Get Ready, Get Set…
If you’re planning to travel outside of your health plan service area, it’s always a good idea to review your health plan’s Evidence of Coverage and to contact your health plan directly to understand what is covered and how to access care if — and before — the need arises.
In addition, here are a few general travel tips you should know.
If You’re Traveling in the United States
- Emergency and Urgent Care — Emergency services and urgent care are covered nationwide under all CalPERS health plans.
- PPO Platinum Plan — PPO Platinum CalPERS members typically have access to nationwide provider networks and may seek care outside of California.
If You’re Traveling Outside the United States
- Emergency and Urgent Care — Emergency services and urgent care are covered worldwide under CalPERS Basic health plans. However, it’s crucial to understand the limitations of this coverage. It typically only applies to unforeseen emergencies and may not cover non-emergency medical needs, routine care, or significant medical events that require evacuation.
- Medicare Participants — Medicare generally does not provide coverage for health care services obtained outside the United States (whether with or outside of the CalPERS program).
- Contact Medicare at 1-800-MEDICARE (or 800-633-4227).
- Travel Medical Insurance — You may want to consider purchasing travel medical insurance. These policies are designed specifically for overseas emergencies and can fill the gaps left by your primary health plan.
- Smart Traveler Enrollment Program — If you are traveling outside the United States, consider signing up for the U.S. Department of State’s Smart Traveler Enrollment Program (STEP). This free service provides health updates and more for the country you’re visiting. It also lets the nearest U.S. embassy or consulate know you’re there, which can help facilitate assistance in case of an emergency.
Don’t Forget to Pack These (or Know Where to Find Them)
- Health Plan ID Card — Always carry your physical ID card and save a photo of both sides of the card on your phone or in a cloud storage service as a backup. Your ID card informs doctors, medical facilities, and pharmacies that you have health coverage.
- Medications — Bring all your regular medications in their original prescription bottles with labels. Pack extra doses in case of travel delays. If possible, carry a copy of your prescriptions or a doctor’s note for controlled substances or large quantities, especially for international travel.
- Emergency Contact Information — Have a list of emergency contacts on hand, including your primary care physician, family members, and your health plan’s 24/7 international assistance number (if applicable).
- Understand the Claim Process (Especially for International Travel):
- Health Claim Form — While not always necessary to pack a physical form, know where to download it from your health plan’s website or how to request one. You may need to file a claim for reimbursement if you pay out-of-pocket expenses or receive care from non-participating providers. Having access to the form can help speed up the reimbursement process.
- Key Information to Collect if You Receive Care:
- Itemized Bills — Detailed bills showing services, dates, diagnosis codes, and charges.
- Proof of Payment — Receipts, credit card statements, or bank records.
- Medical Reports/Doctor’s Notes — A written diagnosis, treatment summary, or discharge report.
- Prescription Details — Detailed medication receipts with the drug name, strength, quantity, and prescribing physician.
- Online Portals and Direct Billing — Most health plans offer online claim submission or have direct billing arrangements with providers in your destination country. These can significantly simplify the process.
By taking these practical steps before your trip, you can travel with greater peace of mind knowing you’re better prepared for any health care needs that may arise. Safe travels!