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Emergency Medical Expense Coverage

23 March 2011
Emergency Medical Expense Coverage

This coverage provides reimbursement for emergency medical and dental care in the case of sudden, unexpected illnesses or injuries during your trip.

Contents (click to jump down)
What does Medical/Dental Expense cover?
What is NOT covered?
Understanding Primary and Secondary Medical Coverage
Important notes about this coverage
What type of policy covers this?
Package Plans: How much coverage does each company provide?
Travel Medical Plans: How much coverage does each company provide?
Annual Plans:How much coverage does each company provide?
Summary

Let us tell you a story

Susan and Richard had long planned on an African safari for their 30th wedding anniversary. When they found a safari through Zimbabwe that included the opportunity to witness a wildlife migration, they jumped at it.

While they were in Tarangire National Park photographing the big game migration, one elephant was spooked and stampeded toward the tour jeeps, slamming into the one that held Susan, Richard, and their driver. Susan was thrown from the jeep, knocking her unconscious. The driver contacted their tour operator who sent a medical transport, while Richard used the driver’s global phone to contact their travel insurance provider. The operator told Richard which medical facility had the best doctors and could care for Susan’s injuries. When the medical team arrived, they determined that Susan had a broken pelvis and several broken ribs. They transported Richard and Susan to the medical facility Richard directed them to and Susan’s injuries were treated. Without travel insurance coverage, Richard and Susan would not have known which medical facility to trust or how to cover the transportation and medical care Susan badly needed.

What does Medical/Dental Expense cover?

This coverage provides reimbursement for emergency medical and/or dental care if you experience:

  • a sudden unexpected illness or injury that is either life threatening or could result in irreparable harm if left untreated, or
  • an injury or infection, lost filling, or broken tooth that requires immediate treatment by a dentist.

Reasonable and customary costs generally covered include:

  • services of physicians and nurses
  • surgery, anesthesia, X-rays and lab costs
  • local ambulance services
  • prescription drugs
  • prosthetics and therapeutic services and supplies

Unlike your typical health insurance at home, travel insurance reimburses you for your medical expenses while on your trip. You’ll probably still have to pay your medical bills yourself first, and then receive reimbursement from the insurance company. In some cases, a travel insurance plan can advance payment to a medical facility, but this is on a case-by-case basis and depends entirely on the travel insurance provider.

What is NOT covered?

Medical expenses resulting from the following are not covered:

  • pre-existing medical conditions (see this page for more information)
  • suicide or any attempt at self-destruction
  • injury or illness related to alcohol or drug use
  • injuries related to participation in professional, semi-professional, or amateur sports (unless specifically included in the policy coverage)
  • injuries related to participation in hazardous activities such as hang-gliding, para-gliding, skiing, scuba diving, and more (unless specifically included in the policy coverage)
  • cosmetic or elective treatments
  • mental, nervous, or psychological disorders
  • normal pregnancy, resulting childbirth, or elective abortion

Most package plans exclude coverage for dental treatment except as a result from accidental injury to an insured’s sound natural teeth which means the following are not covered:

  • dental bridges, dentures, dental braces or orthodontic devices

Understanding Primary and Secondary Medical Coverage

A primary health plan is a group health, an individual health, or a governmental health plan that will act as the first payor of claims (such as Medicare or your employer-based health plan) and, as such, is your primary medical coverage.

Secondary medical coverage starts paying after primary coverage has paid its portion. This means that secondary medical coverage will pay deductibles, co-pays, and additional out-of-pocket expenses up to the policy limit.

Secondary coverage assumes there is other coverage that is considered primary. If you don’t have other medical coverage, your secondary coverage becomes primary by default.

Travel insurance plans with primary medical benefits will ask for information about your other medical insurance. This also means that they will submit your claim to your other insurance first and then process the claim as secondary coverage.

Important notes about this coverage

  • You must provide information about your other health insurance even if you are traveling outside the U.S. and know you won’t have coverage
  • Dental coverage is usually limited to a per-tooth maximum (typically between $100 and $250)

What type of policy covers this?

Package Plans: How much coverage does each company provide?

PolicyCompanyPrimary or secondaryPolicy limitDeductible
BasicAllianzSecondary$10,000
ClassicAllianzSecondary$25,000
DeluxeAllianzPrimary$50,000
Drive ProtectionAllianzSecondary$1,000
QuickTrip ProtectorAllianzSecondary$25,000
CustomCSASecondary$50,000
Custom LuxeCSASecondary$250,000
EssentialsGlobal AlertSecondary$25,000
Global Alert PreferredGlobal AlertSecondary$100,000
Global Alert Preferred PlusGlobal AlertSecondary$250,000
TravelGap VoyagerHTH WorldwideSecondary$50,000-$1,000,000
TravelGap ExcursionHTH WorldwideSecondary *$50,000-$1,000,000
Trip ProtectorHTH WorldwideSecondary$500,000
Trip Protector PreferredHTH WorldwideSecondary$1,000,000
Advantage AssetMH RossSecondary$25,000
Advantage BridgeMH RossSecondary$100,000
Advantage CompleteMH RossSecondary$250,000
RoundTripSeven CornersSecondary$150,000
RoundTrip ChoiceSeven CornersSecondary$150,000
RoundTrip EliteSeven CornersSecondary$75,000
Adventure TravelTravel GuardSecondary$25,000
BasicTravel GuardSecondary$10,000 ***$50
BusinessTravel GuardSecondary$50,000
GoldTravel GuardPrimary$50,000
My Travel GuardTravel GuardSecondary$25,000 $50
Pack 'n GoTravel GuardSecondary$25,000
PlatinumTravel GuardPrimary$10,000
Savvy TravelerTravel GuardSecondary$10,000$50
SilverTravel GuardSecondary$15,000 $50
Sportsman'sTravel GuardSecondary$25,000
Tee, Tour, and TravelTravel GuardSecondary$25,000
Select BasicTravel Insurance ServicesSecondary$10,000
Select EliteTravel Insurance ServicesSecondary$50,000
Select PlusTravel Insurance ServicesSecondary$100,000
Trip Protector Lite ExpandedTravel InsuredSecondary$10,000 $50
Trip Protector Lite ExpandedTravel InsuredSecondary **$15,000 $50
Worldwide Trip ProtectorTravel InsuredSecondary **$50,000 $50
Worldwide Trip Protector GoldTravel InsuredSecondary **$50,000 $50
BasicTravelexPrimary *$15,000 (for sickness) $15,000 (for accidents)
Business TravelerTravelexSecondary$50,000
Travel LiteTravelexPrimary *$15,000 (for sickness) $15,000 (for accidents)
Travel MaxTravelexPrimary$100,000
Travel PlusTravelexPrimary$75,000
Travel SelectTravelexPrimary$50,000
Travel Select AdvantageTravelexPrimary$50,000
VacationTravelSafeSecondary$35,000
Vacation ClassicTravelSafeSecondary$100,000
Protect-a-GroupTravelSafeSecondary$100,000

* Plan requires you to have a primary health plan
** Optional upgrade to make this medical coverage primary.
*** Optional upgrade to add additional medical

Travel Medical Plans: How much coverage does each company provide?

PolicyCompanyPrimary or secondaryPolicy limitDeductible
TravMed AbroadFrontierMEDEXSecondary$100,000 *$25
TravMed ChoiceFrontierMEDEXSecondary$50,000-$500,000 *$100-$250
TravMed InternationalFrontierMEDEXSecondary$1,000,000 $100-$1,000
TravMed GlobalFrontierMEDEXSecondary$250,000 *$100-$1,000
Diplomat America ***Global UnderwritersSecondary$50,000-$500,000$50-$5,000
Diplomat LT ***Global UnderwritersSecondary$500,000-$1,000,000$50-$5,000
Diplomat International ***Global UnderwritersSecondary$50,000-$1,000,000$0-$5,000
Liaison WorldwideSeven CornersSecondary$50,000-$500,000 **$100-$2,500
Liaison InternationalSeven CornersPrimary$50,000-$1,000,000$100-$2,500
Liaison MajesticSeven CornersSecondary$60,000-$1,000,000$100-$2,500
Liaison ContinentSeven CornersSecondary$50,000-$1,000,000$100-$2,500
Worldwide HealthTravel GuardSecondary$50,000-$1,000,000$100-$2,500
InterMedicalTravel Insurance$25,000-$100,000$50
WorldMedTravel Insurance$5,000-$500,000 *
Study USATravel Insurance$250,000-$300,000
Visit USATravel Insurance$50,000-$100,000
Atlas TravelTravel InsuredPrimary$50,000-$1,000,000 *$0-$2,500

* Less if over age 70
** Less if over age 80
*** Eligibility limited after age 59 or 69 depending on the plan

Annual Plans:How much coverage does each company provide?

PolicyCompanyPrimary or secondaryPolicy limitDeductible
Annual Travel ProtectionAllianzSecondary$20,000
Annual Business TravelerAllianzSecondary$5,000-$25,000
TravelGap Multi-Trip GoldHTH WorldwideSecondary$250,000 **
U.S. Student AbroadHTH WorldwidePrimary$250,000
TravelGap Multi-Trip SilverHTH WorldwideSecondary *$50,000
Global CitizenHTH WorldwidePrimary$5,000,000$250-$1,000
Global Student USAHTH WorldwidePrimary$250,000$100
Business TravelerTravelexSecondary$50,000
TravelRiteTravel GuardSecondary$10,000
Worldwide Health InternationalTravel GuardSecondary$50,000-$1,000,000$100-$2,500
MedEvacTravel GuardSecondary$50,000

* Plan requires you to have a primary health plan
** Less if insured is over age 70

Summary

  • This coverage provides reimbursement for reasonable costs associated with emergency medical and/or dental care while traveling
  • Not all medical conditions are covered with this coverage (pre-existing conditions are not)
  • You must provide information about any current health coverage when you purchase your plan
  • The coverage may be secondary or primary depending on the plan
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Damian Tysdal
Author
DamianTysdal

Damian Tysdal is the founder of CoverTrip, and he believes travel insurance should be easier to understand. He started the first travel insurance blog in 2006.

Damian Tysdal is the founder of CoverTrip, and he believes travel insurance should be easier to understand. He started the first travel insurance blog in 2006.