Summer travel health care: 3 essential steps to avoid surprise medical bills
For most people, they are not very ready. Nearly two-thirds (63%) of Americans said they would not know what to do if they needed medical care while traveling away from home, according to a new eHealth survey. The survey also found 54% of Americans incorrectly believe their health plan generally includes coverage while traveling internationally.
Whether you're planning a cross-country road trip or an international adventure, understanding your health insurance coverage while traveling is crucial for avoiding unexpected medical bills and ensuring you receive proper care when needed.
Here are three steps to help with that before, during, and after your trip:
Before your trip
It is a good idea to schedule a wellness visit, if you have not had one already. This appointment can help determine your fitness for travel and identify potential health issues. Best of all, these annual preventive exams are typically covered at no additional out-of-pocket cost as part of your health plan. Likewise, your physician can check if you and your family members are up to date on recommended vaccinations, which can be especially important when traveling internationally.
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Finally, whether you are covered through an employer or individual plan, Medicare and Medicaid, check with your plan to understand what is covered while traveling outside of your home area, including to determine whether any U.S. destinations will have in-network care providers available and whether any international destinations will have coverage at all.
During your trip
It's important to know emergency care will typically be covered by your plan, assuming you are still in the U.S. For people with Medicare Advantage, these plans may include limited coverage for non-emergency care outside of the plan's local or regional provider network. If traveling internationally, most health insurance plans, including Original Medicare and Medicare Advantage, have limited or no coverage for care, other than a few limited exceptions such as when you're on a cruise ship in U.S. territorial waters.
If you need medical care on your trip, make sure to keep a digital or physical copy of your insurance card and list of emergency contacts. Also, consider bringing a credit card credit in case you need to pay out of pocket for medical care in a foreign country.
After your trip
Make sure to save all documentation, including any bills, receipts and medical records, if you did receive care while traveling. These are important if you file a reimbursement claim with your insurer, in cases where the care may be covered. Some plans require claims to be submitted within a specific timeframe, so don't delay.
If you visited an out-of-network provider, ask about setting up a payment plan if the bill is substantial. Finally, evaluate what type of additional coverage may be necessary moving forward, such as a travel insurance plan, which may include coverage for emergency medical care abroad, medical evacuation or trip cancellation.
For people who qualify for Medicare, consider enrolling in a Medicare Supplement plan, ideally when you first become eligible for Medicare. Medicare Supplement plans may include an emergency care benefit for international travel.
By considering these tips, your health insurance can be a safety net — not a stressor — on your summer getaway.
Whitney Stidom is vice president of consumer enablement at eHealth, a leading online health insurance marketplace that helps consumers confidently navigate their health benefit decisions.
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Yahoo
22 minutes ago
- Yahoo
If Thimerosal Is Safe, Why Is It Being Removed From Vaccines?
Credit - Getty Images There's a newly appointed panel of experts at the U.S. Centers for Disease Control and Prevention (CDC), freshly chosen by U.S. Health Secretary Robert F. Kennedy Jr. Called the Advisory Committee on Immunization Practices, it sets the immunization schedule for Americans. And some of the new members have histories of vaccine-skepticism. On June 26, this panel voted to remove thimerosal from flu vaccines. The ingredient has long been the target of anti-vaccine activists, despite numerous studies showing it's safe in small amounts. The committee's recommendation now goes to the CDC's acting director to become a formal recommendation. (Susan Monarez, President Trump's selection to head the agency, is currently undergoing confirmation hearings). Here's how thimerosal got into vaccines, why it's being taken out, and what the latest recommendation could mean for next season's flu shots. Thimerosal, which contains a form of mercury called ethylmercury, has been used in vaccines as a preservative since the 1930s to prevent growth of fungi and bacteria. At the time, most vaccines came in larger vials that contained multiple doses, and while the vaccine makers produced a sterile and safe product, 'each time you pierce a needle [into the vial] you are potentially introducing contaminants that can lead to infection,' says Dr. Jason Goldman, president of the American College of Physicians. 'While the vaccine itself was safe, the vials got contaminated, and there were deaths from infection. So the decision was made to put a preservative in it.' That preservative—thimerosal—was used routinely in vaccines until 2001, when federal health officials decided to remove it from the majority of childhood vaccines. It is currently only used in flu vaccines that come in multi-dose vials. (Most of the flu vaccines in the U.S. come in single-dose syringes that do not contain thimerosal.) Ethylmercury is cleared from the body more quickly than methylmercury, which is primarily found in deep-sea fish like tuna. Both types of mercury can be toxic to cells, particularly in the brain, but the more quickly-cleared ethylmercury has less time to cause such harm, according to the CDC. Read More: FDA Approves a Twice-Yearly Shot to Prevent HIV 'Data from many studies show no evidence of harm caused by the low doses of thimerosal in vaccines,' the CDC's website says. That includes studies that looked at a variety of neurological and psychological outcomes, as well as autism. However, researchers say longer term data on the health effects of exposure to both types of mercury isn't completely clear yet. In 2001, federal health officials decided to remove thimerosal from most childhood vaccines, which at the time included shots for influenza, diphtheria, tetanus, pertussis, and hepatitis B. Thimerosal remained in trace amounts in larger vials of the annual flu vaccine to protect against contamination. Dr. Paul Offit, a member of the Advisory Committee on Immunization Practices at the time, says there were a number of reasons for the decision back then—most of which had more to do with policy pressures and optics than with concerns over health harms. In early 1998, Andrew Wakefield, a gastroenterologist in the U.K., had published a paper in which he linked the MMR vaccine for measles, mumps, and rubella to an increased risk of autism. His paper has since been debunked and his medical license has been revoked, but his findings sparked the anti-vaccine movement that continues today, despite evidence that vaccines have saved lives and provide more benefit than harm. After Wakefield's paper gained notoriety, a U.S. Congressman asked the CDC's vaccine experts to review the data and vote whether, as Wakefield suggested, the vaccines for the three diseases should be separated and given individually to reduce any potential harm to infants. It wasn't based in science, and 'around the table we voted 'no,'' says Offit, who was part the committee. Read More: A Study Retracted 15 Years Ago Continues to Threaten Childhood Vaccines A few months later, vaccine maker Wyeth decided to remove RotaShield, the first vaccine to protect against rotavirus, from the market—just 10 months after it was approved. The vaccine was linked to rare bowel obstruction in some babies who had received it in their first six months. The withdrawal understandably added to the public's concerns about the safety of vaccines. So when issues about the potential risks of mercury in thimerosal emerged, in part due to Wakefield's paper, Offit says the committee was faced with addressing Americans' growing concern that federal health agencies were not adequately ensuring vaccine safety. 'We had a vaccine that had been approved and then taken off the market; we did not buy Andrew Wakefield's notion to separate the MMR vaccine into three component parts. And now we had thimerosal,' says Offit. The committee's leader, as well as the members, 'were cognizant of the fact that it looked like were weren't paying attention to vaccine safety, or that we didn't care. Because we approved RotaShield, and we didn't listen to Andrew Wakefield.' 'My understanding was that at the time, there was essentially no evidence of any harm from thimerosal,' says Dr. Sean O'Leary, chair of the committee on infectious diseases at the American Academy of Pediatrics. 'But the concern was that it probably hasn't been studied as well as perhaps we'd like. And since we have the technology to remove it from the childhood vaccine schedule, we should go ahead and do that. But many, many people questioned that decision.' One of them was Offit, who can't recall if there was an actual vote, but says he would have voted against removing thimerosal had there been one. Nothing about the makeup of the vaccines changed—only the formulation to package it into sterile, single-use syringes. 'It was an anti-science move,' he says. 'It did nothing to make vaccines safer—all we did was make them more expensive. We didn't explain ourselves. We didn't trust the American public to understand the nuance.' Read More: Measles Is Now Showing Up in Wastewater As a result, the decision to remove thimerosal was interpreted by many in the public, including anti-vaccine activists, as acknowledgement that thimerosal was unsafe and harmful. That decision, says Offit, 'gave birth to two anti vaccine groups—Moms Against Mercury and Generation Rescue. Any reasonable person would have thought, 'Why take it out so precipitously unless there was a problem?'' Because of that decision, currently only about 3% to 4% of flu vaccines in the U.S. that come in multi-dose vials contain thimerosal. And these larger vials are mostly used in rural and low-resource settings since they are less expensive than single-dose syringes. Most children who have received their immunizations at pediatrician offices for decades now have not been exposed to thimerosal. 'I don't know of any pediatric practices that use the multi-dose vials,' says O'Leary. 'It's pretty uncommon. Even if pediatricians did use the multi-dose vials, it's a non-issue because it's safe. This is a very clear effort to shine a light on this anti-vaccine trope that thimerosal is somehow dangerous.' 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The experts TIME spoke to about the latest decision say that the CDC posted a description and references for studies that have supported the safety of thimerosal in vaccines, but that it was removed from the agency's website before the committee meeting. 'I am very concerned that this committee will do everything it can to undermine the vaccine schedule and the public's trust in science and data,' says Goldman. 'If that happens, and vaccines are no longer appropriately recommended, it will lead to an increase in infections and deaths and put the entire public health system at risk.' The recommendation is 'unprecedented,' says O'Leary, and therefore it's not clear how long manufacturers will have to comply, or what happens to existing vials that are already purchased and stored for the upcoming flu season, since they are legally approved. 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Time Magazine
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The Surprising Reason Rural Hospitals Are Closing
Thomasville Regional Medical Center was supposed to be a gamechanger. Situated in the U.S. Congressional district with the worst health outcomes in the country, the hospital opened in 2020 with state-of-the art equipment, including a 3D mammogram and an MRI scanner. But it closed less than five years later in Sept. 2024. The hospital now stands empty: its pristine hallways dark, its expensive machines gathering dust. 'It's almost like the apocalypse happened,' says Sheldon Day, the mayor of Thomasville, who had worked for almost a decade to get a hospital to open there. This apocalypse is happening throughout rural communities across the country. More than 100 rural hospitals have closed in the past decade, according to the Center for Healthcare Quality and Payment Reform (CHQPR), a national policy center that works to improve health care payment systems and whose data have been cited by the Bipartisan Policy Center. About one-third of all rural hospitals in the country are at risk of closing because of financial problems. In Alabama, 23 rural hospitals—about half of all of them in the state—are at immediate risk of closing, according to CHQPR. Even more rural hospitals might be in trouble if Congress passes the huge piece of legislation before it, called the One Big Beautiful Bill Act, which includes significant cuts that would slash Medicaid spending in rural areas by $119 billion over 10 years, according to KFF. Thom Tillis, the U.S. Senator from North Carolina who said he couldn't support the bill in its current form, said in a statement on June 28 that Congress needed to achieve the tax cuts and spending in the bill 'without hurting our rural communities and hospitals.' Why rural hospitals are closing People often blame rural hospital closures on poor reimbursement rates from Medicare and Medicaid. 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The one in Thomasville, for instance, was getting paid by private insurers roughly half of what it was costing to deliver services, according to federal data compiled by CHQPR. This is a very different situation than what is happening between private insurers and urban hospitals, he says. Urban hospitals and large rural hospitals are able to make up for the losses from Medicare and Medicaid patients with what they can charge private insurers. Small rural hospitals can't do that. Rural hospitals actually need higher compensation than urban hospitals, Miller says, because they have the same fixed costs like 24-hour staffing, but have a lower volume of patients to cover those costs. Why small rural hospitals get less from private insurers One reason why small hospitals get less money: Insurers demand discounts. Larger hospitals have more leverage to negotiate with private insurers over those discounts because they have higher patient volumes. Smaller hospitals have less wiggle room to negotiate. Another problem in Alabama in particular is that just one health insurer, Blue Cross and Blue Shield of Alabama, has an estimated 94% of the large-group private insurance market, which most people with private health insurance fall under. Hospitals can't negotiate as well because they have to accept Blue Cross and Blue Shield of Alabama patients, and losing those patients would be financially ruinous. That's how one small rural hospital in Alabama, Medical Center Barbour in Eufaula, gets paid just $65 for an X-ray by Blue Cross and Blue Shield of Alabama, compared to $97.03 by Aetna, according to Miller's data. 'Alabama Blue Cross could single-handedly save all the rural hospitals in Alabama,' Miller says. 'It just has to pay adequately.' Read More: Medicaid Expansions Saved Tens of Thousands of Lives, Study Finds In a statement, Blue Cross Blue Shield of Alabama said that it works each year with the Alabama Hospital Association to evaluate the care rural hospitals provide and to compensate those facilities. It disputed CHQPR's assertion that private insurers are responsible for 65-80% of patient costs in rural hospitals in Alabama, saying that Blue Cross and Blue Shield of Alabama patients comprise only a small share of patient volume at rural hospitals in Alabama (while declining to offer specific numbers). 'Thus, the largest financial impact to rural hospitals is the government payer sector,' the company said. A Blue Cross and Blue Shield of Alabama spokesperson said the company's market share statewide is 'different for different market segments'—but referred TIME to federal data showing that it, and not any other insurer, covers the vast majority of Alabamans. The company launched a medical scholarship program in 2016 to promote access to quality health care in rural areas of Alabama, a spokesperson said, and 38 medical students have now graduated and are practicing in rural parts of the state. The challenges facing rural hospitals nationwide have gotten worse in the last year or two, Miller says, because costs have gone up after the pandemic as labor became scarce and many doctors and nurses quit the field after getting burned out. What's more, the federal government offered many pandemic-era grants to hospitals so they could stay open, but those have run out. One reason the Thomasville hospital failed is that it could not get any of those federal grants because it had not been open long enough. What happens when a rural hospital closes On a recent weekday afternoon, Dr. Daveta Dozier, a family physician who has practiced in Thomasville for 40 years, walked me through the closed Thomasville hospital. The hallways and patient rooms should have been buzzing with beeps and medical conversations, but the building was eerily quiet, like it had flatlined. She pointed out the MRI machine where she'd send patients so they could avoid the 90-minute roundtrip drive to Mobile, and the laboratory where her patients could get blood work done. Now, she says, when she tells her patients to get complicated lab work or imaging, they can't do it locally. So many don't do it at all. 'Half the time they don't go,' she says. 'Either they can't find family to take them or they're working and they can't get off.' This means by the time they end up seeking health care, they are sicker than they would have been had the hospital stayed open. That corresponds to what doctors have been seeing across the country after isolated rural hospitals close. One study found that following a closure, the hospitalization rates and average length of hospital stays increased for locals. When hospitals were more isolated, rural patients were more likely to be readmitted to a hospital after an initial stay. Dozier is in private practice with her husband, who is also the medical director for the local nursing home. In the past few weeks, she says, the nursing home had eight separate patients with medical needs like urinary tract infections and pneumonia that required them to be transported to hospitals in Mobile. Had the hospital in Thomasville been open, they could have been treated there. Now, their families have to make the trek to visit them. 'The first thing you hear them say is, 'I don't want to go to Mobile,'' she says. Read More: When Fighting with Your Insurance Company Becomes a Full-Time Job Barbara Smith, 78, knows what it's like to drive frequently to Mobile for care. Her husband, who recently passed away, had bladder cancer, and the nearest treatment center was nearly 2 hours from their home. 'It sure was a lot of driving,' she says. With closures of rural hospitals like the one in Thomasville, some hospitals' emergency rooms in urban areas of Alabama become full and send patients to other hospitals—and sometimes other states—to be seen, Dozier says. Emergency department crowding is a growing problem across the country. There is another hospital 20 minutes south of Thomasville called Grove Hill Memorial Hospital. But it is also financially struggling and recently made the decision to convert to what's called a rural emergency hospital, which means it will only have an emergency room and not inpatient care. With that conversion, it receives federal funding to help it stay open—but patients won't be able to get much there except for emergency services. I asked Stacey Gilchrist, chief operating officer of the Thomasville hospital in receivership, why Thomasville needed a hospital when patients could go to Grove Hill for emergency services. She gave the example of a 40-year old woman who rushed to the Thomasville hospital when she was having chest pains; doctors there stabilized her, but other physicians in Mobile who later treated her said she would likely have died if she needed to drive further. 'If you're having a heart attack, do you want to ride 20 minutes down the road, or five minutes?' she says. Many of Thomasville's patients come from even more rural areas. Riding 20 more minutes could be the difference between life and death for them, she says. What's more, she says, Thomasville's hospital was much more than an emergency room. It had 29 rooms where patients could stay overnight and be treated for serious conditions, a lab, and the newest equipment that isn't in any other rural hospital in the region. Shrinking access, less health care Thomasville is located in Alabama's 7th Congressional District, which stretches between Birmingham and the state's border with Mississippi. A Harvard study from 2022 found that the district ranked last in terms of life expectancies nationwide. Officials like Mayor Day say this is partly because it's so hard to access health care. 'People just simply don't go to the doctor until they get real sick,' he says. He had hoped that opening the Thomasville hospital would help. He and local officials had worked for years to put together an incentive package to encourage someone to reopen a hospital in Thomasville, after the last one closed in the wake of the Great Recession. 'We really wanted to change the dynamic of health care here,' he says. Read More: They Hated Health Insurance. So They Started Paying For Each Other's Care Thomasville is not the only community optimistic enough to try to open a rural hospital at a time when many were closing. Between 2017 and 2023, 11 acute care general hospitals were opened in rural areas, according to data from KFF. But 61 hospitals closed during the same time period. The city gave the investors who built the Thomasville hospital a discount on the land and approved a one-cent sales tax that would go to the hospital to help it stay open. The investors bought new equipment, knowing that money can be made in diagnostics if they could get people to come to Thomasville rather than going elsewhere for tests like MRIs and CT scans. Specialists from Mobile started coming up a few days a week to see patients, sparing residents the long drive. A physical therapy practice opened in the building, and Day had plans to expand the campus and open a cancer treatment center. But then the pandemic hit, and costs spiraled out of control because the hospital could do fewer money-making procedures and had to spend more on personal protective equipment and other pandemic-related services. Compensation by private payers remained stubbornly low at rural hospitals across the country during the pandemic, according to CHQPR. Finally, the Thomasville hospital's owners ran out of money, filed for bankruptcy, and shut it down. The hospital closure had an impact on the local economy. Businesses think twice about opening in a rural location without health care, Day says. And existing businesses that can't move, like farms who need lots of rural land, have to deal with sicker workers. How rural hospitals can succeed A new owner has bought the Thomasville hospital's assets out of bankruptcy, and Day says they plan to reopen the Thomasville hospital soon. He's hoping they can do things differently this time so that they can figure out a way to keep the rural hospital from losing money. One idea is to join a network with a big, urban hospital so they can more effectively negotiate reimbursement from insurers. Another is to create a network of rural hospitals that can band together to negotiate. And Day is hoping that Congress will act. One bill, the Rural Hospital Stabilization Act of 2025, was introduced in April and would give grants to rural hospitals to help them stay out of the red. U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has talked about being more proactive to prevent chronic diseases before they happen, and Day thinks the Thomasville hospital could play a role in that by making it easier for patients to get preventative care close to home. Day is already talking about using AI in the hospital and creating a medical campus to attract people from across the region, adding assisted living services and dementia care. Details are thin, and all of that takes money. But as a mayor who has seen a hospital close twice in his town, he hopes that, working with elected officials, he can figure out a way to change the hospital's fate this time. 'Every rural community in the country is facing this battle,' he says. 'But closing hospitals is not an option. If you don't have basic health care, you're going to kill your community.'
CBS News
an hour ago
- CBS News
Who qualifies for medical debt relief now?
We may receive commissions from some links to products on this page. Promotions are subject to availability and retailer terms. There are a few ways to have your medical debt forgiven now, but if you want to pursue these options, you'll have to qualify first. Getty Images Medical bills don't always arrive when you're prepared to deal with them. They tend to show up after a serious medical emergency, in the middle of a recovery from an injury or just when you're starting to feel financially stable again. And in today's economy, where budgets are stretched due to inflation, insurance doesn't always cover what you'd expect and medical costs keep rising, it's easier than ever to find yourself staring down a medical balance you can't afford to pay. Just ask the over 100 million Americans who owe a collective $220 billion in medical debt right now. And, according to recent surveys, tens of millions of people are either putting off necessary medical care due to the high cost or are turning to their borrowing options, like credit cards and personal loans, to cover their medical expenses. Millions of others have already fallen behind and are trying to avoid collections, wage garnishment or bankruptcy. But if you're dealing with your own unaffordable medical bills right now, the good news is that there may be more options than you'd think. From hospital-based programs to full-blown debt relief strategies, the options outlined below could help you get rid of your medical debt for good. The key is knowing which ones you qualify for and how to take the next step before the bills spiral out of control. Find out how you can start tackling your expensive medical debt today. Who qualifies for medical debt relief now? Struggling to pay off your medical debt? Here's who could qualify for medical debt relief today: Those who qualify for hospital charity care Hospital charity care offers the most direct path to medical debt relief for many people. Federal law requires that nonprofit hospitals — which account for nearly three-fifths (58%) of community hospitals — provide some level of charity care as a condition of receiving tax-exempt status, which means most hospitals must offer bill forgiveness or significant discounts to patients who meet their financial criteria. While it can vary by state, in general, households under 204% of the federal poverty level qualify for free care in 2025, and families under 322% qualify for discounted care. However, many hospitals are more generous with their assistance programs. For example, some will provide free or heavily discounted care to those with income that is at or below 200% and 300% of the federal poverty guidelines, though it depends on the hospital policy. To qualify, you will typically need to show documentation of your income and household size. Many hospitals will also consider patients with severe medical hardships, even if their income exceeds the standard guidelines. You should also know that if a patient qualifies for charity care, the law requires nonprofit hospitals to refund any payments that have already been made toward that bill, meaning you can apply even after paying part of what's owed. Learn more about the benefits of pursuing debt relief now. Those pursuing debt forgiveness For those who don't qualify for charity care or state programs, working with a debt relief company on debt forgiveness, also known as debt settlement, could offer another path to having your medical debt forgiven. During the debt settlement process, a debt relief expert will try to negotiate with your creditors to reduce your balances in return for lump-sum payments on the accounts. To qualify, though, you typically need to be behind on your payments, have at least $5,000 to $10,000 in unsecured debt and demonstrate an inability to repay the full amount. Taking this path can help reduce your medical debt significantly — often by 30% to 50% or more, depending on the creditor's flexibility — and it tends to suit people with multiple medical debts or those with debts that are near or already in collections. But while you can use this type of debt relief to try and reduce your medical debt, it comes with a few downsides. Your credit may take a hit due to late payments, for example, and the process takes months or years to complete. The fees debt relief companies charge can also eat into savings, so it's important to weigh all the factors before taking this route. Those filing for bankruptcy protection For those with overwhelming medical debt and limited income, filing for bankruptcy offers the most comprehensive relief option, as it wipes the slate clean of your medical debt and your other types of debt or reorganizes your debt to make it more affordable. There are two main types of bankruptcy for individuals: Chapter 7 and Chapter 13. Chapter 7 bankruptcy can eliminate most unsecured medical debt entirely. However, it requires passing a means test, showing your income is below your state's median income for your household size. If you don't qualify for Chapter 7, Chapter 13 requires regular income sufficient to make structured payments over three to five years. The main benefit of filing for bankruptcy is that it provides legal protection from creditors and can eliminate your medical debt in full. However, it also has serious long-term credit consequences, so it should be considered only after exploring other options. The bottom line Dealing with medical debt can be overwhelming, but it's important to remember that you're not powerless. There are real, actionable ways to get relief, whether you qualify for hospital charity care, pursue your debt settlement options or file for bankruptcy as a last resort. In order to deal with the issue, though, you'll want to act early, ask the right questions and choose the solution that best fits your financial situation. Doing that will help ensure you're on the right path to getting rid of your medical debt for good.
