Did you know that visiting a country with government-funded health care doesn’t automatically entitle you to health care in that country? Usually, you still have to pay for health care, including in emergencies. One exception is if your country and your host country have a reciprocal healthcare agreement.
Imagine being able to leave your country and travel, confident that your emergency health care is covered at your destination — by the government. That is what a reciprocal health care agreement enables.
What are the details of reciprocal health care for travelers? How do you know if you have reciprocal health care at a travel destination? Here’s a guide to the basics of reciprocal health care.
Many countries provide publicly funded health care for their citizens. Some of these countries make essential health care available to citizens from other countries at low or no cost. That is a reciprocal health care agreement. It’s intended to be an exchange of public health care for the public good. Every reciprocal healthcare agreement is unique. In each case, the countries involved have negotiated the agreement.
A reciprocal healthcare agreement is limited to medically necessary care for emergencies and illnesses. Medically necessary care is care in emergencies or for illness or injury that must be treated immediately. The goal is to provide urgent health support for each others’ citizens as a public good.
Reciprocal health care has received more attention since the COVID-19 pandemic began. Because COVID-19 can be life-threatening or severe, its treatment is often considered medically necessary. COVID-19 treatment and vaccination are covered under many reciprocal healthcare agreements.
Reciprocal healthcare has important limits. It is not complete medical care – it only covers urgent medical problems for travelers. It also does not cover:
To qualify for reciprocal care, you may also need to prove that your stay in your host country is temporary. ‘’Temporary” is often defined as less than six months. Longer-term visitors, such as digital nomads, may be in a country for a longer time. This may create a gap in their care eligibility for reciprocal care.
In addition, not all types of health care are publicly funded in all countries. And if it’s not funded, you can’t receive that care under a reciprocal health care agreement: it’s not available to receive. For example, medical care that is funded in the UK, such as dental care, may not be funded in the reciprocal countries of New Zealand and Australia.
Because of these limitations around reciprocal health care, visitors and travelers still need travel health insurance.
No, the United States does not have reciprocal healthcare agreements, not even with allies like the United Kingdom. Why? The United States government does not provide healthcare for its own citizens, such as doctors or hospitals. This means the United States government does not have the services available to participate in a reciprocal healthcare agreement.
The United States provides some health insurance that citizens can apply for through the Affordable Care Act and Medicare. However, this is not available to international visitors.
This lack means that visitors to the United States urgently need to have travel health insurance. Health care in the United States is of good quality, but it is extremely expensive, even for U.S. citizens. You can expect to pay at the time of service or when you are discharged from a hospital.
Canada does not have reciprocal health care agreements. Canada does have a publicly funded healthcare system. Each of Canada’s provinces has its own independent health system. At this time, Canada has not negotiated international agreements for reciprocal healthcare due to the challenges around coordinating this for provinces.
Visitors to Canada also need to have travel health insurance. Again, Canadian health care is good quality but expensive.
This list notes major countries that share reciprocal healthcare through agreements. Countries with public health care systems and strong ties to other countries often negotiate these.
If you are traveling and you have an emergency, you can go to a hospital or clinic and request emergency care. You will have to prove that you are eligible for reciprocal health care. This can include:
Make sure your own travel documentation is organized and easy to find. If you are traveling with a companion, make sure you can provide this information for each other in case of emergency. Check the links provided here for what is required to get reciprocal health care in different countries.
It’s a privilege to travel with reciprocal health care available. The limits of reciprocal health care mean that you will still want travel health insurance: for complete coverage, for a longer stay, and for peace of mind.
