What happens if you need healthcare services when you are hundreds of miles away from the nearest in-network provider? How you receive emergency or non-emergency medical care and pay for it depends largely on your health insurance plan.

Coverage in an Emergency

All plans cover emergency services at any hospital in the nation regardless of whether you are in your hometown or several states away. If the emergency is deemed life-threatening – such as if you were seriously injured in an auto accident – your emergency care would be covered as though it were in-network.

While this seems straightforward, there may be a catch: different health insurance companies have different rules on what they consider to be an emergency. If you are rushed to the hospital via ambulance for a life-threatening allergic reaction or after a serious auto accident, your health insurance company should be responsible for paying the medical expenses you accrue, no matter where you get care in the USA. Health insurance companies will likely deny claims that are determined not “true emergencies” and you are not in a network hospital. For example, if you go to a hospital for an ingrown toenail, this may not be considered an emergency because it isn’t something that just happens overnight. Waiting too long can potentially raise a concern with your health insurance company as the ’emergency’ could have been prevented. You will most likely pay for that bill out of pocket. However, if you were to bring the concern to your primary care doctor, you would pay a fraction of the cost. Be thoughtful in your decisions about healthcare or be prepared to pay out of your own pocket. Emergency rooms are for very serious situations, urgent care visits are for more minor emergencies and doctor’s offices are for ingrown toenails.

Getting Healthcare When You’re Away from Home
Schedule a Virtual Visit

Telemedicine is a great option when you are away from home and you need non-emergency care. For example, if you are on vacation and you have acid reflux or develop a condition such as pink eye, you may be able to receive treatment advice and prescriptions via phone with a doctor. Not only is this option convenient – by not having to leave your hotel and navigate an unfamiliar city while you’re sick or hurt – but it also ensures you stay in-network. Many insurance companies offer lower co-pays if utilizing telemedicine, depending on your plan.

Buy Supplemental Coverage

If your plan is not a PPO Plan, and you are worried that your coverage is not adequate when you travel, you may want to look into a supplemental plan that can help pay for out-of-pocket costs. If you travel often, then adding supplemental coverage like an indemnity plan may make sense.

Coverage varies from one health insurance provider to another, but generally, there are two types of add-on plans. One add-on plan would be critical illness/accident coverage which may cover medical costs if you are injured or receive a bad diagnosis, whether you are able to go to an in-network provider or not. Another add-on plan would be a hospital indemnity-style plan which will pay you directly for hospital admission costs that may or may not be covered by your regular health insurance. This plan pays money directly to you that can be used at your discretion for medical co-pays, deductibles, and other expenses due to an injury or illness. Always check your plan details to for a list of covered benefits.

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Buy a Supplement Plan with a National PPO Network

Some health insurance companies offer non-aca (Obamacare) national PPO networks. You may still need to seek out an in-network provider, but these providers are located throughout the country. These plans typically either minimally cover preventive care or not at all. They also do not cover pre-existing conditions, at least for a certain time frame depending on the plan. These plans do not cover mental health and usually prescription coverage is limited. Some of these plans work very well for coverage needed prior to your regular health insurance plan deductible kicking in.

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