If you are planning a trip to the United States, one of the best things you can do while getting prepared is to purchase travel medical insurance for your journey.
As you research travel medical insurance options for the United States, you may notice that there are two main types of travel medical insurance: comprehensive plans and limited or fixed plans.
These plans can differ greatly in coverage and benefits, so it is important to understand the differences between the two so you can decide which type of plan is right for your trip.
What Exactly Is Travel Medical Insurance?
Travel medical insurance is temporary health coverage for individuals who are traveling outside of their home country.
Since most long-term health insurance plans that individuals have in their home country won’t cover them abroad, travel medical insurance bridges this gap in coverage when visiting another country.
It offers coverage for emergency medical expenses incurred abroad for new injuries or illnesses, including hospitalization, urgent care, prescription medication, emergency medical evacuation, repatriation of remains, and more.
Is Travel Medical Insurance Necessary for Trips to the US?
Travel medical insurance is considered a necessity for those who are visiting the United States considering that the US has some of the highest medical costs in the world.
Without insurance, a hospitalization or trip to the doctor for an unexpected illness or injury can quickly add up to thousands of dollars out-of-pocket.
With travel medical insurance, US visitors can have peace of mind knowing that they have health coverage for emergencies during their stay to protect against a potentially huge financial burden in the event of needing medical attention.
Comprehensive vs Limited Plans: An Overview
There are several key differences when it comes to comprehensive travel medical insurance plans and limited or fixed travel medical insurance plans.
The most important difference between the two is the way that coverage works. Comprehensive plans work on percentage-based coverage, meaning a certain percentage of eligible medical expenses are covered up to the policy maximum, typically 100%. Limited plans only offer fixed coverage for each type of treatment or service, meaning you can only be covered for eligible medical expenses up to the maximum for each particular treatment or service.
For example, let’s say you break your foot during your stay in the US and that all of your medical expenses are eligible for coverage under your plan. Your hospitalization cost $5,000, surgery cost $7,000, and prescription medication cost $100.
A comprehensive plan that pays 100% of eligible expenses could cover all of your total medical expenses after your deductible is met and up to the policy maximum.
A limited plan, on the other hand, would only cover up to the fixed maximum per benefit. So if your limited plan only covers up to $3,000 for hospitalization, you would be responsible for the remaining $2,000 plus your deductible. This would be true for each item billed for your medical treatment. The fixed amounts of coverage for each billable item would be listed in your policy’s description of coverage, and any amounts above the fixed coverage amount for those items would need to be paid by you.
Pros and Cons of Limited vs Comprehensive Plans
When weighing your options between a limited and comprehensive travel medical insurance plan, consider the following pros and cons of each.
Pros of Limited Plans
- Lower cost compared to comprehensive plans
- Basic coverage for a low risk traveler
Cons of Limited Plans
- Fixed coverage on each service or treatment
- Risk of high out-of-pocket costs
- May not have access to PPO network or direct billing
- Have to meet a deductible for each separate illness or injury
Pros of Comprehensive Plans
- Excellent, comprehensive coverage
- Added travel benefits
- Access to a PPO network and direct billing
- One-time deductible
Cons of Comprehensive Plans
- Higher cost than limited plans
How to Choose Between Limited and Comprehensive Coverage
In order to best choose between a limited and comprehensive travel medical insurance plan for your specific needs, consider the following.
Age
With older age comes an increased risk of potential injury or illness, especially when traveling abroad. Travelers who are older in age should definitely consider a comprehensive coverage plan when traveling to the United States for the best medical coverage if an accident or ailment were to occur.
Out-of-Pocket Cost Affordability
Ask yourself if you can afford to pay thousands of dollars out-of-pocket for medical care. If the answer is yes, a limited plan could work for you, as it only offers fixed coverage for certain benefits, meaning the likelihood of having to pay for a good portion of your medical expenses is greater.
Comprehensive coverage, on the other hand, offers percentage-based coverage and often allows travelers to have no out-of-pocket costs for eligible expenses except for their deductible.
PPO Network and Direct Billing
Another thing to consider is having access to a PPO network and therefore direct billing or cashless pay. Getting a comprehensive travel medical insurance plan will give you access to care through a trusted PPO network, which also means better rates for medical care. It also means that your healthcare provider will likely bill your insurance directly rather than having to pay upfront and receive reimbursement later.
Limited coverage travel medical insurance plans may not have access to a PPO network, meaning that cashless pay may not be an option. In this case, you will need to pay for your medical expenses upfront and file for reimbursement later on.
Why Comprehensive Plans Are Preferred
Comprehensive travel medical insurance plans are preferred for travelers to the United States because they offer the best overall coverage and protection for visitors.
With a comprehensive plan, you can worry less about paying for care out-of-pocket and receive better benefits overall than from a limited plan.
While comprehensive plans are slightly more expensive than limited plans, you could end up saving thousands of dollars in the long run with percentage-based coverage versus fixed coverage if you end up needing emergency medical care.
Get the Best Coverage for Your US Trip
Now that you understand the key differences between comprehensive and limited coverage travel medical insurance plans, you can make a more educated decision on which type of plan is right for your needs.
Still have questions? Feel free to reach out to our Customer Success Team for assistance or browse our travel medical insurance plans to find the right coverage.
