Extended travel with ACA

[conversationalphrase]

This is our first year on ACA, actually it will start on April 1. The only practical provider in our area is Ambetter, which basically does not offer any coverage away from home. We are planning an extended, indefinite length, trip to Alaska (and Canada) this summer.

What are other ACA insureds doing for medical coverage during extended travel?

I'm finding travel insurance that bundles medical and evac insurance with a bunch of other stuff I don't care about like trip cancellation, lost baggage, rental car, etc.... Is there a pure travel medical insurance provider?

 

[njhowie]

You're free to apply a trip price of $0 (or $1) when pricing the insurance. That will give you the medical and nothing for the trip or those other extras you don't want.

ACA, no different than private insurance, should/will provide out of network coverage in an emergency situation. They likely wouldn't provide evac cost coverage, but as far as the hospital goes, I would be surprised if there was no coverage.

One suggestion to entirely avoid dealing with your insurance in the event medical attention is required - look for a travel plan which provides "primary" medical coverage as opposed to "secondary". Primary means they cover it, no hassles, no need to even check with your ACA provider. In the case of secondary, you will have to go to your ACA insurer and show that you have no coverage. In the event that your ACA insurer provides any coverage, then there will be a coordination of benefits between the two providers - the travel insurance only covering above what your ACA does not. So, it is possible that the travel insurance will cover nothing if your ACA insurer does cover it.

So, if you opt for secondary medical coverage with the travel insurance, before doing it, you should check with your ACA insurer to be sure of what they do/don't cover - otherwise you may be paying for insurance you won't get any benefit out of. If you go primary, there's no involvement with your ACA insurer - the travel insurance will automatically pay it all.

 

[augam]

I believe Urgent Care would be covered if you are out of town.

 

[Aerides]

It really depends on your provider, and their network. I'd probably call them and discuss options - throw scenarios at them:

Heart attack, Broken leg, etc. Of course, asking about Alaska is on thing, Canada is entirely different. Travel plan coverage is needed for international stuff generally, at least coverage for emergency + get home. Depending on the country you are visiting as well, they might cover emergency stuff for tourists (I believe the UK has some allowances, others will know better).

Fortunately for us with Florida Blue, we know their network extends when out of state to provide quite decent emergency options.

 

[conversationalphrase]

I called Ambetter this morning. In the USA emergency room visits are covered only if you are not admitted to the hospital. If you are admitted then there is no coverage. Internationally there is no coverage at all.

We need to find a good travel medical insurance!

 

[ncbill]

There are policies that cover you within the U.S. as long as you are at least 100 miles from home...so you'd want one that both pays for "evacuation" & medical coverage until you get back to your home network of providers. I've posted on this in the past, will see if I can find the info.

 

[conversationalphrase]

There are policies that cover you within the U.S. as long as you are at least 100 miles from home...so you'd want one that both pays for "evacuation" & medical coverage until you get back to your home network of providers. I've posted on this in the past, will see if I can find the info.

Any luck finding this? I haven't found anything that seems to fit.

 

[ncbill]

Any luck finding this? I haven't found anything that seems to fit.

We use this (Travel Pro Deluxe) but medical coverage limits are pretty low before you get back to your home network:

https://travel.nationwide.com/plans/annual

 

[conversationalphrase]

Thanks for the link. That wouldn't work for us because the max individual trip length is 30 days.

So far the best I have found is AIG Travelguard, but I'm still looking.

 

[conversationalphrase]

I stumbled across this article, which describes another option; re-enrolling in a new ACA plan when you travel between states. This would only be practical for snow bird type travel between two states for a season.

Has anyone tried this?

https://www.verywellhealth.com/health-insurance-for-multiple-states-4584359

 

[sengsational]

Getting new ACA every move would be expensive, as the deductible resets (as the article mentions). They don't talk about timing. I'd bet you'd have to overlap a month to be safe, meaning you would pay for 14 months a year.

Here's a better approach that they don't mention. Cheaper for medical and taxes. You shop in many metro areas of states without state income taxes (TX, TN, FL). You have no intention of living there, only establish residency for the purpose of getting an ACA policy that's A) inexpensive, and B) has nationwide in-network coverage. Then you spend 5.9 months in one state, 5.9 months in some other state, and 0.2 months in neither of those two states with a primary coverage travel policy.

 

[GTFan]

Here's a better approach that they don't mention. Cheaper for medical and taxes. You shop in many metro areas of states without state income taxes (TX, TN, FL). You have no intention of living there, only establish residency for the purpose of getting an ACA policy that's A) inexpensive, and B) has nationwide in-network coverage. Then you spend 5.9 months in one state, 5.9 months in some other state, and 0.2 months in neither of those two states with a primary coverage travel policy.

Good luck getting one of those policies.

 

[sengsational]

It's just a matter of shopping for the cheapest location to buy a Blue Cross policy.

When traveling within the United States, most Blue Cross Blue Shield members will be covered under the BlueCard program, which connects all 36 individual Blue Cross Blue Shield companies so that members can enjoy access to the savings the local Blue Cross Blue Shield plan has negotiated with its doctors and hospitals.
For example, if a member of Blue Cross Blue Shield of Texas, whose Plan includes the BlueCard program, falls and breaks his arm while hiking in Yellowstone, he will be charged the rate Blue Cross Blue Shield of Wyoming has negotiated with the local hospital rather than paying the steep fees he would otherwise encounter.

 

[MBSC]

...only establish residency for the purpose of getting an ACA policy that's A) inexpensive, and B) has nationwide in-network coverage.

It's just a matter of shopping for the cheapest location to buy a Blue Cross policy.
When traveling within the United States, most Blue Cross Blue Shield members will be covered under the BlueCard program, which connects all 36 individual Blue Cross Blue Shield companies so that members can enjoy access to the savings the local Blue Cross Blue Shield plan has negotiated with its doctors and hospitals.
For example, if a member of Blue Cross Blue Shield of Texas, whose Plan includes the BlueCard program, falls and breaks his arm while hiking in Yellowstone, he will be charged the rate Blue Cross Blue Shield of Wyoming has negotiated with the local hospital...

Being responsible for the negotiated rate is not the same as having in-network coverage. It just means you pay less than the standard billed charge. When viewing Texas plans on Healthcare.gov, select "plan details', scroll down to "access to doctors and hospitals" and click to expand. National Provider Network = No. Florida Blue has plans fully connected to BlueCard for national coverage. See more details below.

I called Ambetter this morning. In the USA emergency room visits are covered only if you are not admitted to the hospital. If you are admitted then there is no coverage.

I stumbled across this article, which describes another option; re-enrolling in a new ACA plan when you travel between states. This would only be practical for snow bird type travel between two states for a season.

A majority of BCBS EPO/HMO plans participate in the "Away From Home" program for snowbirds/students. You become a temporary member of the other BCBS company without going through the ACA Marketplace to make the change.

Please note: There are 19 states, in addition to Puerto Rico, that do not participate in this program: Alabama, Alaska, Idaho, Iowa, Kansas, Mississippi, Montana, Nebraska, North Dakota, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Washington, West Virginia and Wyoming. States that are covered are not always covered statewide, and some areas of a covered state may not be available.

Reference: https://www11.anthem.com/provider/va/f5/s1/t0/pw_e234927.pdf?refer=ahpemployer

The BCBS EPO plans in my state do not participate in the program and are connected to the BlueCard national provider network for life-threatening emergencies only. Tele-visits are always in-network regardless of location. For other non-emergencies, I pay the greatly reduced local BCBS negotiated rate instead of the billed charge.

If the ER visit results in an inpatient admission, it falls into the non-emergent category and I pay the negotiated rate until the attending physician certifies I can be discharged or transferred to an in-network facility, whichever comes first.

[From my plan]: With our individual plans, your providers are in a local network and you don’t have out-of-network coverage except in emergency situations.

TIP: If you need non-emergent care while away from your network, look for providers that are in the local Blue Cross or Blue Shield network. You will have to pay the entire bill, but it usually is at the Blue discounted rate. [99% of hospitals and 86% of physicians nationwide are in-network.]

BlueCard out-of-area: Urgent/Emergency Care Only