Employers, insurers and benefit managers are implementing medical travel benefit options to help reduce treatment costs and improve operating margins. Employees see their out of pocket health care costs reduced and quality increased with access options to top level medical care providers.
Most insurers and benefit policies do not have foreign providers in their domestic networks, the MTM Global Health Care Membership (GHCM) is a paying Membership Program with support that provides access to the MTM Global Health Care Network of Health Providers and Partners.
Properly designed plans take advantage of the potential of allowing enrollee’s to travel abroad for lower-cost treatments obtained through The MTM Global Health Care Network - GHCN.
Most employers do not suggest to employees to go abroad for lower-cost care, nor are they actively considering using financial incentives to encourage them to travel abroad. Rather, they are reducing benefit access and increasing costs with all the changes occuring in the heath care environment. GHCM it is a value-added service available to members who request it. Those who take advantage of these services and benefits are often self-insured employees and self funded employers facing steep out-of-pocket payments.
Several health insurers are also experimenting with international coverage. The following is an example of an insurance product that already uses foreign providers.
BlueShield of California has a health network designed for people who choose to get their medical care in Mexico. 11 Access Baja was implemented a year after California passed legislation in 1999 allowing the state’s insurers to reimburse providers in Mexico. Although many of the participants are Mexican nationals who cross the U.S. border each day to work, employers on both sides of the border can offer this plan to their workers. However, the plan requires participants to live within 50 miles of the border to easily access the Mexican primary care physicians in the BlueShield network. By 2005, nearly 40,000 people had signed up for coverage offered by Mexican health care providers.
Because Mexican medical care costs are less, Access Baja premiums are less than two-thirds the cost of the alternative BlueShield of California plans. Hispanic enrollee’s can have a doctor who is fluent in Spanish and has an understanding of their culture. Mexican physicians are often available for same-day appointments as well as evenings and on weekends.
Time will determine whether these pilot plans will be adopted on a broad scale and whether employers or patients will receive the benefit of cost savings via reduced premiums, co-payments or deductibles. As the medical tourism trend grows, other U.S. health industry companies will explore ways to offer medical travel that is partially covered by health insurance.