1) Maintain your existing insurance.
Some primary insurance plans, if you have it in your home country, will cover you overseas. If so, you may need to pay extra costs for being out-of-network or have limits on what will be covered (e.g. emergencies only). Goverment-funded health plans, such as Medicaid in the U.S., often do not cover overseas costs. In these cases, think about whether returning home for treatment would be a viable option.
If your primary insurance will cover you abroad, you may need to pay up-front and get reimbursed upon your return home. Learn about typical costs in the destination for doctor visits, therapies, or medications you may use on an ongoing basis. It may be more or less than you are used to.
Find out if your insurance also offers services through international travel assistance providers, such as 24-hour toll-free assistance for emergencies or pre-payment or prior approval for treatment, which can required in some countries. Otherwise look into also getting your own travel insurance.
2) Purchase individual travel/health coverage.
Travel insurance includes coverage for emergencies, such as lost luggage, security alerts, evacuation, and repatriation (returns of body remains in the event of death).
Travel insurance is generally bundled together with short-term duration health insurance for complete coverage while traveling outside the home country. It typically includes services such as:
- medical treatment in the event of an accident or illness
- referrals to hospitals and pharmacies worldwide
- medication information in the destination
- bedside visits for family members in the event of an emergency
The health insurance is typically offered as supplementary coverage for someone already covered by another medical insurance plan, but in some cases may be the only health insurance a participant uses while abroad (note: visitors to the U.S. will typically need other health insurance if staying for more than one year).
Website search engines, such as those listed in the Related Links, offer comparisons of various individual travel health insurance options. You can filter by coverage of pre-existing conditions and also read about separate exclusions in each plan (such as mental health coverage).
Pay attention to what is covered. For example, 20% co-insurance requirements may be difficult for an international student in the U.S. in the event of a catastrophic illness, since it would require the student pay significant fees. Policies may seem to have high coverage but contain dollar-amount caps on specific common benefits, which creates an illusion of coverage. (Example: $200,000 coverage but surgery cap of only $3,000.)
If these supplemental plans are not enough coverage, also search by major travel health plans that are designed for people working or living overseas (often for over a year) as the coverage may be broader, or look for plans offered in the destination. Additionally, find out if the exchange program offers any group travel/health insurance plans with more coverage.
3) Qualify for health plans in the destination.
Students who directly enroll or are integrated into a host university may be eligible for the health services that local students in that country receive. Students with disabilities should investigate whether they will need additional coverage, such as pre-existing condition coverage, because requirements may vary on what treatment is approved by their health plans. Similiarly people employed during a work exchange in another country may also be provided group insurance through an employer or qualify for national health plans.
If you are a student to the U.S., and your university provides student health plans, then they must comply with the Patient Protection and Affordable Care Act (ACA) regardless of citizenship. Additionally for foreign J visa holders, there are minimums for insurance coverage and repatriation that must meet (and may exceed) the ACA minimum essential health benefits, such as:
- Ambulatory patient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Any international visitor lawfully coming to the U.S. can also access the Individual Health Insurance Marketplace. This has ACA regulated plans and patient protections that come with this, such as non-discrimination for pre-existing conditions and the minimum essential health benefits.
You cannot wait until you have a need for the insurance to purchase it. You can only access it when first arriving in the United States, changing jobs, or other qualified life changes, or during the specific open enrollment time period each year.
For exchange participants to the U.S.: If you are in the U.S. for only a short time and/or have tax-exempt status in the U.S., so you do not need to pay penalties for not having ACA required insurance coverage (see Related Links), then you can look into the options above.