Is My U.S. Health Insurance Valid Abroad?

Readers often write in to International Living to ask whether U.S. health insurance companies cover treatment abroad. For any U.S. resident considering a move abroad, this is an important consideration.

The short answer is: probably not. Most U.S. health insurers don’t cover treatment outside the U.S. Neither, of course, does Medicare. But the long answer is more nuanced…so it’s worth asking your health-insurance company about it if you’re thinking of moving abroad.

Here’s the detail…

Insurance companies are just as aware as consumers are that U.S. medical costs are high. So in the last decade or so, some health insurers (notably Blue Cross Blue Shield) began to cover a few medical procedures when they were performed abroad. This was not general coverage, of course. It was coverage under strictly limited circumstances, in countries where medical care was as good as in the U.S., but much less costly.

In addition, the following conditions prevailed:

It was coverage for a procedure that the insurance company normally covered, and also one that the specific policy-holder qualified for.

In addition, they were procedures that could be scheduled in advance, such as knee or hip replacements. That’s because the insurer would pre-approve the procedure—and its cost—before agreeing to cover it abroad. Information the policy-holder had to provide could include the name of the hospital and/or the doctor, as well as a cost breakdown for the procedure and related care.

Fortunately, medical tourism—the term for going abroad for cheaper medical treatment—is a thriving business in many countries in Latin America and Asia. Hospitals that cater to medical tourists are accustomed to providing cost estimates for procedures. And they often have entire staffs to handle transportation and accommodation for medical tourists. So satisfying an insurance company’s queries doesn’t normally pose a challenge.

This was the situation before the Affordable Care Act came into effect. It’s too early to tell whether insurance companies will now be more or less likely to cover procedures abroad. But again—given that cost is such an issue—it’s worth inquiring.

But even if your U.S. insurer does cover medical-tourism procedures, such as that hip replacement, it’s a far cry from covering all your health-care needs. If you move abroad full-time, therefore, you may well need to consider another option for health insurance. In some countries you may be able to access an excellent nationalized health service. Or you may opt for a local private insurance policy.

The downside of getting a new private policy abroad, of course, is that pre-existing conditions likely won’t be covered (that’s standard procedure among most private health insurers worldwide). But the upside is that the new policy’s cost may well be much lower than what you pay now…and in many countries abroad, even paying out of pocket for health care is very affordable.

However, if you plan to live abroad part-time, or spend significant time abroad checking out destinations before making a final move, consider holding onto your U.S. health insurance. You’ll need it when you’re back in the U.S. And who knows? If your company covers some medical procedures abroad, you may consider a little medical tourism yourself.

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