Annual travel medical insurance for a frequent traveler: an example

Ray Delgado is 58 and lives in San Antonio, Texas, where he runs a small landscape design business. His mother lives in Monterrey, Mexico, and he drives or flies down to see her about four times a year. This year he also planned two weeks in Japan in October with his brother, which made five trips.

Ray has type 2 diabetes, which he manages with a daily medication and regular checkups. He buys his own individual health plan.

This story follows a year of his travel with Multi-Trip Gold, an annual travel medical plan from BlueCross BlueShield Global Solutions (formerly GeoBlue). It shows why he chose it, how he used it and what it did not do.

Why his plan at home wasn’t the whole answer

The carrier’s own pages say most domestic plans offer limited coverage abroad, and that your regular health insurance may not cover you outside the U.S. or “may provide very limited coverage.” They also say medical evacuations “aren’t always covered by your current health insurance” when you’re outside your home country.

Ray had been buying nothing for his trips to Monterrey, on the theory that they were short. After a friend ended up in a hospital abroad, he decided he wanted something in place for every trip without having to think about it each time.

Why he chose a multi-trip plan

A multi-trip plan covers an unlimited number of trips in a 364-day period. Each trip is covered for up to its first 70 days. For someone who leaves the country five times in a year, one plan was simpler than buying coverage trip by trip.

Two more details mattered to him.

• It covers pre-existing conditions. The carrier lists both Multi-Trip plans among the plans that cover current health conditions as soon as you buy them. The certificate says pre-existing conditions are covered “as any other condition, subject to the terms and exclusions listed in the policy.” That included his diabetes.
• It requires a primary health plan. Both Multi-Trip plans require that you’re enrolled in one. Ray’s individual health plan qualified. Medicaid and VA health plans don’t count as a primary plan for this purpose.

There are two levels. Ray chose Gold.

• Gold: a $500,000 maximum benefit and a $200 deductible.
• Platinum: a $1,000,000 maximum benefit and a $100 deductible.

For travelers aged 70 to 95, the maximum on either level is $200,000.

After the deductible, the plan pays 100% of reasonable charges for covered care, up to the maximum. One line in the certificate turned out to matter a lot: the deductible is waived when the care comes from a provider contracted with BlueCross BlueShield Global Solutions.

He bought the plan in February, before his first trip of the year. The carrier says your ID card is available in the member portal as soon as you buy.

Using the app before he went

Ray downloaded the carrier’s mobile app, which has digital ID cards, a provider search, claim tracking, medical translations, a medication equivalents finder and location-based safety alerts.

Before the Japan trip, he used the medication equivalents finder to look up what his diabetes medication is called there, in case his supply was lost. He used the provider search to save the names of a few network doctors and hospitals near where he would be staying in each city.

March: an emergency room visit in Monterrey

On his first trip, Ray caught a stomach bug. After a day of not keeping food or water down, his blood sugar ran high, and he felt weak and dizzy. His mother’s neighbor drove him to a hospital that Ray had found in the app’s provider search. It was in the carrier’s network.

He showed his digital ID card at the front desk. He was given IV fluids, his blood sugar was brought down, and he was watched for several hours, then sent home that night. He was not admitted.

The certificate says a previously diagnosed chronic condition with ongoing, low-level symptoms is not a medical emergency “unless symptoms suddenly become so severe that immediate medical aid is required.” Ray’s diabetes is a long-term condition. The sudden turn is what made this an emergency visit.

To keep the numbers simple, this example assumes no other plan paid any part of Ray’s bills. The certificate says the plan is “secondary coverage to all other policies” and reduces what it pays to the extent another plan covers the same expenses.

The arithmetic

Step 1. Covered charges at the hospital: $780.

Step 2. The hospital was a contracted provider, so the $200 deductible was waived.

Step 3. The plan pays 100% of reasonable charges: $780.

The plan paid the hospital $780 directly. Ray paid nothing, and his $200 deductible was still untouched.

October: a twisted knee in Kyoto

Seven months later, on the second day in Kyoto, Ray missed a step on the stone stairs up to a temple and twisted his right knee. By evening it was swollen and stiff.

He started with telemedicine. Every plan includes unlimited telemedicine at no extra cost, with same-day remote appointments around the clock. The doctor on the video call asked him to put weight on the knee, then suggested he get an X-ray the next morning. The consultation notes came to his phone.

The closest clinic with X-ray wasn’t in the carrier’s network. The carrier says you can choose any doctor or facility, so he went anyway. He used the app’s medical translations to explain what had happened. The X-ray showed a sprain, not a break. The clinic wrapped the knee and gave him a prescription for an anti-inflammatory.

Because the clinic wasn’t contracted with the carrier, it wanted payment on the spot. Ray paid $460, and $18 more at the pharmacy. When he got home, he sent a claim form with the itemized bill and the receipts.

The arithmetic

The certificate pays covered care at 100% of reasonable charges after the deductible. In this example, the claims team accepted the clinic’s full $460 as reasonable. That won’t always happen: with a provider outside the network, the plan can allow less than the bill, and the provider can charge you the difference.

Step 1. Covered charges at the clinic: $460.

Step 2. This clinic wasn’t contracted, so the $200 deductible applied: $460 minus $200 is $260.

Step 3. The plan pays 100% of the rest: $260.

The plan paid Ray back $260 for the clinic visit.

Then the prescription.

Step 1. The pharmacy charged $18.

Step 2. Ray’s $200 deductible had been met at the clinic.

Step 3. Gold pays outpatient prescriptions at 100% of reasonable charges, up to $2,500 per trip.

The plan paid Ray back $18 for the prescription.

For the year: Ray’s medical costs abroad were $780 plus $460 plus $18, or $1,258. The plan paid $780 plus $260 plus $18, or $1,058. Ray paid $200, his deductible. And $1,058 plus $200 is $1,258.

The waiver is why the two visits came out so differently. The Monterrey hospital was in the network, so the deductible never applied. The Kyoto clinic wasn’t.

The summer he almost stayed too long

In July, Ray’s mother had knee surgery of her own, and he wanted to stay with her through the recovery, maybe three months.

That’s where the 70-day limit mattered. The certificate covers each trip for “a maximum of the first 70 consecutive days,” and says the carrier can deny or limit benefits where travel patterns look like living abroad rather than short trips. Days 71 and beyond of a single trip would not have been covered. Ray kept that stay to nine weeks, 63 days, and came home.

If he had needed to stay longer, the carrier’s single-trip plan covers a trip of up to 182 days. That would have been a separate purchase, made before leaving the U.S.

What the plan did not do

It doesn’t cover care at home. The certificate excludes expenses incurred in your home country. Ray’s diabetes checkups, and the physical therapy he did for his knee in San Antonio, went through his regular health plan.

It doesn’t cover mental health care. The Multi-Trip certificates exclude treatment of mental, emotional or functional nervous conditions or disorders, and treatment of substance abuse.

Gold leaves out some extras. Multi-Trip Gold has no accidental death and dismemberment benefit, and its certificate lists no baggage benefit. Platinum includes both. The Multi-Trip plans also have no trip interruption benefit, which the single-trip plans do.

It is not trip cancellation insurance. It covers medical care. If no claims have been filed, part of the premium can be refunded on cancellation. Once a claim has been filed, the certificate says the premium is “fully earned and is non-refundable.” It doesn’t pay back flights or hotels.

It has limits of its own. Emergency medical transportation, which includes evacuation, is covered up to $250,000 per trip on Gold, and only when the plan’s medical director decides adequate care isn’t available locally. Emergency family travel, which helps pay for one person to come to you, has its own conditions. Neither came up for Ray.

It isn’t health insurance for everyday life. The certificate says it is not Minimum Essential Coverage under the Affordable Care Act. It works alongside a primary plan, which is why Ray had to have one.

Is a multi-trip plan right for you?

How many trips do you take? If you leave the country several times a year, one annual plan can be simpler than a plan for each trip.

How long are your trips? Each trip is covered for up to 70 days. A longer stay needs a different plan.

Do you have a condition you manage? Both Multi-Trip levels cover pre-existing conditions, and both require a primary health plan.

Gold or Platinum? Platinum has a higher maximum, a lower deductible, and AD&D and baggage benefits. Gold has a lower maximum and a higher deductible. On either one, using a contracted provider waives the deductible.

Are you ready for the paperwork? Network hospitals can bill the plan directly. Other providers may want payment up front. Give notice of a claim within 60 days of an event and send proof within 90 days.

The short version

Across five trips, Multi-Trip Gold paid $1,058 of Ray’s $1,258 in medical costs abroad: $780 straight to a network hospital in Monterrey with no deductible, and $278 back to him after a clinic visit and a prescription in Kyoto. He paid his $200 deductible once. The plan did not cover anything at home, would not have covered day 71 of a long stay, and was never trip cancellation insurance.

This is an outline of how the plan works. The certificate of coverage sets the full terms, including the exclusions and the limits.