Primary Coverage vs. Secondary Coverage
Last updated on 03/08/2022
A travel insurance plan with emergency medical coverage, whether a comprehensive plan or a medical plan, will refer to the emergency medical coverage as primary or secondary. Sometimes this terminology is confusing to travelers. Ideally, you’ll want to understand your travel insurance plan fully so in the event of a claim, there will be no confusion or frustration.
Secondary Travel Medical Coverage
When emergency medical coverage is secondary, the provider will reimburse you after any other collectible benefits, such as your primary health insurance. If your plan benefit is secondary and benefits from primary sources have been exhausted, or your primary health care provider will not cover you in your destination, the secondary benefit on your plan will act as a primary benefit. Secondary coverage on a plan is most common.
Don’t assume that because you have a primary health coverage here in the United States that you are limited to only secondary emergency medical coverage on your travel insurance. You can use primary coverage, and it may be better for your circumstance.
Primary Travel Medical Coverage
Simply, if you purchase a plan that has primary coverage, you may file a claim first with the travel insurance company. This allows you to file one claim and receive one conclusion. It’s often simpler for travelers to only file one claim, rather than two.
Annual, multi-trip medical plans and some single-trip medical plans require travelers to have primary health insurance. For most plans, any health insurance company would be considered a primary health care provider aside from Medicaid. These details will be specified on the plan certificate and under the “Additional Benefits” section of the quote for review prior to purchasing.
For instance, Medicare is considered your primary health insurance, so a travel insurance plan with secondary coverage may have extra steps to see a conclusion. Generally, the company will require you to file a claim with Medicare first. Once you are denied that claim, you can file a claim with them. Medicare will send a “refusal to reimburse” letter that will be crucial in your claims process with the travel insurance company.
Does Medicare Cover Travel Insurance?
Original Medicare does not cover emergency medical care for travelers outside the U.S. There are supplemental plans such as Medicare Advantage and Medigap that can provide limited additional coverage. For more details on Medicare and travel insurance visit Medicare.gov. Here's some other important information to know about the limitations of Medicare when it comes to traveling abroad:
- Original Medicare does not provide emergency medical care coverage or emergency medical evacuation for travelers outside the U.S.
- There are supplemental plans such as Medicare Advantage and Medigap that can provide limited additional coverage, for more details visit Medicare.gov.
- Expect more paperwork when filing a claim. If a Medicare recipient chooses a plan that has secondary medical coverage, they must still file a claim with Medicare and get an "Explanation of Benefits" form to send to the travel insurance company. According to our Anytime Advocates™, prepare for additional paperwork for claims.
- According to a new survey by InsureMyTrip, an alarming number of all Americans are still unclear whether their domestic health insurance works outside the U.S.
Limitations of Medicare is yet another reason to get travel insurance.
Does Medicaid Cover Medical Emergencies Abroad?
Medicaid provides government-funded health coverage for low-income adults and children. It does not cover emergency medical care that you may receive while traveling outside the U.S. Medicaid also does not provide emergency medical care coverage or emergency medical evacuation for travelers outside the U.S.
While Medicare may provide supplemental options to include some coverage for emergency medical treatment abroad, Medicaid does not.
Disclaimer: The information contained in this article serves as a general overview of benefits and should only be used for informational purposes. Refer to your individual certificate of insurance for specific coverages, exclusions and benefits. When in doubt, please contact one of our licensed agents for additional assistance.