International Medical Insurance Considerations for Education Abroad Professionals

 

Even when you do all that you can to prepare your travelers for a safe and healthy experience abroad, they may still experience health problems that require medical attention. Do you know where they would go if they need medical care at their travel destination? If they do seek medical care, are they covered by insurance?

Due to the complexity of traveler health needs, and the diversity of destinations where most schools offer programs, it is critical that colleges and universities provide an insurance policy for education abroad leaders and participants that covers, at minimum, emergency medical care (including evacuation and repatriation) in case of an accident.

Why should colleges and universities provide international travel medical insurance to students?

  • Although students and faculty may be covered by a medical insurance policy through other entities (parents, employers, etc.), that policy may include little to no coverage outside of the United States.
  • The healthcare infrastructure at the travel destination may not meet the same standards as the U.S. healthcare system, and there may be a lack of English-speaking providers. An international insurance carrier should be able to recommend practitioners and health care facilities and assist travelers with navigating the local health care system.
  • In the case of an incident with multiple injured students and/or faculty, having all travelers insured by the same carrier with the same level of coverage will make it easier to assist the group and solve problems while managing the incident.
  • Similarly, education abroad professionals can more effectively advise students regarding questions about insurance coverage or medical care abroad when all students are covered by the same, comprehensive policy.
  • Many international insurance policies include benefits beyond medical services for individual travelers. Examples include: security or natural disaster evacuation, medical evacuation, bedside visits (e.g., a family member can travel to be present if a traveler is seriously ill), and mental health counseling services.

Primary Considerations

  • Review your institution’s current insurance policy coverage. Discuss current vs. desired policy requirements with university compliance officer, risk manager, and/or insurance broker. If you want to make any changes to the status quo, you will need buy in from these individuals/units.
  • Identify which travelers you want to cover. Consider the following:
    • Who at your institution travels internationally on programs or for business purposes? Students, faculty, staff, alumni, trustees and board members. Which of these constituents should be covered by your policy? Who is responsible for insurance matters related to those constituents that are not covered by your policy?
    • Does your institution permit partners and dependents to travel? Can/should you be covering those companions as well?
    • How will you handle coverage for students on programs or activities that provide separate/mandatory coverage? Will you consider exceptions to a mandated at your institution? If not, be prepared to articulate to students why both/multiple policies are required.
    • Are you responsible for non-credit student travel? If not, do you know who is? It may be important to cover that kind of student traveler in your policy as well.
    • How is insurance handled at your institution for domestic travel (i.e., within the U.S)? Does your institution consider travel to U.S. territories (like Puerto Rico or the Virgin Islands) to be domestic travel?  It is important to know if any international insurance policy you are considering covers travelers in U.S. territories, or if those locations are excluded by the insurer.
    • Is coverage mandatory? If so, how will that mandate be enforced?
  • Determine term of coverage. Consider the following:
    • Are your travelers covered door-to-door from the time of their departure to the time of their return home?
    • Are deviations/sojourns allowed (i.e., are travelers covered for leisure travel before or after the program? If so, for how long? What if they travel to another country)?
  • Review exclusions carefully: make sure you understand what is covered and what is excluded by your international travel medical insurance policy. If an activity or situation is excluded, and you want coverage for it, ask about it. Check for the following:
    • High-risk activity exclusions. Bungee jumping, scuba diving, ATV or motorcycle riding, and other adventure activities may not be covered.
    • Pre-existing condition exclusions. What if a student requires care for a pre-existing condition?
    • Mental health coverage. Is this provided? How can it be accessed?
    • Act of war/terrorism exclusions. If someone is injured in a terrorist attack, is the medical treatment for those injuries covered in your policy?
    • Exclusion of coverage for injuries, etc. resulting from alcohol/drug consumption or from self-harm.
    • Natural disaster coverage. Check to see how this would work. For example, do you have coverage to be evacuated before a hurricane/typhoon, or only after the fact? Exactly what kinds of natural disaster qualifies for coverage?
    • International students. Does your policy only cover U.S. citizens and permanent residents? Or can international students traveling abroad on your program(s) be covered as well? Your policy should provide expense reimbursement when international students need to be sent back to their home country due to a medical emergency/repatriation.
  • Consider the specific travel and emergency services offered by the carrier. Some examples are:
    • Pre-departure trainings
    • Travel tracking (may require additional fee/contract)
    • Research on best hospitals and English-speaking health care practitioners at program destinations
    • Pre-trip travel, security and medical briefings
    • Travel alerts
    • Medical translation services
    • Medical translation guides
    • Medication search (to find out if medication is available at a destination)
  • Consider your current structure and evaluate what kind of business process you may need to build to support managing enrollment in the insurance policy. Some questions to consider:
    • Do you have a blanket policy (covering everyone) or do you have to enroll each individual traveler?
    • How are you going to actually enroll travelers in the insurance policy? Is it a manual process? A batch process?
    • Who will cover the cost for enrollment? How will you manage billing and payment? Is it wrapped into education abroad program fees? Can you charge to student accounts? What about faculty/staff travelers?
    • Do you have sufficient staff to manage the process?

Other Considerations

  • Understand the procedure for scheduling appointments with medical professionals abroad. Check to see if your coverage will differ if travelers schedule their own appointments instead of having the insurance provider coordinate care.
  • Research the process for filing an insurance claim while in another country, and understand when the insurer will make a guarantee of payment to a medical facility or provider. Travelers may have to pay bills out of pocket in their host country, sometimes in cash, and then submit copies of the receipts for reimbursement after they return.
  • Consider the value of products like travel insurance that might provide coverage for trip cancellation insurance or lost/stolen property. You may choose to purchase a separate product like this as a way to guard against what could be substantial financial penalties for students’ changing travel plans or lost/stolen property. If you don’t provide such a policy, you may choose instead to recommend such coverage to your travelers.
  • Share all of this information with your students. As part of your comprehensive support for education abroad participants, you need to ensure that you appropriately advise your students about their international health insurance coverage and resources. Consider the following:
    • Review your pre-departure orientation materials, including presentations and handbooks, to ensure that you effectively communicate what you want your students understand about their health care coverage.
    • Refrain from offering medical advice to your students.
    • Do your students know how to seek medical care and use the insurance? For example, how do they find a provider and pay for the care received? Who do they call if they need to find a doctor or counselor?
    • Stress the importance of having available funds to cover unanticipated, out-of-pocket costs. If there is a co-pay or deductible, they need to be aware. If they have to pay up-front and submit a claim for reimbursement later (potentially even after they return to the US), you should tell them.
    • Do students know what to do if traveling with prescription medication? Advise them to research whether or not their medication is available in their host country, and outline any related services offered by your insurance provider. Refer them to experts who can share professional advice about traveling to their specific destination(s) with their specific medication(s).

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