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And now for a medical interlude.

Updated: Oct 25, 2023

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As a US family living overseas, there are unique challenges we face when it comes to healthcare and insurance when visiting the USA. We have adjusted (read: LOVE) to the private healthcare system in Spain, but when we travel back to the United States, ensuring that we have proper medical coverage is of paramount importance. In this blog post, I'll guide you through the ins and outs of travel medical insurance for US expats who do not maintain traditional US employer-provided insurance. I've drawn from my own experiences and research to provide valuable insights and actionable advice. I'd start with a good assessment of your personal/family's needs. Think through a few questions so that you can find a travel policy that will take care of you:

  • What is your current healthcare situation in your host country?

    • Are you covered by a local healthcare system, and if so, to what extent?

    • Do you have private health insurance in your host country, and does it provide any coverage during visits to the US?

  • How often do you travel back to the United States?

    • Is it for short, occasional visits, or do you spend more extended periods there?

  • Do you have any pre-existing medical conditions or ongoing treatments?

    • This will be crucial when considering the type of travel medical insurance you require.

  • Are you planning to engage in any high-risk activities during your US visits, such as extreme sports or adventure travel?

    • Certain policies may exclude coverage for such activities, so it's essential to be aware of this.

  • Are you a US citizen, a permanent resident, or do you have any other immigration status? This is important because many (almost all) of the plans that I've found will not cover USAmerican citizens returning to the USA.

    • Some insurance options may have eligibility criteria based on your legal status.


Now, let's discuss the key points you need to consider when evaluating travel medical insurance options:

  1. Coverage Limits: Ensure the policy provides adequate coverage for medical emergencies, hospital stays, and other essential services. It's crucial to read the fine print and understand the maximum benefit limits. Consider policies with high maximum benefit limits, as medical costs in the US can be steep.

  2. Pre-existing Conditions: Determine how the policy handles pre-existing conditions. Some may offer limited coverage or exclude them altogether, while others may provide coverage after a waiting period. If you are in ongoing treatment, you are unlikely to find a provider that will cover treatment while in the US. However, it is entirely possible to find coverage for an acute flare-up of a dormant condition.

  3. Emergency Evacuation: Look for insurance that includes emergency medical evacuation coverage, especially if you plan to visit remote areas in the US. Research providers that have a strong network of evacuation services and understand their response times.

  4. Trip Duration: Choose a policy that matches the duration of your visits to the US. Some policies have limits on the length of coverage for each trip.

  5. Network Providers: Check if the insurance company has a network of healthcare providers in the US, as this can simplify the billing process. Learn how to access the network and find in-network providers easily.

  6. Deductibles and Premiums: Consider your budget when selecting a policy. Higher deductibles often result in lower premiums, but you'll pay more out-of-pocket in case of a claim. Consider your financial situation and how much you're willing to pay out-of-pocket in case of a claim.

  7. Claims Process: Understand the claims process and ensure it's straightforward and accessible, especially when you're dealing with medical emergencies. Keep copies of your medical records and receipts to expedite the claims process.

  8. Additional Benefits: Some policies offer additional benefits like coverage for trip cancellations, baggage loss, or even dental and vision care. Evaluate if these extras are necessary for your trips.

We have used www.visitorscoverage.com for our insurance plans while we visit the US. Given our family's health history and my neuroses about health insurance, we get the Patriot Platinum coverage with low deductibles. This plan does cover acute flares of pre-existing conditions and also has COVID coverage, if necessary. When my sons were a bit younger and in sleepaway camp, we also included the adventure riders for them so that they could participate in all the adrenaline-pumping activities their bodies could handle. Over the past 5 years, we have purchased the insurance each time we return to the USA for every member of our family. Fortunately, we have only had to use the insurance twice, once when I tripped and broke my wrist (emergency room, x-rays, air cast cost me the $250 deductible) and second last month when one of us needed an antibiotic prescription. The insurance for the two of us was $89 and the savings on the prescription exceeded $110.

Choosing travel medical insurance as a US expat can be a complex decision, but with a thorough understanding of these evaluation points and careful consideration of your personal circumstances, you can select a policy that provides you with peace of mind during your visits to the United States.

Safe travels & good health!


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