Most travelers are are mis-informed about how Primary & Secondary Medical Travel Insurance coverage works. Read this to learn the truth about what Primary or Secondary Medical coverage means and how they differ:
Primary Medical Coverage means your medical bills are paid from the first dollar. No “coordination of benefit” claim forms need to be filed. You need to know that many travel insurance plans with primary medical benefits will still ask on the claim forms if you have other medical insurance. I (Steve) don’t know why they ask if they are a primary plan, though.
Primary Medical Coverage works best if your medical claim is less than the coverage amount. That’s because your travel insurance will pay the claim up to its limit. But, when the Primary travel insurance benefits are exhausted, your other insurance won’t count your deductibles and co-pays as paid.
For example, here’s what happens if you have a $70,000 medical claim with a travel insurance plan that has $50,000 Primary coverage:
- You submit the $70,000 medical claim to the travel insurance. It pays $50,000 (its maximum)
- You submit the remaining $20,000 to your medical insurance plan. Let’s say it has a $5,000 deductible with a 20% copay.
- Of the remaining $20,000 your medical insurance plan will pay $12,000 and you will be liable for at least that $8,000. You could be liable for more. Here’s how:
Gayle B. said “I work for Blue Cross. Please keep in mind if your travel insurance pays primary to the providers, those medical providers do not have to apply the Blue Cross discount so the billed charges may be quite higher. I would check carefully and call your Blue Cross customer service number on the back of your ID card before you make a decision”.
Secondary Medical Coverage means your medical bills are paid after any other coverage you have pays its share. This means that Secondary coverage will pay any deductibles, out-of-pocket expenses or co-pays up to its coverage limit.
Here’s a little detail that’s good to know: You probably will have to pay your medical bills yourself while on your trip. That’s because travel insurance plans are “indemnification” plans (you will be reimbursed – indemnified) after your trip by the insurance company. Travel insurance is not a “pay on behalf of” plan. You don’t just give the medical facility a card. In some cases, a few companies can guarantee payment to the medical facility, but it’s on a case-by-case basis.
How Much Medical & Emergency Medical Evacuation Coverage is Adequate?
There are a few things you need to find out before you settle on an amount of Emergency Medical/Dental and Emergency Medical Transportation coverage.
- What other coverage do you have? If you’re a US Citizen & have Medicare, Medicare doesn’t cover you outside the USA, though Medigap Policies C, D, E, F, G, H, I & J have some coverage
- If you have individual or group insurance, what are your deductibles & copays if you’re outside your provider’s service area? This is similar to “Out of Network” benefits. Here’s a good way to find out exactly how your regular insurance covers you
A common myth is that Primary plans cost more than Secondary plans. The actual cost of Travel Insurance is based on your age, trip cost and trip length. Some Primary plans are less expensive than Secondary plans at certain ages and vice versa for other ages.
As for the emergency medical transportation cost, we know of one that was from Rochester Mayo to South Africa with a team of doctors on the plane. It cost $122,000. We also know of transports from the Caribbean to the USA that cost about $25,000.
One thing to be aware of is that the emergency medical transportation portion of a policy doesn’t pay for the medical treatment. That’s covered under the emergency medical portion of the travel insurance policy.
As you can see, takes some thought whether to choose Primary or Secondary medical. Click here to compare travel insurance plans with the important details.
I hope this makes sense. If you want the right travel insurance advice, call us at 1-888-407-3854 and we'll help you figure it all out.
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