If Your Parent Gets Sick in the USA: How to Use Visitor Insurance
For a life-threatening emergency, call 911 first. Otherwise, do four things: pick the right kind of care, call the plan before a planned hospital treatment, keep every bill, and file the claim before the plan's deadline. Those four things are what let the plan pay back the charges it covers.
Urgent care, walk-in clinic, or emergency room?
A fever or a bad cough: an urgent care or walk-in clinic. Chest pain, breathing trouble or a bad fall: the emergency room or 911.
Plans commonly charge much less for a clinic visit than for an emergency room visit that does not end in a hospital stay. In one carrier's sample policy, an urgent care clinic visit has a $25 copay and a walk-in clinic visit a $15 copay (a flat amount paid at the visit). Neither is subject to the deductible, the amount you pay before the plan starts paying, and a $0-deductible plan has no copay. A US emergency room visit for an illness that does not lead straight to a hospital admission has its own $250 deductible per visit; an injury visit has no such deductible. [1]
Call the plan before a planned hospital treatment
Many plans require their approval before non-emergency hospital care; plans call this pre-certification. You or the doctor's office call the number on the insurance ID card before the treatment, follow the plan's instructions and send any documents it asks for, and tell the hospital that the plan needs pre-certification.
In one carrier's sample policy, a hospital stay, surgery and several other treatments must be pre-certified before admission. If they are not, the plan cuts the covered charges for that treatment by 50%, then takes the deductible and your percentage share from what is left. An emergency hospital admission must be pre-certified within 48 hours of admission, or as soon as reasonably possible. [1]
In-network saves money
Using a doctor or hospital in the plan's network, the providers it has an agreement with, commonly leaves less of the bill with you. In one carrier's sample policy, the plan pays 100% of covered charges in network and 90% out of network, after the deductible, so 10% of those charges is yours. When there is time, ask the clinic or hospital whether it takes the plan's network before care begins. [1]
Keep everything, then file the claim
Plans pay only on a complete claim, so keep paperwork from the first visit. In one carrier's sample policy, that means the plan's claim form (available online, one for each new illness or injury), itemized bills and statements from every doctor and hospital, and the original receipts for anything you paid, including prescriptions, each showing the provider's name, address and phone, the date and what was done. The deadline is 180 days from the date the cost was incurred.
If the hospital bills the insurer directly, you still keep copies of everything. If you paid yourself, you file the claim to be paid back for the charges the plan accepts. [1]
Four things to keep in one place
- The insurance ID card and the plan's phone number.
- The policy document or certificate.
- Every bill, statement and receipt, each showing the date and the provider's name.
- A short log of who you called and when.
Your next step
Before the trip, save the plan's phone number in your phone and your parent's. If you are still choosing a plan, compare with your parent's exact age and travel dates, and put the clinic copays, emergency room deductible and claim deadline side by side.
Compare visitor insurance plans
Related guides
Sources
This IMG sample policy illustrates the wording. Terms differ by plan; your parent's own policy documents determine the benefits. The copays, deductibles, percentages and deadlines quoted from the sample are not a quote or a promise of payment, and this page uses no invented example numbers.