This is important: Primary isn't better than Secondary coverage, even though it's sold as if it's better. The difference between them is the order which claims are paid. |
What Do Primary or Secondary Medical Coverage Mean and How Do They Differ?
Primary Medical Coverage means your medical bills are paid from the first dollar. No "coordination of benefit" claim forms need to be filed.
This works best if the medical claim's less than the coverage amount. That's because even though you had insurance pay for part of the claim, when the Primary benefits are exhausted, your other insurance won't consider any deductibles or co-pays to be satisfied.
For example, here's what happens if you have a $70,000 medical claim with a travel insurance plan that has $50,000 Primary coverage:
1) You submit the $70,000 medical claim to the travel insurance. It pays $50,000 (its maximum)
2) You submit the remaining $20,000 to your medical insurance plan. Let's say it has a $5,000 deductible with a 20% copay.
3) Of the remaining $20,000 your medical insurance plan will pay $12,000 and you will be liable for $8,000.
Secondary Medical Coverage means your medical bills are paid after any other coverage you have pays their share. This means that Secondary coverage will pay any deductibles, out-of-pocket expenses or co-pays up to its coverage limit.
Here's a little detail that's good to know: You probably will have to pay your medical bills yourself while on your trip. That's because travel insurance plans are "indemnification" plans (you will be reimbursed - indemnified) after your trip by the insurance company. Travel insurance is not a "pay on behalf of" plan. You don't just give the medical facility a card. In some cases, a few companies can guarantee payment to the medical facility, but it's on a case-by-case basis.
Here's another little detail that's good to know: Secondary coverage assumes you have other coverage that's Primary. If you don't have other coverage Secondary becomes Primary.
How Much Medical & Emergency Medical Evacuation Coverage is Adequate?
There are a few things you need to find out before you settle on an amount of Emergency Medical/Dental and Emergency Medical Transportation coverage.
What other coverage do you have? If you're a US Citizen & have Medicare, it doesn't cover you outside the USA. If you have a Medicare Supplement, it's a little trickier. That's because they typically pay "whatever Medicare doesn't pay". The surprise comes when you are outside the USA. That's because Medicare won't pay anyway, so many Medicare Supplement plans won't pay either for the part that Medicare's not obligated to pay. Therefore, it's best to assume that your share will be equal to a 35 to 40% copay.
If you have individual or group insurance, what are your deductibles & copays if you're outside your provider's service area? This is similar to "Out of Network" benefits.
Will your current medical insurance pay before or after a Travel Insurance plan? If your current medical insurance pays before other insurance you can then submit your out of pocket costs to the travel insurance for reimbursement.
On the other hand, if your current insurance pays after a Travel Insurance plan (meaning the Travel Insurance is Primary), then you don't have to wait for your current insurance to finish its claim before the travel insurance pays.
A common myth is that Primary plans cost more than Secondary plans. The actual cost of Travel Insurance is based on your age, trip cost and trip length. Some Primary plans are less expensive than Secondary plans at certain ages and vice versa for other ages.
As for the emergency medical transportation cost, we know of one that was from Rochester Mayo to South Africa with a team of doctors on the plane. It cost $122,000. We also know of transports from the Caribbean to the USA that cost about $25,000.
One thing to be aware of is that the emergency medical transportation portion of a policy doesn't pay for the medical treatment. That's covered under the emergency medical portion of the travel insurance policy.
Want the right travel insurance plan for your trip? Make one easy toll free phone call to Steve, Tara, Deanna, Becky, Teresa or Mary at 1-888-407-3854 (US & Canada) or 507-214-3854. 8 am - 10 pm Eastern time. Fast service.
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