Does Obamacare Cover International Travel?

If you have health insurance through the Affordable Care Act (ACA), also known as Obamacare, you may wonder if your coverage extends to international travel. The answer is that it depends on your plan type, network, and destination. Here are some of the main factors that affect your international coverage under Obamacare.

Key Takeaways:

• Your plan type, network, and destination determine how much and what kind of international coverage you can access under Obamacare.
• HMOs and EPOs usually do not cover any out-of-network care, except for emergencies or urgent care, while PPOs and POS plans usually cover some out-of-network care, but at a higher cost.
• Some countries have reciprocal healthcare agreements with the United States, which means that they provide free or low-cost healthcare services to U.S. citizens who visit their country.
• You may want to consider buying a supplemental travel health insurance policy or a short-term international health insurance plan to cover any gaps or emergencies that may arise during your trip.

Plan Type

The type of plan you have can determine how much and what kind of international coverage you can access. Generally, there are four types of plans available through the Health Insurance Marketplace:

• HMO (Health Maintenance Organization): This is a type of plan that requires you to get your care from a network of providers that contract with the plan. You usually need a referral from your primary care provider (PCP) to see a specialist. HMOs typically do not cover any out-of-network care, except for emergencies or urgent care. This means that if you travel abroad, you may have to pay the full cost of any non-emergency or non-urgent care you receive there.
• PPO (Preferred Provider Organization): This is a type of plan that allows you to get your care from any provider, but gives you lower costs if you use providers in the plan’s network. You do not need a referral from your PCP to see a specialist. PPOs usually cover some out-of-network care, but at a higher cost than in-network care. This means that if you travel abroad, you may be able to get some non-emergency or non-urgent care there, but you will pay more for it.
• EPO (Exclusive Provider Organization): This is a type of plan that combines some features of HMOs and PPOs. It requires you to get your care from a network of providers that contract with the plan, but does not require a referral from your PCP to see a specialist. EPOs typically do not cover any out-of-network care, except for emergencies or urgent care. This means that if you travel abroad, you may have to pay the full cost of any non-emergency or non-urgent care you receive there.
• POS (Point of Service): This is a type of plan that also combines some features of HMOs and PPOs. It requires you to get a referral from your PCP to see a specialist, but allows you to get your care from any provider, with lower costs if you use providers in the plan’s network. POS plans usually cover some out-of-network care, but at a higher cost than in-network care. This means that if you travel abroad, you may be able to get some non-emergency or non-urgent care there, but you will pay more for it.

You can check your plan type by looking at your plan ID card, your plan documents, or your Marketplace account. You can also contact your plan directly to ask about your international coverage options.

Network

The network of providers that contract with your plan can also affect your international coverage. Some plans have regional or national networks that include providers in other countries, while others have local networks that only include providers in your state or area. You can check your plan’s network by looking at your plan’s provider directory, which should be available online or by request. You can also contact your plan directly to ask about your network size and scope.

If your plan has a regional or national network that includes providers in other countries, you may be able to get in-network care when you travel abroad, as long as you use those providers. However, you should be aware that not all providers in other countries may be in your network, and that your network may change over time. Therefore, you should always verify with your plan and the provider before getting any international care.

If your plan has a local network that only includes providers in your state or area, you may not be able to get in-network care when you travel abroad, unless it is an emergency or urgent situation. In this case, you may have to pay the full cost of any non-emergency or non-urgent care you receive there, or look for another plan that covers international care.

Destination

The destination where you travel can also affect your international coverage. Some countries have reciprocal healthcare agreements with the United States, which means that they provide free or low-cost healthcare services to U.S. citizens who visit their country. Examples include Australia, France, Germany, Italy, Spain, and the United Kingdom. If you travel to one of these countries, you may be able to access their public health system and pay little or nothing for your care.

However, you should be aware that these agreements do not cover all types of healthcare services or all types of travelers. You may still need to pay for some services, such as prescriptions, dental care, or private care. You may also need to show proof of your U.S. citizenship, such as your passport, and proof of your health insurance, such as your plan ID card. You should also check the specific terms and conditions of each agreement before you travel.

If you travel to a country that does not have a reciprocal health care agreement with the United States, you may have to pay the full cost of any health care services you receive there, unless your plan covers them. You should also be aware that some countries may have different standards of quality and safety for their healthcare services, and that some services may not be available or accessible in some areas. You should also check the travel advisories and health information for your destination before you travel.

Conclusion

Obamacare does cover international travel, but the extent and cost of your coverage may depend on your plan type, network, and destination. You should always review your plan details and contact your plan directly to ask about your international coverage options and costs. You should also be prepared to pay some out-of-pocket expenses for any out-of-network or out-of-country care you receive. Additionally, you may want to consider buying a supplemental travel health insurance policy or a short-term international health insurance plan to cover any gaps or emergencies that may arise during your trip.