4th Quarter 2011 Benefits Corner


        by Al Horan


In this article, I will cover medical care services provided outside the United States.  Recently, I was contacted by an organization that arranges for an individual policy which delivers medical treatment abroad.  The objective of this arrangement is for the patient to receive quality care at a significantly reduced cost.  The countries we discussed were India, Thailand and Singapore.

Now let’s look closer at the proposal. Firstly, many providers of medical insurance restrict coverage to emergency medical care only if the insured is treated abroad. In the case of Medicare it only covers the U.S. Secondly, depending upon the country, the level of care can vary a lot. When I worked for Caltex I visited hospitals in Africa and Asia. I also was treated in Bahrain and The Phillipines. The medical care I received was good although the medical facilities did not have sophisticated diagnostic equipment like most U.S. hospitals.


Level of care, quality of facilities varies


In the case of hospitals I visited in East Africa, the level of care and quality of the facilities were substandard. I also noticed that in countries where the level of care and quality of the facilities were good, generally the level of aftercare that a patient received following a major procedure was limited. Finally, I found that many doctors in foreign countries are not as likely as U.S. doctors to openly discuss with patients their medical conditions.


Caltex’s medical advisor advocated treating American expatriates and their family members having major medical problems in the U.S. But emergencies requiring immediate attention were generally treated overseas. Likewise, non-life threatening conditions were generally treated in-country.


Surgeon skills good in most developed nations


Our doctor generally felt the skills possessed by surgeons in most developed nations were good. However, he was concerned about the rate of infection in tropical areas and also the level of aftercare following surgery. Whenever possible we would transport an individual to the U.S. via a commercial airliner. Also the individual would usually be accompanied by a medical person.


When a commercial carrier could not be used we transported the individual via air ambulance. Air ambulances are expensive because they are specially equipped plus they have medical staff on board. I can recall evacuating an individual via air ambulance from Asia to the U.S. at a cost of approximately $125,000.


The final area I would like to cover is traveling overseas on pleasure. I always enjoyed visiting other countries. But depending on the country there could be issues to be aware of before embarking on a trip. When traveling to developing nations it is always important to address the area of medical care in advance because of challenges that can be faced.


Information sources available regarding health issues


A good source of information is the “Yellow Book 2012” which was written by the Center for Disease Control. It is available from Barnes & Noble or Amazon.com at a cost of approximately $30. Also it is possible to obtain valuable information from the Federal Government by visiting the CDC’s website (www.cdc.gov/travel) for health issues, including the location of local clinics; and the U.S. State Department’s website (www.state.gov) for country profiles, travel advisories and contact information for U.S. Embassies/Consulates.


It also is a good idea to take extra copies of your medical records, including a record of your inoculations, i.e. certifications of vaccinations are required by some countries (for more information visit U.S. Department of Health and Human Services’ website www.hhs.gov).

Lastly it would be advisable to carry a medical travel kit with you especially if you will be visiting less developed countries. Typically, a kit should contain first aid supplies and over the counter medications for stomach problems, etc.


Overseas Chevron medical insurance covers emergency care only


While traveling overseas your Chevron medical insurance will cover emergency care only. This includes ground and air ambulance if appropriate emergency services, as determined by UHC, are not available in the immediate area. Transport is to the nearest medical facility that can reasonably be expected to render emergency care. Non-emergency medical services and travel expenses are not covered by UHC.


Remember that Medicare does not provide coverage while you are outside the U.S. If you will be temporarily relocating to a foreign country you may wish to look into individual supplemental medical coverage for non-emergency care. This type of coverage is available through an insurer like BUPA (their website is global.ihi.com). This insurance would not be sponsored by Chevron and you would not receive a company contribution towards individual plan coverage.


Contact Chevron Service Center if permanently relocating overseas


If you will be permanently relocating to a foreign country you should contact Chevron’s Service Center within 31 days of your move to inquire about plan coverage. You can reach a customer service representative who can advise you of your plan options at 1-888-825-5247.


However, Medicare-eligible retirees who travel to the U.S. for medical services should have Medicare Part A and Part B in place. This is because for services obtained in the U.S. the Chevron plan will pay benefits based on Medicare being your primary coverage. If you do not have Medicare Part A and Part B, your claims will be paid by UHC as though Medicare paid its share of the cost for services. Therefore, your UHC coverage will pay only a small portion of the remaining cost as the secondary insurer.


I realize this article merely contains an overview of foreign travel and medicine. Therefore, feel free to contact me if you have questions.


Al Horan, 972-964-1787, awhoran@verizon.net