Stop Loss Insurance For Medical Tourism

The passage of PPACA has caused many insurance brokers to consider alternative health care products for self-insured clients. Among those products is an international provider network.

Stop loss insurance is available to cover foreign risk.

Traveling across international borders to receive high-quality health care at a fraction of its U.S. price is gaining acceptance with Americans, with over 500,000 seeking treatment abroad in 2009.  An international network of hospitals and providers can be easily added to an employer’s existing self-insured health plan.

Typically, adding a medical travel health care benefit to an existing health plan costs nothing with no compromise on the quality of care, and the medical procedure savings range from 50 to 80 percent of U.S. prices.

But will a traditional stop loss insurance policy cover expenses overseas? Many will not.

Specialized stop loss insurance in the medical travel industry provides significant financial protection for the client in the event that the patient requires additional medical treatment stemming from the medical procedure they received when abroad.

The amount of stop loss coverage available depends upon the specific policy, but regardless of what you use, your goal is to limit the employer’s financial responsibility. For example, a medical travel stop loss policy may limit a client’s maximum responsibility to $50,000 in total medical travel expenses. Total medical travel expenses include: The initial approved medical procedure and travel expenses for the patient and companion Any additional required medical treatment and the expenses for the modified travel arrangements for the companion and patient. In this scenario, once the total medical travel expenses exceed $50,000, the stop loss insurance that the facilitator provides will kick in for the next $100,000 worth of expenses. Therefore, the client will potentially be responsible for a maximum of $50,000 in total medical travel expenses — still far less than the average U.S. cost of $75,000 for a lumbar laminectomy with fusion alone, without additional medical treatment.

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