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Does My Health Insurance Work Outside Of The United States?

Most health plans do not cover medical services outside of the United States. While many health plans, both job-based and those offered in the health insurance marketplace, do provide some coverage for out-of-network services, this coverage often stops at the U.S. border. This includes cruise ships that have sailed beyond U.S. territorial waters.

Medicare beneficiaries are not covered outside of the country. There are a few exceptions:

  • Emergency services in Canada are covered if the emergency occurs while you are traveling between Alaska and the Continental United States.
  • Medical care on a cruise ship is covered if the ship is within six hours of arriving at or departing from a U.S. Port.
  • If you live near the Mexican or Canadian border, and the nearest hospital is located in one of these foreign countries, Medicare may pay for non-urgent out-patient care at the foreign facility.

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Check with your insurance company

While the Affordable Care Act (ACA) requires health plans cover urgent care, even if provided outside of the plan's provider network, it is best to check your coverage if you do plan to travel outside of the country. Foreign doctors, hospitals and pharmacies may require you pay upfront for services. Additionally, the costs of a medical transport back to the U.S. can easily exceed $10,000, depending on the nature of your illness and your location, according to the U.S. Department of State.

If your travel plans include a trip abroad, the U.S. Department of State recommends you contact your insurer and ask the following questions:

  • Does the policy cover emergency services abroad, including medical evacuation costs?
  • Will the insurance company guarantee payments to doctors and hospitals outside the country?
  • Will the insurance company pay medical care providers directly?
  • Does the policy cover injuries from high-risk activities such as mountain climbing or scuba diving?

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Consider travel insurance

If your health plan does not cover you outside of the country, you may wish to consider buying travel insurance. Travel insurance policies remain in force only for the days you select, and they are relatively inexpensive. You may purchase general travel insurance that covers many travel hazards such as lost baggage, delayed flights and medical care, or buy a policy just for medical costs.

Gillian Burdett is a freelance writer covering all things home and living. Her work can be found on Examiner.com.

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