how does travel medical insurance work?

How Does Travel Medical Insurance Work?

Let’s face it— purchasing travel medical insurance can seem like a daunting task. Maybe this is your first time traveling abroad, or maybe you understand that a travel medical policy operates differently than your standard, home country health plan, but you’re not sure exactly how.

Here, we’ll explain how travel medical insurance works so that you can confidently purchase the plan that’s right for you. 

When and Where You're Covered

When does my coverage start?

Since travel medical insurance only covers international trips, your coverage will start the moment you depart your home country. (Your home country is the country where you primarily reside and receive mail.)

If your policy is scheduled to take effect on or before the day you take off for your destination country, understand that your coverage won't go into effect until you cross your home country's national border.

It’s also important to understand that your travel medical policy will not cover the treatment of an illness or injury that began while you were still in your home country; it will only cover ailments incurred abroad.

When does my coverage end?

If you have an Atlas Travel policy from Tokio Marine HCC – MIS Group, your coverage will end either the moment you return to your home country (unless you have started a benefit period or are eligible for home country coverage) or 11:59 p.m. Eastern Time on your policy end date.

What about injuries & illnesses that require treatment after I arrive home?

If you incur an injury or illness while traveling and you are initially treated outside your home country, then your travel medical policy may continue to cover this treatment once you’ve arrived back in your home country—many policies do.

However, in these types of situations, most insurance policies limit the amount of coverage they’ll provide for the treatment you receive upon return to your home country. With an Atlas Travel policy, for example, eligible medical expenses would be covered for the 90 days immediately following the first day you sought treatment abroad.

How to Use Your Insurance

When should I purchase my policy?

Ideally, you’ll want to purchase your travel medical policy before leaving on your trip. (See our “What to Do Before You Buy a Policy” checklist to ensure you get the plan that’s right for you!)

However, life happens, and you may end up needing to acquire a policy once you’ve already arrived in your destination country. That’s perfectly okay—you can still get coverage for the remainder of your trip.

In either case, your travel medical insurance will only cover treatments for eligible injuries and illnesses incurred after your policy becomes effective. Remember, travel medical insurance does not cover pre-existing conditions.

Not sure what a pre-existing condition is, exactly? “Pre-existing condition” means any condition:

  • for which medical advice, diagnosis, care, or treatment was recommended or received within a defined period of time prior to your effective date of coverage (this specified period of time varies from plan to plan and is typically around 2 years)
  • which would cause a reasonably prudent person to seek medical advice, diagnosis, care, or treatment within the defined period of time prior to your effective date of coverage
  • that existed (with reasonable medical certainty) prior to your effective date of coverage, whether or not it was known to you
How do I use my insurance abroad?

After you purchase your travel medical insurance policy (See our "What to Do After You Buy a Policy” checklist), you will have the option to download your fulfillment documents directly from the confirmation page—or to download them through your confirmation email.

Among your fulfillment documents will be your medical ID card, which will contain your name, the name and phone number of your insurer, your ID number, your effective date of coverage, and your international provider network.

When you go to a medical facility to receive treatment, you will show this card to prove you have insurance coverage. You will also call the number on your card in order to activate other benefits, such as Trip Interruption, Lost Checked Luggage, or Personal Liability.

Not sure how to file a claim? See "How Does the Claims Process Work?"

How Billing and Payments Work

What’s the difference between direct billing and reimbursement?

You’ll likely find that billing and payments for medical services and treatments provided in your destination country do not work the same way for every medical provider.

In the United States, it is common practice for the medical facility to send a bill directly to your insurance company. This is known as "direct billing." In this case, you are responsible for your copay (if applicable) at the time of service and will later be billed by the medical provider for any applicable deductible and/or coinsurance for covered expenses.

However, there are millions of medical providers around the world, and it would be impossible for every single one of them have a direct relationship with all insurance companies. This means you may have to pay for some medical services up front when traveling in certain countries.

In fact, many travel medical insurance plans operate primarily on a pay-first system in which you file a claim for reimbursement post-treatment. Some facilities may require you to make this up-front payment before they'll provide any services at all—though this is largely dependent on location.

What is pre-authorization?

Sometimes insurance companies require you to get authorization for certain medical procedures before you receive treatment. The penalty for not acquiring the preauthorization frequently comes in the form of reduced payout for that service. For example, you could be required to pay 50% of the cost rather than your typical 10%.

Luckily, you can avoid this penalty by understanding exactly which services require pre-authorization—a task that can be easily accomplished by reading through your policy documents.

If you have Atlas Travel insurance from Tokio Marine HCC – MIS Group, you can rest easy knowing your plan does not have this pre-authorization stipulation on any of its services.

Where to Seek Treatment

How do I find healthcare facilities?

You’re likely familiar with high-quality versus low-quality healthcare facilities within your own country. Seeking healthcare in a foreign country, however, can be pretty disorienting—especially if you’ve had little or no experience with the country’s health system.

Insurance companies work with a network of medical providers, so you can get help navigating this foreign healthcare system by looking up the local providers in your network.

See the provider network for Atlas Travel.

Most insurers have their provider network available online so you can easily find a provider while traveling. Additionally, customer service representatives can further assist you in finding care.

Another option is to look up providers in your destination ahead of time. Store their names and addresses in your phone so you have easy access to them in case of immediate need. Once you're in the country, you can also ask around to see which facilities local residents recommend!

Need more advice? See "How to Choose the Best Travel Medical Insurance."