How Health Insurance Works for Americans Abroad

How does health insurance work for Americans abroad?

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If you’re abroad for a short time period (whether for vacation or a work trip), a good health insurance plan can help you avoid unpleasant surprises. Here’s some basic information about health insurance and coverage outside the U.S., including questions to ask your health insurance provider before living abroad.

Paying for Health Care in Another Country

An accident without medical coverage can turn into an expensive, serious issue. Medical expenses potentially incurred after a simple accident (such as falling off your bike or slipping while hiking) could include: 

  • Ambulance costs or air ambulance evacuation coverage
  • Lab tests, x-rays, or other diagnostic testing
  • Surgical costs, hospital room and board, physical therapy, or other expenses  
  • Prescription drugs 
  • Dressings and casts

It’s a common misconception that a country with universal health care may allow visitors to use the same services as citizens. As a visitor, you may not be eligible, and may have to pay part or all of any health care costs.

Some countries will cover a few expenses for anyone, including visitors. For example, the National Health Service in the UK offers treatment for infectious diseases, family planning, and emergency services—but that doesn’t include emergency services in a hospital.

In most cases, you’ll pay out of pocket expenses up front even if you have out-of-network provider coverage or you buy supplemental insurance. Your insurance should reimburse you later, if you’ve followed its rules. Make sure you get complete receipts of charges and payments. U.S. consular officers can help transfer funds from your U.S. bank account to your health care provider or hospital abroad. 

U.S. Health Insurance and Health Care Abroad

Every health insurance policy is different. Some plans don’t provide any coverage at all outside of the primary coverage area. Some American health insurance or homeowners plans will cover you abroad, but only in emergencies or with preauthorization first. And they may not cover you in the event of a natural disaster or terrorist attack.

Private, employer-offered health insurance or COBRA plans may offer some coverage—check with your specific insurance provider to get details. Depending on your health care plan, you may be able to access advice and assistance, or a medical provider by phone or video chat, while away.

Ask your insurer if authorization is required before you can seek treatment or use medical services, or in which circumstances authorization is required. Not following policy requirements may put you in a situation where you’ll pay expenses out of pocket, or coverage may be denied.

Medicare doesn’t cover your medical expenses when you are abroad, except in extremely limited circumstances. Some Medigap policies cover emergency services in foreign countries.

Your credit card may come with a few limited benefits, including a 24-hour health advice line, accident and death insurance for transportation fares purchased with the card, and trip cancellation for illness. However, most don’t cover medical emergencies or preexisting conditions and have limited financial benefits.  

Health Insurance Policies to Cover You Abroad

Depending on how long you will be traveling for, different supplemental health insurance or travel insurance plans can provide you with the coverage you need. Consider these options, based on where you’re going, how long you’ll be gone, and your risk tolerance.

Trip Cancellation Insurance

This type of insurance helps you recover non-refundable costs for airline tickets, hotels, and other travel expenses, in case you or a family member become ill before travel, and may also cover you if a disease outbreak occurs right before you leave. However, read over your potential policy’s rules for preexisting conditions, physician verification, rules about purchase dates, and what constitutes a “covered reason.”

Medical Evacuation Insurance

This type of plan will pay for medical care and emergency evacuation if you’re suddenly ill. This is particularly beneficial if you’re traveling to a remote destination, the U.S. State Department points out. Insurance can be purchased on daily, annual, or expat plans.

Single-Trip Travel Insurance Plan

Travel insurance can cover you for routine or emergency health care, and can also cover you for additional services such as air ambulance, trip cancellation and delay, and lost baggage. Some insurers may also offer coverage for preexisting conditions. 

Annual Travel Plan

For frequent or long-term travelers, this comprehensive plan may cover your medical emergencies or routine care for an entire year, along with trip cancellation and interruption. Check the maximum length of each trip covered, and if there are any limitations on countries visited. Some require you to spend at least three months outside your “home country” per year.

An Expat Insurance Policy

These policies are designed for those living and working abroad, and may include expanded medical coverage, mental health, dental care, cancer treatments, and other more serious or chronic medical situations. They may require you to spend at least six months per year outside your “home country.”

International Association for Medical Assistance to Travelers

IAMAT is a nonprofit organization that connects travelers with English-speaking doctors around the world. Office calls and other medical visits (which you pay directly) won’t cost more than a set price. Membership is free, although donations are requested.

The U.S. State Department recommends that your travel insurance covers emergency medical care and evacuation to the U.S., travel costs, and preexisting conditions. Make sure the plan covers any types of activities abroad (such as rock-climbing), the length of time you’ll be gone, and the region you’re traveling to. 

Before Traveling Abroad: Best-Practices Checklist

Research potential risks in your destination so you can make a better decision about the health insurance you may need to ensure adequate protection. The Centers for Disease Control recommends the following actions:

  • In advance, research health care facilities you may need, at your destination. For example, where is the closest children’s hospital in the case of an emergency?
  • Know the names of your conditions, allergies, prescriptions, and blood type, preferably in the local language. Bring copies of any prescriptions, including contacts or glasses. 
  • Avoid traveling when you’re sick, and buy trip cancellation insurance if necessary. 
  • Avoid transfusions when abroad, as screening standards vary.
  • Get documentation of any medical treatment you receive while abroad. 
  • The CDC’s Getting Health Care Abroad guide offers even more help. You can search by country and how long you plan to travel. Americans traveling out of the country can also check the CDC’s Destination List to learn more about health issues in various countries, required vaccinations, and more.

Ask Your Health Insurance Provider Before Travel

Consider asking these questions and more of your insurance provider before enrolling—and certainly before leaving for your trip.

  1. What are the deductibles, co-pays, waiting periods, or lifetime maximums?
  2. How extensive is the provider network? 
  3. Do I need to call someone before seeking medical care?
  4. How are medical claims filed? 
  5. Are any travel regions or travel activities excluded?
  6. Does my medical insurance cover evacuation?
  7. Are preexisting medical conditions covered when abroad?
  8. Are prescription drugs covered?
  9. Is preventative care covered? How about routine doctor visits or dental exams?
  10. How long is the coverage good for?

The Bottom Line on Health Care for Short-Term Travelers

Before traveling, it’s best to prepare for the unexpected. When researching your current insurance or potential plans, ask for a list of what’s covered when abroad and what’s not, to help you compare your options.

Understanding your existing or newly purchased health insurance policy before you travel will help you spend your time enjoying your destination instead of worrying about health and unexpected costs while away.

Article Sources

  1. Centers for Disease Control. "Chapter 6: Health Care Abroad." Accessed Jan. 18, 2020.

  2. Premera. "Coverage While Traveling." Accessed Jan. 18, 2020. 

  3. United Healthcare Global. "Did You Know?" Accessed Jan. 6, 2020. 

  4. Kaiser Permanente Insurance. "Kaiser Permanente Travel Coverage Brochure." Accessed Jan. 18, 2020. 

  5. Medicare.Gov. "Medicare Coverage Outside the United States." Accessed Jan. 18, 2020. 

  6. U.S. State Department. "Insurance Providers for Overseas Coverage." Accessed Jan. 18, 2020.

  7. Allianz Travel Insurance. "Covered Reasons Explained." Accessed Jan. 18, 2020.

  8. Allianz. "OneTrip Basic." Accessed Jan. 18, 2020. 

  9. GeoBlue. "GeoBlue Xplorer Premier Plan Comparison." Accessed Jan. 18, 2020. 

  10. Allianz. "AllTrips Prime." Accessed Jan. 18, 2020. 

  11. IAMAT. Frequently Asked Questions. Accessed Jan. 18, 2020. 

  12. CDC. "Obtaining Healthcare Abroad." Accessed Jan. 18, 2020.