What happens when Americans get sick overseas?

[vafoodie]

We've been incredibly fortunate never to have that happen, but as we age, might not be the case. So what happens? As of now, we have Cigna insurance. If DH retires, we'll either have ACA or buy insurance through one of our employers.

 

[audreyh1]

If it’s in Europe I would simply go to a clinic recommended by my hotel. I don’t worry about medical costs in Europe as they are so much lower than in the US. My insurance wouldn’t reimburse either.

DH’s Medigap plan provides some overseas coverage (reimbursement).

Some people carry travel medical emergency and evacuation insurance. That’s for the more serious stuff.

 

[bearkeley]

Depends on the country, and how sick you are. Pre-Covid, an urgent care visit in Australia would only cost you $50, or in Indonesia, about $27 for the visit and 3 weeks worth of medication, $10k for cancer care (radiation, hospitalization, etc) at an affiliate hospital of Columbia University in the Philippines, or $0 in Argentina. When we were working and since we’ve retired, on ACA, our BlueCross plans didn’t cover international, so we normally purchase Geo Blue Travel Insurance whenever we travelled. Cost for the both of us for a 5 month trip to multiple countries have been around $1000 premium for both of us, with zero deductible for care and prescriptions.

 

[vafoodie]

Depends on the country, and how sick you are. Pre-Covid, an urgent care visit in Australia would only cost you $50, or in Indonesia, about $27 for the visit and 3 weeks worth of medication, $10k for cancer care (radiation, hospitalization, etc) at an affiliate hospital of Columbia University in the Philippines, or $0 in Argentina. When we were working and since we’ve retired, on ACA, our BlueCross plans didn’t cover international, so we normally purchase Geo Blue Travel Insurance whenever we travelled. Cost for the both of us for a 5 month trip to multiple countries have been around $1000 premium for both of us, with zero deductible for care and prescriptions.

I will be picking your brain about this 5 month trip. Are you a gypsynester (empty nester who travels)? To be such is our goal.

 

[bearkeley]

I will be picking your brain about this 5 month trip. Are you a gypsynester (empty nester who travels)? To be such is our goal.

Pick away! [emoji2]. Can we still be called gypsynesters if we had dogs instead of kids? We’ve been fortunate and although missing our international trips since Covid, also enjoying domestic adventures!

 

[tmm99]

Travel insurances usually do not cover pre-existing conditions, correct? What do you do if you have some pre-existing conditions and they flare up during your travel?

 

[Sarpy]

Look for a policy which has a pre-existing condition waiver if you purchase the insurance within a certain amount of time (usually a couple of weeks or so) after your first payment for the trip. There are quite a few companies out there that offer this. We just signed up with Allianz for a trip next summer.

One typical condition is that you have to be physically able to travel at the time you buy the insurance.

 

[Alan]

We always had a PPO plan with BCBS and they were well set up with their website to look for in network medical facilities in overseas countries which I used and noted each time before we left. The only country we went to that they didn’t cover was Vanuatu so we took out travel insurance for that vacation.

Even without insurance ER treatment and visits to a GP are free to visitors in the UK and many/most EU countries, plus any resulting prescriptions are very low cost compared to the USA. At a minimum I would get travel insurance that covers hospitalizations.

 

[audreyh1]

Travel insurances usually do not cover pre-existing conditions, correct? What do you do if you have some pre-existing conditions and they flare up during your travel?

Usually if you buy it early enough and are under a certain age it does.

 

[braumeister]

Even without insurance ER treatment and visits to a GP are free to visitors in the UK and many/most EU countries, plus any resulting prescriptions are very low cost compared to the USA. At a minimum I would get travel insurance that covers hospitalizations.

I had an ER visit in Norway (which is not in the EU, although it is in the Schengen zone) a few years ago and I was charged the same as a local citizen would have been. About $48, pay at the kiosk when leaving. Spent about 3 hours there for tests and consultation with a doctor. Surprisingly good experience.

 

[mystang52]

I have a pre-existing condition. Travel insurance covers pre-existing as long as you purchase the insurance within a small window after your first trip deposit (usually 2 weeks or so), and as noted earlier you were healthy to travel at time of purchase.
My choice is to not travel to "exotic" locales as I'd be concerned about medical care in event I got sick. That being said, we researched and planned a trip to Eastern Europe, pre-COVID, thanks in part to input from fellow ER-org's here.
We were in Aruba 2 years ago and I had to make 2 visits to the Emergency Room. My travel insurance covered the costs, but even if they had not the total bill was something like $400.

 

[DrRoy]

I was injured in Norway a few years ago and needed some stitches. The bill was about $150.

 

[Lucie]

Good travel insurance should cover you, if you are just visiting. We always get travel insurance for international travel. My husband collapsed in Cancun and was taken to the hospital via ambulance. The 12 mile ambulance ride was $1900, almost as much as the 2 day hospital stay and tests. The travel insurance was secondary, as our BC/BS was primary. Since the hospital was "out of network" for BC/BS, we paid the deductible and the travel insurance reimbursed us. Oddly, the hospital would not allow the medics to move him from the ambulance into the hospital without charging us a $2k deposit on our credit card, despite evidence of travel insurance. Good thing he was not having a heart attack.

 

[athena53]

I have a pre-existing condition. Travel insurance covers pre-existing as long as you purchase the insurance within a small window after your first trip deposit (usually 2 weeks or so), and as noted earlier you were healthy to travel at time of purchase.

What if you book more than a year in advance? Here's a far-fetched but real-life example. In November, 2019 I made a deposit on a future cruise at the end of one in Hawaii. Good for 2 years, didn't have to decide where or when, and it gave you a discount in addition to a credit for the deposit. Sometime in early 2021 I applied the deposit to a trip off Belize and Guatemala in October, 2021. From what I've seen, you cannot buy travel insurance more than a year ahead of time. I was planning to buy it closer to the trip date (no pre-existing conditions at the time) but hadn't when they sent me a note in May of this year. The COVID situation in Belize was dicey. Did I want to book another cruise instead? So, I switched to Alaska. I leave tomorrow.

I do have a pre-existing condition now but of course Medicare will cover. How and when would they have expected me to buy insurance if I'd stuck with Belize and Guatemala? First payment made almost 2 years in advance and the actual itinerary chosen more than a year in advance.

And, to those in general good health- that was my situation for years but I also realized that I was kayaking, walking on glaciers, snorkeling, etc. and thus just as subject to a Stuff Happens incident as some with pre-existing conditions who were less adventurous.

 

[Surewhitey]

Mexico would be a challenge as there are different hospitals that accept (or not) US insurance. We had friends who were from Washington who lived permanently there for over a decade. She developed some type of cancer that was aggressive.

Long story short, we were helping them to find low altitude flights back (she was on oxygen) to either Houston or Florida to get treatment not available in Mexico. She passed away in Tulum in less than 3 months. They stayed as they were past the viability of the meds working even in the states.

FYI, the flights ranged from $5k to 15k.

 

[audreyh1]

Oddly, the hospital would not allow the medics to move him from the ambulance into the hospital without charging us a $2k deposit on our credit card, despite evidence of travel insurance. Good thing he was not having a heart attack.

Doesn’t seem odd at all to me. They can’t afford to take in non-paying customers. Something not allowed in emergency rooms in the US.

 

[Alan]

Oddly, the hospital would not allow the medics to move him from the ambulance into the hospital without charging us a $2k deposit on our credit card, despite evidence of travel insurance. Good thing he was not having a heart attack.

I think this is normal to pay up front and claim back on the insurance.

Even in the USA a heart attack would be treated first without payment. This happened to an employee of an english friend I knew in the USA. He worked in Maryland for a defense contractor and a recent secondee from England was working for him. The secondee was in Florida on holiday when he had a heart attack and also did not carry proof of insurance on him or a credit card with enough guarantee to pay the very high cost of heart surgery. The hospital stabilized his condition but he needed bypass surgery and they wouldn't proceed without payment so he called his manager in Maryland who didn't know the insurance details of his secondee as he was at home on a Sunday afternoon so he gave the hospital his own Corporate Amex card details and paid the very large bill. He said that it was all sorted out with the company and the insurance company but found it alarming that the hospital would withhold such vital surgery without payment.

 

[audreyh1]

Good point! In the US they stabilize the emergency room patient. Additional steps is another thing entirely.

 

[ncbill]

What if you book more than a year in advance? Here's a far-fetched but real-life example. In November, 2019 I made a deposit on a future cruise at the end of one in Hawaii. Good for 2 years, didn't have to decide where or when, and it gave you a discount in addition to a credit for the deposit. Sometime in early 2021 I applied the deposit to a trip off Belize and Guatemala in October, 2021. From what I've seen, you cannot buy travel insurance more than a year ahead of time. I was planning to buy it closer to the trip date (no pre-existing conditions at the time) but hadn't when they sent me a note in May of this year. The COVID situation in Belize was dicey. Did I want to book another cruise instead? So, I switched to Alaska. I leave tomorrow.

I do have a pre-existing condition now but of course Medicare will cover. How and when would they have expected me to buy insurance if I'd stuck with Belize and Guatemala? First payment made almost 2 years in advance and the actual itinerary chosen more than a year in advance.

And, to those in general good health- that was my situation for years but I also realized that I was kayaking, walking on glaciers, snorkeling, etc. and thus just as subject to a Stuff Happens incident as some with pre-existing conditions who were less adventurous.

I buy annual travel insurance (Pro Deluxe) from:

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

Look-back for pre-existing conditions is only 90 days.

 

[brett]

We carry out of country medical/evac when we travel.

My spouse did end up in hospital in Kuala Lumpur with several cracked vertebrae. Went to the hospital that our hotel recommended. Turned out to be a well regarded medical tourism hospital.

Paid the bill, got the paperwork. Submitted to our travel insurance carrier and were refunded promptly.

 

[tmm99]

I have a friend who had a stroke a few years ago. He gets medical care through VA hospital. I want him and his wife to come to visit me in Canada. Does the VA medical care extend to foreign countries if he travels abroad? If not, I guess he could get travel insurance that accepts pre-existing conditions?

I had a former co-worker whose father from India was visiting relatives either in the US or Canada and had a heart attack. I don't think he had travel insurance, for whatever reason. The cost of medical care in the hospital was costing the family $100K plus and they started a GoFundMe to try to air-lift him back home (I can't remember the exact amount but I think it was around $200K as it had to be a special medical care team flight). He eventually passed in the hospital but the medical care for him might have bankrupted a couple of family members...

 

[Koolau]

Mexico would be a challenge as there are different hospitals that accept (or not) US insurance. We had friends who were from Washington who lived permanently there for over a decade. She developed some type of cancer that was aggressive.

Long story short, we were helping them to find low altitude flights back (she was on oxygen) to either Houston or Florida to get treatment not available in Mexico. She passed away in Tulum in less than 3 months. They stayed as they were past the viability of the meds working even in the states.

FYI, the flights ranged from $5k to 15k.

It's been several years but a school mate was in Mexico with her husband. They were on a scooter and were hit. She had a concussion and they would not treat her without a cash payment up front. By the time the husband could get funds, it was too late and she died. Then, even claiming her body was difficult (cash was the only language spoken, apparently.) Flight home was problematic and distressing and expensive. I hope things are different now but this was my only experience - second hand. YMMV

 

[mystang52]

What if you book more than a year in advance? Here's a far-fetched but real-life example. In November, 2019 I made a deposit on a future cruise at the end of one in Hawaii. Good for 2 years, didn't have to decide where or when, and it gave you a discount in addition to a credit for the deposit. Sometime in early 2021 I applied the deposit to a trip off Belize and Guatemala in October, 2021. From what I've seen, you cannot buy travel insurance more than a year ahead of time. I was planning to buy it closer to the trip date (no pre-existing conditions at the time) but hadn't when they sent me a note in May of this year. The COVID situation in Belize was dicey. Did I want to book another cruise instead? So, I switched to Alaska. I leave tomorrow.

I do have a pre-existing condition now but of course Medicare will cover. How and when would they have expected me to buy insurance if I'd stuck with Belize and Guatemala? First payment made almost 2 years in advance and the actual itinerary chosen more than a year in advance.

All insurance policy coverages hinge on the Terms of the policy. Keeping in mind that disclaimer, from what I understand the clock starts ticking once you've applied the deposit to a specific trip.
P.S. Of course, that pre-existing issue only comes into play if the cause of the trip cancellation is that pre-existing condition.

 

[braumeister]

I have a friend who had a stroke a few years ago. He gets medical care through VA hospital. I want him and his wife to come to visit me in Canada. Does the VA medical care extend to foreign countries if he travels abroad? If not, I guess he could get travel insurance that accepts pre-existing conditions?

VA will cover medical costs for his specific service-connected conditions/disabilities, but for most other issues he will have to pay out of pocket or get travel insurance.

 

[Katsmeow]

About 20 years ago I was in Vietnam and got sick (extremely bad sore throat and just feeling awful. I was in bed for 3 days and had laryngitis.) I did have travel insurance. When I did go to the doctor they said I had to pay them and claim insurance after I got home. The total charge was not that much (maybe $100) so I didn't bother.

A few years later, we had an au pair from Germany. Her father visited her (he was on a business trip to the US) and came down with appendicitis and had to go to the hospital and have surgery. They were beyond shocked when the hospital sent him a big bill later for the surgery. I doubt he paid it.