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Different health insurance topic: International/traveler policies
Old 10-25-2016, 01:20 PM   #1
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Different health insurance topic: International/traveler policies

Someone referenced this on one of the ongoing PPACA threads, and it seemingly deserves a thread of its own that will survive any theoretical locking of the others...

If one is out of North America for 3-6 (or more) months a year (and less than 330 days), coverage under a normal individual policy has a lot of holes.

A quick web search revealed "GeoBlue," which purports to cover international travelers (subject to various limitations) for a surprisingly affordable price. Although it effectively excludes injuries from scuba diving, when combined with DAN insurance (or the like), it becomes more attractive.

[The GeoBlue is merely one product that I threw up as an example. The state department has many such providers linked from its web site: https://travel.state.gov/content/pas...roviders.html]

Has anyone used a product of this type? [Was it useful overseas or a waste of money?]

Edited to add the bracketed blue materials for clarity.
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Old 10-25-2016, 02:12 PM   #2
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Thanks for opening a new thread for this topic. I'm very curious for our future as well.
I hope if/when we FIRE that we will be able to be outside the USA for 330 days for a few years or do 'year bunching': 330 days outside one year or two and then stay more than 30 days in the USA in other years like you're asking here.
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Old 10-25-2016, 04:50 PM   #3
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I'd be interested in this also. But trying to guess at which plan you are looking at, I tried the trekker plan

taken from
Quote:
Will my pre-existing condition be covered under a GeoBlue Trekker plan?
The GeoBlue Trekker plans are available to those who have primary insurance in the U.S. and will both cover pre-existing conditions. Please refer to the definition of a primary health plan for more specific information on what plans qualify as primary insurance.
Did I just stumble on the one that requires a full health insurance plan to back stop the travel plan? It was not clear if you were looking for an additional plan to your US based plan?
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Old 10-25-2016, 04:59 PM   #4
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Bingybear,

Yes, that is what I was looking at--given that we will not be out of the USA for more than 330 days in a given year, we'd be obligated (at least to the extent of any tax refunds) to maintain ACA compliant coverage... (My 330 days reference was somewhat opaque--sorry!)

E.T.A. Looks like aida2003, at least for some years, would be outside of the obligation and need something that didn't require underlying ACA coverage.
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Old 10-25-2016, 05:12 PM   #5
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The way I read it, GeoBlue requires a qualifying underlying insurance, full stop. This has nothing to do with "for taxes", but as a primary insurance. GeoBlue will coordinate benefits with your primary insurance... that is you have to sign over the right for them to file with your primary insurance which must meet their standard for primary insurance. Not to say this has to be top tier.

That said, I would assume many travel insurances would require the same.
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Old 10-25-2016, 05:37 PM   #6
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Originally Posted by bingybear View Post
The way I read it, GeoBlue requires a qualifying underlying insurance, full stop. This has nothing to do with "for taxes", but as a primary insurance. GeoBlue will coordinate benefits with your primary insurance... that is you have to sign over the right for them to file with your primary insurance which must meet their standard for primary insurance. Not to say this has to be top tier.

That said, I would assume many travel insurances would require the same.
I agree. If you want to get travel policy of this type, you'd have to have underlying primary. My point, opaque as always, is that I'd basically be required to have primary anyway (by ACA) given that I'd be out of the US for less than 330 days. If I were out of the US for greater than that time period, ACA would be inapplicable and I'd be looking for another type of policy that would cover us adequately. Given extensive international travel + design of ACA policies, however, these international travel policies are seemingly the way to go.

Hopefully, Gone4Good (haven't seen him for a while) or another of our frequent/perpetual travelers can give us some illumination.
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Old 10-25-2016, 06:27 PM   #7
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GeoBlue is a subsidiary of the Blue Cross Blue Shield Association. To check into it further, I'd suggest contacting an insurance agent who represents a BCBS plan, or, there are agents who work with companies to provide coverage to ex-pats working overseas, they may have other recommendations.

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Old 10-25-2016, 07:06 PM   #8
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Btw if on Medicare there is no coverage outside the US unless on a route between the lower 48 and Alaska.
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Old 10-26-2016, 02:20 AM   #9
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We've traveled out of country for up to 7 months at a time for the last 7 years.

Fortunately I have able to hang onto my retiree health insurance PPO plan from BCBS. Before each trip I spend time on their website make copies of the in network providers in the cities we'll be staying in. For 2016 I looked at Marketplace plans to see if I could do better than $700/ month but where we lived in Texas I could not even find a PPO plan so stuck to my retiree plan.
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Old 10-26-2016, 05:54 AM   #10
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That's one of the reasons I am glad to have my Federal plan in retirement. All of their plans cover international travel. Can you get international coverage in a Medicare supplemental or do you have to get it separately?
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Old 10-26-2016, 08:53 AM   #11
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Originally Posted by Alan View Post
.... Before each trip I spend time on their website make copies of the in network providers in the cities we'll be staying in. For 2016 I looked at Marketplace plans to see if I could do better than $700/ month but where we lived in Texas I could not even find a PPO plan so stuck to my retiree plan.
Nice. Very prudent too.

The E.R. population falls into a bunch of weird cracks--its members are at the forefront of no one's minds when crafting US healthcare policies....

Out of curiosity (and if you choose to answer!), will you guys be covered by NHS now that you have landed permanently[?] in Great Britain--or will you be keeping the retiree plan until you age out of it? I am not familiar enough with that system to know what, if any, work years might be required to qualify for it...
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Old 10-26-2016, 09:26 AM   #12
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Oh my, this is new that Medicare doesn't cover anything outside the USA. Not only are its premiums quite high (per my neighbor), but you must sign up at 65 (or else you'll pay much higher premiums for life if delay a year or more), and no help if you step out of the USA. It feels like it wants all FRA people stay together on the continent.
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Old 10-26-2016, 09:34 AM   #13
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Oh my, this is new that Medicare doesn't cover anything outside the USA. ...
It appears to qualify as underlying primary for the international travel policies though.
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Old 10-26-2016, 09:48 AM   #14
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Originally Posted by 2017ish View Post
Out of curiosity (and if you choose to answer!), will you guys be covered by NHS now that you have landed permanently[?] in Great Britain--or will you be keeping the retiree plan until you age out of it? I am not familiar enough with that system to know what, if any, work years might be required to qualify for it...
Once we landed on May 8th with the intent to stay we were immediately covered and signed up at one of our local health centers in the town we live in. (I have a prescription I needed transferring and that was done straight away with the doc saying that it is exactly the same as what is prescribed here so no switching to another generic). We also applied for our EU Health card and carried that with us on our 2 week trip to Belgium. Not sure if that will go away with the Brexit negotiations or be replaced with something similar as many EU citizens still reside in the UK and it makes sense to have reciprocal agreements.

As Open Enrollment approached with my ex-employer I told them we didn't need any health insurance in 2017 and gave them our new permanent address as that in the UK. We'll be in the US for November and December, returning back to the UK January 17th so I have travel insurance set up to cover January through World Nomads.
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Old 10-26-2016, 09:49 AM   #15
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Can you get international coverage in a Medicare supplemental or do you have to get it separately?
Medigap plans C, D, F, G, M, and N provide foreign travel emergency health care coverage but with a lifetime limit of $50k. In general, you pay the foreign provider then seek reimbursement from the Medigap plan by submitting copies of bills and receipts.

Quote:
Medigap plans C, D, F, G, M, and N provide foreign travel emergency health care coverage when you travel outside the U.S. They pay 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.

These Medigap policies cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care. Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000.

Before you travel outside the U.S., talk with your Medigap company or insurance agent to get more information about your Medigap coverage while traveling.

Medicare Coverage Outside the United States: https://www.medicare.gov/Pubs/pdf/11037.pdf
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Old 10-26-2016, 01:41 PM   #16
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Originally Posted by 2017ish View Post
It appears to qualify as underlying primary for the international travel policies though.
How would this work?
Say you have Medicare and then by a travel/medical evacuation insurance before you leave overseas. If something happens, I'm guessing first you'll submit your claim to Medicare. It will reject those claims. Then you'll seek a reimbursement from the provider of your travel insurance, is that right?
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Old 10-26-2016, 01:51 PM   #17
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Originally Posted by aida2003 View Post
How would this work?
Say you have Medicare and then by a travel/medical evacuation insurance before you leave overseas. If something happens, I'm guessing first you'll submit your claim to Medicare. It will reject those claims. Then you'll seek a reimbursement from the provider of your travel insurance, is that right?
I know [almost] nothing about medicare and very little about these international travel policies. But, from bingybear's link in post 3, this is the way the GeoBlue policies apparently would handle it:

Quote:
The GeoBlue Trekker plans are secondary insurance. However, GeoBlue will process and pay overseas claims as a primary payor and reserves the right, where applicable, to contact your primary insurance company to coordinate benefits.
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Old 10-26-2016, 10:28 PM   #18
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My escape hatch is to go to the UK for a while if the US health insurance system goes berserk. I would be uninsurable if pre-existing conditions come back. Luckily my mother was British so I have a UK passport.
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Old 10-27-2016, 04:59 AM   #19
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Originally Posted by Alan View Post
We've traveled out of country for up to 7 months at a time for the last 7 years.

Fortunately I have able to hang onto my retiree health insurance PPO plan from BCBS. Before each trip I spend time on their website make copies of the in network providers in the cities we'll be staying in. For 2016 I looked at Marketplace plans to see if I could do better than $700/ month but where we lived in Texas I could not even find a PPO plan so stuck to my retiree plan.
I'm wondering what Geoblue provides over and above what Alan does here. Is it just a concierge giving easy access to the BCBS doctors and hospitals?
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Old 10-27-2016, 11:13 AM   #20
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I'm wondering what Geoblue provides over and above what Alan does here. Is it just a concierge giving easy access to the BCBS doctors and hospitals?
GeoBlue is similar to the network that is in place for the Blue Cross Blue Shield plans across the USA. This benefit is available on Medicare Advantage plans sold by BCBS.

The arrangement is that the hospital/doctor agrees to be reimbursed at the rate the home plan would have paid - as if you were seeing your own doctor. So they have contracted with hospitals world-wide. You'd have to go to their site to determine if there is a hospital/doctor in the area where you are traveling that is affiliated with the plan, as Alan does before he travels.

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