How Health Insurance Coverage Works When Away from Home

What happens if you need healthcare services when you are hundreds of miles away from the nearest in-network provider? How you receive emergency or non-emergency medical care and pay for it depends largely on your health insurance plan.

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What You Need About Health Insurance When Traveling

All plans cover emergency services at any hospital in the nation regardless of whether you are in your hometown or several states away. If the emergency is deemed life-threatening – such as if you were seriously injured in an auto accident – your emergency care would be covered as though it were in-network.

While this seems straightforward, there may be a catch: different health insurance companies have different rules on what they consider to be an emergency. If you are rushed to the hospital via ambulance for a life-threatening allergic reaction or after a serious auto accident, your health insurance company should be responsible for paying the medical expenses you incur, no matter where you get care in the USA. See your policy. Health insurance companies most likely will deny claims that they decide are not “true emergencies” and you are not in a network hospital. It’s not a good idea to go an emergency room on a Friday night with an ingrown toenail. Ingrown toenails don’t grow instantly, and if you’ve had time to get to the urgent care or see your doctor all week long and you wait that is not a true emergency and especially if you go to an emergency room that is not in your network. You will most likely pay for that bill out of your own pocket. If you do go into a hospital with an ingrown toenail on a Friday night but you go to an in-network hospital, it may be “covered”, but you are going to pay an awful lot for that toenail when you could have paid a fraction of the bill at an urgent care or in a doctor’s office. Be thoughtful in your decisions about healthcare or be prepared to pay out of your own pocket. Emergency rooms are for very, very serious situations. Urgent care visits are for more minor urgencies an doctor’s offices are for ingrown toenails.

Getting Healthcare When You’re Away from Home

Schedule a Virtual Visit

Telemedicine is a great option when you are away from home, and you need non-emergency care. If for example, you are on vacation and you have acid reflux or develop a condition like pink eye, you may be able to receive treatment advice and prescriptions virtually. Via “telemedicine” (or whatever service your insurance company uses), and depending on your plan, you may be able to make a simple phone call to resolve your pink eye, or acid reflux. Not only is this option convenient – by not having to leave your hotel and navigate an unfamiliar city while you’re sick or hurt – but it also lets you stay in-network. Many of the insurance companies are offering $0 co-pays for virtual visits, or very low co-pays, depending on your plan.

Buy Supplemental Coverage

If your plan is not a PPO Plan, and you are worried that your coverage is not adequate when you travel, you may want to look into a supplemental plan that can help pay you for out-of-pocket costs. If you travel often, then adding supplemental coverage like an indemnity plan may make sense.

Coverage varies from one health insurance provider to another, but generally, there are two types of add-on plans. Additional critical illness/accident coverage may cover medical costs if you are injured or receive a bad diagnosis, whether you are able to go to an in-network provider or not. Check the plan details. Hospital indemnity-style plans pay you directly (you must see your plan details) for hospital admission costs that may or may not be covered by your regular health insurance. This plan pays money directly to you that can be used at your discretion for medical co-pays, deductibles, and other expenses due to an injury or illness. Some of these plans do have networks and you’d show the medical provider your medical card like you would your insurance card that pay the medical provider directly first. Some of these plans have networks that will pay the hospitals and providers directly that help you have access to their network prices which helps your overall out of pocket costs. Again, check the details of your plan.

Buy a Supplement Plan with a National PPO Network

Some health insurance companies offer non-aca (Obamacare) national PPO networks. You still may need to seek out an in-network provider, but these providers are located throughout the country. These plans typically do not cover preventive care or minimally do, nor do they cover pre-existing conditions, at least for a certain time frame depending on the plan, nor do they cover mental health generally, and usually prescriptions coverage is limited. But some of these plans work very well for coverage needed and high expenses out of your pocket, prior to your regular health insurance plan deductible kicking in.

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Getting the Right Coverage with Nevada Insurance Enrollment

Finding a health insurance plan that fits your lifestyle is important for getting prompt, affordable care. A Nevada Insurance Enrollment health insurance agent can help you identify your needs and choose a plan that fits your needs and budget.

Related Articles:

What Is a Health Insurance Network?

Telemedicine and Your Health Insurance Coverage

Where To Go: Emergency Room or Urgent Care Facility?

What Is Preventive Health? It’s Free and Can Save Your Life!


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