Medical care outside of USA
Whether you need individual coverage for a vacation, or group coverage for employees in locations around the world, our International site has a product to meet your needs.
Immigrants to USA must have Health Insurance or prove a huge bank account
President Trump signed a proclamation late Friday 10.4.2019 barring legal immigrants who cannot prove they will have “approved health care coverage” or the means to pay for it within 30 days of their arrival to the United States. Politico *
Trump said uninsured individuals are a burden on the health care industry and U.S. taxpayers.
“Immigrants who enter this country should not further saddle our health care system, and subsequently American taxpayers, with higher costs,” Trump declared.
Beginning Nov. 3, only immigrants covered by approved health insurance or those who can show they can pay for “reasonably foreseeable medical costs” will be allowed entry into the U.S.
The announcement affects immigrants applying for visas from overseas. It doesn’t apply to non-citizen children of U.S. citizens. Refugees and asylum-seekers are also exempt.
However, it would apply to the spouses and parents of U.S. citizens and the immediate family members of lawful permanent residents. NPR *
Section 212(f) of the Immigration and Nationality Act, which grants the president authority to declare certain migrants ineligible for entry because it “would be contrary to the national interest” and “detrimental to the interests of the United States.” Washington Post *
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MYTH: Medical evacuation and repatriation are the same.
Reality: Medical evacuation typically means moving a patient from one location where the local care is inadequate to another nearby location that better meets the patient's needs. This does not necessarily refer to moving from the patient’s initial emergency medical transport to the first care setting. Repatriation means transport, usually medically-supervised, back to the patient’s country of residence. There are situations where a medical evacuation is also a repatriation. There are situations where a patient is medically evacuated only to a nearby Center of Excellence (CoE) to receive care and recover, and then the patient continues with their journey. More commonly, the patient has both – evacuated first to a nearby CoE and then repatriated back home for longer term care/convalescence.
MYTH: For a repatriation to be covered, the patient must first have a covered emergency medical evacuation.
Reality: While it is common for an emergency medical evacuation to occur first, not all GeoBlue policies require this for the repatriation to be covered. On most individual policies, the GeoBlue Medical Director may determine a medically-supported transport is required to return the patient to their residence, irrespective of whether a covered emergency medical evacuation preceded it. An example is where the traveler is hospitalized and treated in a visiting CoE city,, but still requires medically-supervised transport to safely get home for further treatment or recovery.
MYTH: Medical evacuation back to the U.S. is always the best course of action
Reality: Based on the situation and treatment needed, the GeoBlue Global Health & Safety (GHS) team works with the treating facility to determine patient stability and the risk and benefits of a move to another facility. These factors dictate whether a member requires evacuation back to the U.S.* In most emergency cases, the patient will first be stabilized then a plan arranged for medical evacuation to the closest Center of Excellence or repatriation. Should transport be recommended, the GHS team then coordinates and arranges direct payment for the best method of transportation – for example, ambulance, helicopter, fixed wing air ambulance – which may require a few days to complete. Uber™ and taxis do not count as ground medical transportation.
MYTH: Evacuation membership programs offer better value than a true travel health insurance plan.
Reality: While there are benefits to having a medical evacuation plan in place, these programs do not typically offer the comprehensive coverage and specialty service that travel health insurance plans provide, meaning that any care not associated with a medical evacuation – such as inpatient or outpatient care – may not be covered. Prompt settlement of medical expenses at each care setting is essential to secure the cooperation of the medical providers in discharging and handing the patient over to the medical transport vendor’s team.
MYTH: Evacuations happen within minutes; after all, it is an emergency situation.
Reality: While emergency medical evacuations involve very serious medical conditions, the patient is usually hospitalized in a setting that can meet their immediate, short-term treatment requirements. In fact, it is critical that the patient be stable enough before an evacuation is undertaken (a determination that is usually jointly made by the treating doctor, the GeoBlue medical team, and the transport vendor’s medical authority). While GeoBlue maintains a global network of medical transport resources, there are also several factors that affect the timeframe for transport, including: arrangements with a receiving care facility, transit time for the transport resources to get to the patient, crew rest, landing permits, seat availability, weather, etc. GHS works to keep the patient and family informed of the timeframes throughout the course of the transport.
MYTH: Emergency medical evacuation by air ambulance is the best method for transport.
Reality: Emergency transportation vehicles have one goal: provide life-sustaining care to patients who need to get from point A to point B. Similar to ground ambulances, air ambulances are packed with life-saving equipment and provide minimal space for travelers. Aside from the necessary travelers – the emergency responder, the patient and possibly one other travel companion – there is usually no extra room for luggage, no extra seats, nor in-flight catering or other amenities. The cabin environment can be loud. Additionally, because of size and range, air ambulances can often only go short distances in comparison to a commercial jet. In some situations, transport by air ambulance is the right course. In others, evacuation by commercial airline is also appropriate. The latter provides significantly more comfort and typically shorter transit times; however, they may not provide sufficient support for the patient’s condition. GeoBlue’s GHS team has experienced medical staff who can make these determinations based on the patient’s condition, needs during transport, distance to the nearest CoE, among other factors.
FACT: GeoBlue simplifies the healthcare process for members in crisis.
In a medical emergency, GeoBlue is available 24/7/365 to support members with concierge-level service through direct contact with healthcare facilities to identify best treatment and care required, coordination of appropriate medical transportation, arrangement of direct pay to healthcare providers and services with a goal to simplify and streamline a challenging, stressful event.
*NOTE: Even if the evacuation route is not to the U.S., we fulfill member requests to repatriate home post evacuation, when they are stable. 4.2.2019 Agent Email from Geo Blue
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Healthcare providers and taxpayers bear substantial costs in paying for medical expenses incurred by people who lack health insurance or the ability to pay for their healthcare. Hospitals and other providers often administer care to the uninsured without any hope of receiving reimbursement from them. The costs associated with this care are passed on to the American people in the form of higher taxes, higher premiums, and higher fees for medical services. In total, uncompensated care costs — the overall measure of unreimbursed services that hospitals give their patients — have exceeded $35 billion in each of the last 10 years. These costs amount to approximately $7 million on average for each hospital in the United States, and can drive hospitals into insolvency. Beyond uncompensated care costs, the uninsured strain Federal and State government budgets through their reliance on publicly funded programs, which ultimately are financed by taxpayers.
Beyond imposing higher costs on hospitals and other healthcare infrastructure, uninsured individuals often use emergency rooms to seek remedies for a variety of non-emergency conditions, causing overcrowding and delays for those who truly need emergency services. This non-emergency usage places a large burden on taxpayers, who reimburse hospitals for a portion of their uncompensated emergency care costs.
While our healthcare system grapples with the challenges caused by uncompensated care, the United States Government is making the problem worse by admitting thousands of aliens who have not demonstrated any ability to pay for their healthcare costs. Notably, data show that lawful immigrants are about three times more likely than United States citizens to lack health insurance. Immigrants who enter this country should not further saddle our healthcare system, and subsequently American taxpayers, with higher costs.
The United States has a long history of welcoming immigrants who come lawfully in search of brighter futures. We must continue that tradition while also addressing the challenges facing our healthcare system, including protecting both it and the American taxpayer from the burdens of uncompensated care. Continuing to allow entry into the United States of certain immigrants who lack health insurance or the demonstrated ability to pay for their healthcare would be detrimental to these interests.
NOW, THEREFORE, I, DONALD J. TRUMP, by the authority vested in me by the Constitution and the laws of the United States of America, including sections 212(f) and 215(a) of the Immigration and Nationality Act (8 U.S.C. 1182(f) and 1185(a)) and section 301 of title 3, United States Code, hereby find that the unrestricted immigrant entry into the United States of persons described in section 1 of this proclamation would, except as provided for in section 2 of this proclamation, be detrimental to the interests of the United States, and that their entry should be subject to certain restrictions, limitations, and exceptions. I therefore hereby proclaim the following:
Section 1. Suspension and Limitation on Entry.
(a) The entry into the United States as immigrants of aliens who will financially burden the United States healthcare system is hereby suspended and limited subject to section 2 of this proclamation. An alien will financially burden the United States healthcare system unless the alien will be covered by approved health insurance, as defined in subsection (b) of this section, within 30 days of the alien’s entry into the United States, or unless the alien possesses the financial resources to pay for reasonably foreseeable medical costs.
(b) Approved health insurance means coverage under any of the following plans or programs:
(i) an employer-sponsored plan, including a retiree plan, association health plan, and coverage provided by the Consolidated Omnibus Budget Reconciliation Act of 1985;
(ii) an unsubsidized health plan offered in the individual market within a State;
So, Covered CA with subsidies, won’t cut it.
(iii) a short-term limited duration health policy effective for a minimum of 364 days — or until the beginning of planned, extended travel outside the United States;
(iv) a catastrophic plan;
(v) a family member’s plan;
(vi) a medical plan under chapter 55 of title 10, United States Code, including coverage under the TRICARE program;
(vii) a visitor health insurance plan that provides adequate coverage for medical care for a minimum of 364 days — or until the beginning of planned, extended travel outside the United States;
(viii) a medical plan under the Medicare program; or
(ix) any other health plan that provides adequate coverage for medical care [MEC? Minimum Essential Coverage] as determined by the Secretary of Health and Human Services or his designee.
(c) For persons over the age of 18, approved health insurance does not include coverage under the Medicaid [Medi-Cal] program.
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Sec. 2. Scope of Suspension and Limitation on Entry.
(a) Section 1 of this proclamation shall apply only to aliens seeking to enter the United States pursuant to an immigrant visa.
(b) Section 1 of this proclamation shall not apply to:
(i) any alien holding a valid immigrant visa issued before the effective date of this proclamation;
(ii) any alien seeking to enter the United States pursuant to a Special Immigrant Visa, in either the SI or SQ classification, who is also a national of Afghanistan or Iraq, or his or her spouse and children, if any;
(iii) any alien who is the child of a United States citizen or who is seeking to enter the United States pursuant to an IR-2, IR-3, IR-4, IH-3, or IH-4 visa;
(iv) any alien seeking to enter the United States pursuant to an IR-5 visa, provided that the alien or the alien’s sponsor demonstrates to the satisfaction of the consular officer that the alien’s healthcare will not impose a substantial burden on the United States healthcare system;
(v) any alien seeking to enter the United States pursuant to a SB-1 visa;
(vi) any alien under the age of 18, except for any alien accompanying a parent who is also immigrating to the United States and subject to this proclamation;
(vii) any alien whose entry would further important United States law enforcement objectives, as determined by the Secretary of State or his designee based on a recommendation of the Attorney General or his designee; or
(viii) any alien whose entry would be in the national interest, as determined by the Secretary of State or his designee on a case-by-case basis.
(c) Consistent with subsection (a) of this section, this proclamation does not affect the entry of aliens entering the United States through means other than immigrant visas, including lawful permanent residents. Further, nothing in this proclamation shall be construed to affect any individual’s eligibility for asylum, refugee status, withholding of removal, or protection under the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, consistent with the laws and regulations of the United States.
Sec. 3. Implementation and Enforcement.
(a) An alien subject to this proclamation must establish that he or she meets its requirements, to the satisfaction of a consular officer, before the adjudication and issuance of an immigrant visa. The Secretary of State may establish standards and procedures governing such determinations.
(b) The review required by subsection (a) of this section is separate and independent from the review and determination required by other statutes, regulations, or proclamations in determining the admissibility of an alien.
(c) An alien who circumvents the application of this proclamation through fraud, willful misrepresentation of a material fact, or illegal entry shall be a priority for removal by the Department of Homeland Security.
Sec. 4. Reports on the Financial Burdens Imposed by Immigrants on the Healthcare System.
(a) The Secretary of State, in consultation with the Secretary of Health and Human Services, the Secretary of Homeland Security, and the heads of other appropriate agencies, shall submit to the President a report regarding:
(i) the continued necessity of and any adjustments that may be warranted to the suspension and limitation on entry in section 1 of this proclamation; and
(ii) other measures that may be warranted to protect the integrity of the United States healthcare system.
(b) The report required by subsection (a) of this section shall be submitted within 180 days of the effective date of this proclamation, with subsequent reports submitted annually thereafter throughout the effective duration of the suspension and limitation on entry set forth in section 1 of this proclamation. If the Secretary of State, in consultation with the heads of other appropriate executive departments and agencies, determines that circumstances no longer warrant the continued effectiveness of the suspension or limitation on entry set forth in section 1 of this proclamation or that circumstances warrant additional measures, the Secretary shall immediately so advise the President.
(c) The Secretary of State and Secretary of Health and Human Services shall coordinate any policy recommendations associated with the reports described in subsection (a) of this section.
Sec. 5. Severability.
It is the policy of the United States to enforce this proclamation to the maximum extent possible to advance the interests of the United States. Accordingly:
(a) if any provision of this proclamation, or the application of any provision to any person or circumstance, is held to be invalid, the remainder of the proclamation and the application of its other provisions to any other persons or circumstances shall not be affected thereby; and
(b) if any provision of this proclamation, or the application of any provision to any person or circumstance, is held to be invalid because of the failure to follow certain procedures, the relevant executive branch officials shall implement those procedural requirements to conform with existing law and with any applicable court orders.
Sec. 6. General Provisions.
(a) Nothing in this proclamation shall be construed to impair or otherwise affect:
(i) United States Government obligations under applicable international agreements;
(ii) the authority granted by law to an executive department or agency, or the head thereof; or
(iii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This proclamation shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This proclamation is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
Sec. 7. Effective Date.
This proclamation is effective at 12:01 a.m. eastern daylight time on November 3, 2019.
IN WITNESS WHEREOF, I have hereunto set my hand this fourth day of October, in the year of our Lord two thousand nineteen, and of the Independence of the United States of America the two hundred and forty-fourth.
DONALD J. TRUMP White House.Gov *
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