Question about insurance while travelling in US

[petershk]

Hi all.

I'm planning the RE part and of course this leads to the fun topic of health insurance.

I'm 40, DW 35. Kids are 1 and 3.

I've used Kaiser for years and am pretty happy but... Once I RE we plan to travel around the US quite a bit. I haven't done a lot of research but was wondering if anyone has suggestions for what the best insurance option (or things to consider) if you're going to travel around the country a bunch?

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[Alan]

I've had a PPO plan for the 6 years we've been retired and before we set off on a trip I look up the in network doctors and hospitals in the cities we'll be staying in and then make copies of screen shots to have at hand should they be needed. I know we could always look them up on line should we need to but prefer to have done all the research ahead of time while I have fast and reliable wifi.

 

[rodi]

Like - you I've had Kaiser for years and been happy. I know some folks don't like the closed network but I have a decent primary and my kids Pediatrician is awesome.

They cover emergency care when you are out of network.

I guess it depends on how much non-emergency medical care you think you'd need while travelling. I try to arrange doctor visits for when I'm not travelling.

We've used the emergency care twice- once in Santa Barbara, the other time in Las Vegas. Both times I called the Kaiser hotline and after talking to a nurse was advised to go to the ER. A third time younger son spiked a fever and showed signs of an ear infection - again, called Kaiser and they referred me to a specific urgent care clinic they had a billing arrangement with.

From Kaiser's website:

Q. If I’m out of my home area and need emergency care, will this be covered?
A. Yes. Emergency care is covered outside your usual service area. You’ll pay a deductible payment or, if you’ve met your deductible, a copay or coinsurance for emergency services. See your Evidence of Coverage for details.

 

[bingybear]

I would pick your insurance plan carefully. Most of the health insurance plans I have had during my working years have had nation wide networks and some extended globally. With the ACA... many insurers (not all ) have gone to a more local network. This will only proved you with life threatening emergency care while travelling. So look for a plan with good nationwide coverage.

 

[photoguy]

We explicitly selected a PPO plan due to the amount of traveling we've been doing in the US. We've used it for non-emergency care in a number of different states without problems. The only issue we've run into is scheduling (i.e. getting the appointment in before we move to the next place). When we're planning to visit a city/area we check to make sure that the area has a critical mass of physicians.

Our plan allows for out-of-network coverage and caps the max OOP at some reasonable amount (I forgot the exact limit). We've never had to use an out-of-network provider but it provides some reassurance we don't accidentally get stuck with a large medical bill.

We got our plan through an ACA exchange (coveredCA). Our PPO plan is actually decreasing premium costs next year (6%) so I'm hopeful that the patient body is financially healthy mix for the insurer. Based on other threads, it seems like PPOs are a dying breed in many states.

If we didn't have access to a PPO, I'm not sure what we would do.

 

[ziggy29]

Our plan allows for out-of-network coverage and caps the max OOP at some reasonable amount (I forgot the exact limit). We've never had to use an out-of-network provider but it provides some reassurance we don't accidentally get stuck with a large medical bill.

It doesn't protect you from the potential for balance billing, does it? That's where the really scary and uncertain part of the out-of-network equation comes into play, IMO.

 

[photoguy]

You're right -- I double checked my plan benefits document and balance billing wasn't covered (beyond the allowed amount).

 

[MBSC]

All ACA compliant plans cover emergency care. If a PPO is unavailable or unaffordable, find an agent familiar with 'National Provider Networks' (aka Extended Provider Networks) and 'Away from Home' programs. For example, the Cigna Vantage series of EPO plans use the LocalPlus and OAP Away from Home networks that become national networks outside your home area.
Cigna Network Provider search: Cigna Health Care Provider Directory

Some BCBS EPO & POS products participate in the BlueCard Program, the Blue's version of a national provider network.
BlueCard Program: Manage Healthcare Coverage for Travelers and Students | BCBS.com

Aetna, Humana, and United Healthcare may have similar programs in select markets.

Only 9 states have restrictions on PPO out-of-network balance billing and some of them have exclusions (far right column in link below). For clarification, this is where the service is performed, not where the plan was written.

State Restriction Against Providers Balance Billing Managed Care Enrollees | The Henry J. Kaiser Family Foundation