covered under Medicare, or not provide coverage at all.  Be sure to check with your health insurance provider to see if and how you are covered.

Travel medical coverage is designed to pay for medical expenses that result from a covered injury or sickness while traveling. Travel medical can either be purchased on its own in a travel medical only policy, or within a comprehensive package policyIt is important to note that all travel medical plans and comprehensive package plans also include emergency medical evacuation and repatriation.  

Which of these are better? The comprehensive package plans tend to have lower benefit amounts for medical and emergency medical evacuation, but have a shorter pre-existing medical conditions look back time and these are the only plans that offer a pre-existing medical conditions waiver. Travel medical only plans offer more flexible deductibles, higher medical benefits and can be purchased up to a year in length.  

Travel medical coverage provides payment for:

  • Ordered by a Legally qualified Physician

  • medical services

  • prescription drugs

  • prosthetics

  • therapeutic services and supplies

  • Result from a visit to Hospital or ambulatory medical-surgical center services

  • Transportation furnished by a professional ambulance company to and/or from a Hospital.

What to look for

On a basic level, all travel medical insurance works through reimbursement- you pay the expense out of pocket and submit a claim to get reimbursed for that loss.  Medical coverage can either be secondary or primary. On our site we differentiate the two by having a small raised number “2” next to the benefit amount designating that the benefit is secondary. 

With secondary coverage, you must first submit your claim to your primary insurance plan and wait until you receive their “explanation of benefits” (EOB) that shows what is and is not covered.  Once you have the EOB you can then complete your claim with the travel insurance company. With primary coverage, you can submit your claim directly to the insurance company.

Plans that offer primary coverage are usually more expensive and offer lower benefit amounts that those that are secondary.  Which should you choose?   That depends on you.  If you don’t want to deal with the extra work involved with a secondary plan, then go for those that are primary. 

Primary Coverage

  • Pays before any other coverage that you might have for the same financial loss.

  • Claims take less time since you're only dealing with just the travel insurance company.

  • Coverage usually costs more because the travel insurance company is responsible for the full coverage.  Medical limits not as high as secondary plans.

Secondary Coverage

  • Pays after other insurance that you might have for the same financial loss.

  • Higher medical limits

  • Claims take longer since you first have to submit your claim to your own (at home) coverage before the travel insurance company will consider payment.

How do travel medical plans cover me?

As mentioned above, all travel medical plans work by reimbursement.  That being said, all plans do have a 24 hour emergency assistance number that you can contact during the event of a medical emergency.  By contacting that number, the travel insurance company can either forward payment, guarantee payment, or guarantee that you are insured.  Which of those three they do depends on the policy. Some plans can forward up to the full benefit amount if it is necessary to secure your admission into a medical facility, while others may only do so up to a limited amount, such as $1,000.  Others may guarantee the medical facility that you are insured. Always be sure you know what your policy does.

Pre-existing Medical Conditions

We go in full detail about pre-existing medical conditions in our Travel Insurance Buyers Guide, but what follows is a brief encapsulation.   All travel medical policies exclude pre-existing medical conditions. Many of the comprehensive package plans offer a pre-existing medical conditions waiver.  Some of the travel medical only plans offer coverage due to the acute onset of a pre-existing medical condition - it is important to note that these last type of plans do have age restrictions on the acute onset benefit.

Deductibles

Not all policies that offer travel medical coverage have deductibles.  There are some comprehensive package plans that do, but usually it’s limited to $50.  With the travel medical only plans, you can choose how much of a deductible you want, ranging from $0 to $2,500.

How much is enough?

We get this question quite a bit.  If you are traveling overseas, I’d recommend looking at plans that have at least $50,000 of travel medical coverage and at least $150,000 for emergency medical evacuation and repatriation.  For travelers with pre-existing medical conditions, we’d recommend looking at those comprehensive package plans that offer a pre-existing medical conditions waiver.

What happens in the event of a claim?

The following is from TravelInsuranceRatings.org concerning what to expect during a travel medical claim:

What to Expect When Filing A Claim

The insurance company or their third party administrator(TPA) will send you claim forms that you must complete.  The claim forms will ask what happened and why treatment was sought.

There are three main things that you have to prove when submitting your claim to the travel insurance company:

  1. that the sickness or injury occurred while the policy was in force and that they are covered under the terms of the policy, and
  2. they were not due to a pre-existing condition unless your policy provides a "waiver of pre-existing conditions", and
  3. that the expenses are covered expenses.  Covered expenses usually include treatment by a licensed Physician, nursing expense, hospital expenses, and prescription drugs.

As with all claims, the burden of proof is on you, the insured person so the more information you have and the closer you follow the insurance company's instructions the faster they will be able to handle you claim and the more accurate they will be able to pay you.

Please check out our claims page for each company's contact information.

QuoteWright Rating for Travel Medical

In order to help you choose a plan that best covers your particular trip we have developed the QuoteWright Rating system. Check out our QuoteWright Rating page for more details on how we determine each plan's coverage rating. To give you an idea as to how we rate these plans here is the following criteria:

  • Primary coverage is rated higher than secondary;
  • How long the pre-existing look back period is - the shorter the better;
  • Coverage limits - higher coverage limits rate higher

This is a general overview of what is considered in determining a coverage's rating. We developed the rating to be a helpful tool to quickly get a feel as to how different plans compare to one another. Please make sure to review the policy wording in order to fully understand what is covered in the plan.

 

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