Whether you plan to attend the summer Olympics in Brazil or not, you’ve probably heard about the Zika virus. Growing concerns of this widespread outbreak have really sparked conversation with potential Olympic athletes and spectators preparing for their trip this summer. U.S. soccer goalie Hope Solo was the most recent to speak out about her concerns. Although this virus in particular can be very dangerous to pregnant women and cause major birth defects, there are other issues similar to this that should be considered by everyone when traveling. Do you know what type of health insurance coverage you’d have if you went outside the U.S. and became ill or injured?
For most under 65 individual health plans, you would have whatever your plan offers for out-of-network coverage. This varies based on the plan you chose. For example, the Florida Blue platinum PPO plan in 2016 provides coverage with a $500 deductible + 50% coinsurance up to a $12,500/person out of pocket maximum. These amounts vary for the gold, silver and bronze PPO plans, as well as pre-ACA plans written prior to 2013.
For over 65 year old insureds, Medicare parts A and B do not cover care outside of the U.S. Most Medicare supplements (except for K and L) do have coverage with a $250 deductible. As far as Medicare Advantage plans, the Regional PPO provides coverage with a $950 deductible + 50% coinsurance up to a $10,000 out of pocket maximum.
Another option to consider is travel insurance. There are several options for policies you can purchase separately from your health care plan. These would provide some health care coverage as well as transportation costs to get home in the event of an emergency or death.
There are several different plans available, in which coverage can vary. Be sure to check your specific plan to confirm what’s covered. Whether it’s the Olympics, a tropical island getaway or a backpacking tour of Europe, be sure to add health insurance to your travel plans checklist prior to boarding that flight.
What is coinsurance?
Coinsurance is your shared cost, usually a percentage, of a covered health care service. This cost-sharing can range from 80/20 to 50/50. If applicable, this is calculated after the deductible is met. For example, your plan has a $1,000 deductible and 20% coinsurance. The service you received is a total of $2,000. After the $1,000 deductible, your 20% coinsurance is $200. Your health plan covers the other 80. Coinsurance stops when you reach your out-of-pocket maximum.