It’s open enrollment season right now, and this is the time to review (among other things) your healthcare insurance. Whether you are an employee of a company providing insurance benefits, a retiree ensured through Medicare, or an individual or family utilizing private insurance through the ACA (Covered California in our state), you will probably be making your healthcare decision on factors such as premiums, deductibles, doctor availability, drug availability, etc. One detail that I’ve rarely seen addressed in the plethora of plan documents one receives is the scope of healthcare coverage provided while you’re outside the U.S.

Think about having a medical emergency while traveling. Perhaps contracting the flu, or sustaining a car or bicycle accident. While the likelihood of such an occurrence is low, it’s typically greater for retirees who, having more available time and money, tend to travel more than younger families. And experiencing it in a foreign country is significantly more stressful that if it were to occur at home. Do you know what your healthcare insurance will cover and how much it will cost?

To find out you’ll probably need to contact the companies whose policies you are evaluating. Ideally they can provide you with a searchable pdf of the complete policy. Alternatively you may need to talk to a representative. In either case, if the policy states that it includes coverage for all claims worldwide, that’s probably the best you can get. Anything your insurance would pay for in the U.S would be covered equally internationally. Of course, the claims process would be different. If you required hospitalization in another country, for example, you’d probably have to pay the expenses out of pocket and then seek reimbursement from your insurer after returning to the U.S.

More commonly the policy will only cover emergencies. At the very least it will require that that the healthcare provided is medically necessary. Unfortunately whether or not a particular event will be covered depends on how the nurse or doctor treating you reports it. So be sure to discuss that with them prior to completing your treatment.

Also make sure to understand the policy’s limits and out-of-pocket costs for out-of-country medical services. They could be very different from those that apply to your local healthcare providers.

An alternative to using your own healthcare insurance to cover medical emergencies while abroad is to purchase travel insurance. These are policies that cover you primarily for costs associated with trip cancellations or interruptions. But they also include coverage for emergency and possibly non-emergency doctor & nurse expenses, hospitalizations, and drugs. Some even include coverage for medical evacuations via helicopter or plane, something that your regular healthcare insurance probably doesn’t even cover. But all these coverages do have limits and may exclude pre-existing conditions, so reviewing the policy carefully is important. Christopher Elliott, a leading consumer advocacy proponent, shares his view of the top such companies in Forbes: https://www.forbes.com/sites/christopherelliott/2018/08/18/the-best-and-worst-travel-insurance-companies/#6ea3f5694fc2.

As you analyze your healthcare insurance choices during open enrollment, make sure to consider the scope of international coverage each policy provides if you plan to do any travelling next year. The time to prepare for medical emergencies is well before they occur.