The Ins and Outs of Out-of-Area Health Coverage

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The Ins and Outs of Out-of-Area Health Coverage

With spring and summer breaks right around the corner, there’s a good chance you and your family will fly the coop in the not too distant future. While no one likes to think of getting sick or injured on vacation (believe me, I know!), it’s important to know the details of your health care coverage, should the need arise.

Many health plans offer access to a national network of doctors. In the case of CDPHP, this includes 825,000 doctors, nurses, and specialists around the country.1 That means, whether traveling for business or pleasure, you’re covered by an extensive network of health care professionals for coast-to-coast coverage. But even if your plan does not include a national network, such as an HMO, rest assured that you have access to worldwide emergency care, regardless of your plan type.2

In addition to checking what type of coverage you have, there’s some other simple things you can do to prepare for your trip.

Your health insurance company may offer a mobile app that allows you to search for doctors while you’re out of town. CDPHP members have access to Find-A-Doc, an online tool that allows members locate doctors, urgent care centers, emergency rooms, and more – all on the go.

If you take regular medications, it’s a good idea to establish yourself with a national pharmacy chain. Also, get the low-down on prescription refills. Will you be able to refill prescriptions at a network pharmacy when you are away from your home state? Do you have the option to refill them by mail order, or receive a few months’ supply in advance? If you do, this is a good avenue to explore, as it is one less thing you’ll have to worry about so you can enjoy your vacation!

Always be sure to travel with complete and up-to-date contact information for family, friends, and any professionals you depend upon. If you are a CDPHP member, carry your ID cards with you at all times, and call the number listed if you have specific questions about your plan. Remember, your ID card can be as close as your smartphone if you download the My CDPHP Mobile app.

Most importantly, to limit your financial liability, make sure you contact your health plan before you seek services from an out-of-area provider. The plan will be able to answer all of your coverage questions, and avoid any surprises down the road.

A good vacation is a great way to recharge your mental batteries. In fact, a study by the Society for Human Research Management found that HR managers believe using vacation time leads to higher performance (75 percent) and increased job satisfaction (78 percent). But before you pack your sandals and sunscreen, give your health plan a call so you can be confident in your out-of-area coverage.

1The national network is provided by CDPHP Universal Benefits,® Inc. The national network does not extend to members of the Federal Employees Health Benefit Plan, or the Medicare Choices PPO plans. Members of the HMO plan, which is insured by Capital District Physicians’ Health Plan, Inc. (CDPHP®) are also not eligible for the national network.

2CDPHP Medicaid members are covered for urgent and emergency care throughout the United States, District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. CDPHP Medicaid members must pay for emergency care in all other countries, including Canada and Mexico.

2 Responses to “The Ins and Outs of Out-of-Area Health Coverage”

  1. Robert Kelly

    “1The national network is provided by CDPHP Universal Benefits,® Inc. The national network does not extend to members of the Federal Employees Health Benefit Plan, or the Medicare Choices PPO plans. Members of the HMO plan, which is insured by Capital District Physicians’ Health Plan, Inc. (CDPHP®) are also not eligible for the national network.”

    Wouldn’t it be more informative and easier to tell us what plans are eligible for the national network??

    Reply
    • Hi Robert,

      Sorry for the confusion. Generally speaking, most EPO and PPO plans have a national network, however, there are a couple that do not, including Federal Employees Health Benefit Plan and the Medicare Choices PPO plans.

      Thanks for your feedback.

      Reply

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