What Happens When You Need Extended Care While Traveling?

Getting Care While You’re Traveling

Let’s hope it never happens. But let’s say you’re away from home on a trip or a vacation, and you suddenly fall ill or you’re injured in an accident. What happens next? How do you get extended care and how do you get home? Here’s what you should know.

What to Do If You Need Medical Help Out-of-State or Abroad

You need to get help right away. Call 911 (if you’re in the U.S.) or go to the nearest emergency room or hospital. Call an ambulance if you need it.

Keep in mind when it comes to emergency or urgent services:

• You don’t need a referral first from your primary care physician (PCP).
• You don’t need to use an in-network doctor.
• You can get covered emergency medical care whenever you need it, anywhere in the U.S. or its territories, and from any provider with a state license even if they aren’t part of our network.
• You can get covered emergency and urgent care services anywhere in the world.

What’s Covered If You Have a Medical Emergency?

A medical emergency is when you, or any person with an average knowledge of health and medicine, believes you have symptoms that need immediate medical attention to prevent:

• Loss of life
• Loss of a limb
• Loss of use of a limb
• Loss or serious impairment to a bodily function

The medical symptoms may be:

• An illness
• Injury
• Severe pain
• A medical condition quickly getting worse

If it turns out that it was not an emergency, as long as you reasonably thought your health was in serious danger, we’ll cover your care.

But after the doctor has said that it was not an emergency, the amount of cost sharing that you pay will depend on whether you get the care from network providers or out-of-network providers. If you get the care from network providers, your share of the costs will usually be lower than if you get the care from out-of-network providers.

What Braven Health Covers

Braven Health covers ambulance services in any situation where getting to the emergency room in any other way could endanger your health. We also cover medical services during the emergency and if you’re admitted to the hospital as an acute inpatient.

In-network and out-of-network, you pay a $95 copayment in 2023 for worldwide emergency care.

Your emergency or urgent care copayment is waived if you’re admitted to the hospital within 24 hours for the same condition for both in-network and out-of-network services.

What Happens If You Need Rehabilitation Services?

The doctors giving you emergency care will decide when your condition is stable and the medical emergency is over. After the emergency is over, you’re entitled to follow-up care to be sure your condition remains stable.

Your doctors will treat you until they contact Braven and make plans for additional care. Braven covers your follow-up care.

Your doctor will have had you admitted to the hospital as an inpatient for your extended care and rehab. You’ll pay the same hospital copayment whether you get this care in-network or out-of-network.

If you get your follow-up care from out-of-network providers after you’re discharged from the hospital, you may have to pay higher out-of-network cost-sharing amounts.

Going Back to New Jersey

If you need to be driven or airlifted back home after an illness or injury, Braven covers most of your cost. Whether in or out of network, in 2023 you’ll pay:

• A $250 copay (worldwide) for an emergency ground or air ambulance (one way)
• A $250 copay in-network for non-emergency ground or air ambulance (one way)
• 20% coinsurance out-of-network for non-emergency ground or air ambulance (one way)

Questions?

Take look at your Evidence of Coverage, or call Member Services at 1-833-272-8360 (TTY 711).