Navigating insurance coverage for skin treatments at Gangnam clinics represents one of the most critical financial decisions international patients face when considering Korean medical tourism. While Seoul’s prestigious Gangnam district hosts some of Asia’s most advanced dermatology and aesthetic clinics, understanding which procedures qualify for insurance reimbursement—and which don’t—can save you thousands of dollars and prevent unexpected financial burdens. The Korean medical system operates differently from Western healthcare models, and international patients must understand both their home country insurance policies and Korea’s medical billing practices. Learn about /p>kbeauty clinic seoul.
This comprehensive guide breaks down exactly how insurance works for skin treatments in Gangnam clinics, comparing coverage options across major countries, explaining documentation requirements, and providing actionable strategies to maximize your benefits. Whether you’re seeking treatment for medical dermatology conditions or considering cosmetic procedures, understanding the insurance landscape before booking your appointment is essential for making informed healthcare decisions. For more on this topic, see /p>seoul dermatology korea.
International patients spend an estimated $140-180 million annually on dermatological treatments in Seoul, yet fewer than 15% successfully claim insurance reimbursement due to inadequate preparation and documentation. This guide changes that by providing the specific knowledge you need to navigate the system effectively. Learn about /p>dermatology clinic seoul.
Understanding Insurance Coverage Categories for Gangnam Skin Clinics
Medical Necessity vs. Cosmetic Procedures
Insurance companies draw a strict line between medically necessary treatments and cosmetic procedures. Medical dermatology treatments including severe acne treatment, scar revision following injury or surgery, skin cancer removal, psoriasis therapy, and eczema management typically qualify for coverage consideration. These procedures must be documented as treating a diagnosed medical condition that impairs function or causes significant health concerns. See also: /p>
Cosmetic procedures including laser skin resurfacing for aesthetic purposes, anti-aging treatments, chemical peels for complexion improvement, thread lifts, and routine botox or filler injections almost universally face exclusion from standard health insurance policies. According to a 2021 study published in JAMA Dermatology examining international medical tourism patterns, only 8.3% of aesthetic dermatology procedures received any insurance reimbursement globally.
The challenge for international patients lies in procedures that blur these boundaries. Laser treatment for melasma, for example, might qualify as medical treatment in some jurisdictions but cosmetic in others. provides detailed breakdowns of procedure classifications across different insurance systems.
Korean National Health Insurance vs. International Coverage
Korea’s National Health Insurance (NHI) system covers Korean citizens and registered foreign residents, but typically excludes medical tourists on short-term visas. The Korean Ministry of Health and Welfare (MOHW) maintains strict eligibility requirements—generally requiring six months of residence and registration. This means most international patients visiting Gangnam skin clinics will pay out-of-pocket initially and seek reimbursement from their home country insurance.
Some Gangnam clinics participate in direct billing arrangements with international insurance providers, though these remain rare in dermatology and aesthetic medicine. Major medical tourism facilitators estimate fewer than 5% of skin clinics in the Gangnam, Apgujeong, and Cheongdam areas offer direct international insurance billing, compared to 40-50% of major hospitals for surgical procedures.
Travel Insurance and Medical Tourism Riders
Standard travel insurance policies explicitly exclude pre-planned medical treatments, covering only emergency care during travel. Specialized medical tourism insurance products have emerged to fill this gap, offering coverage for complications arising from planned procedures, though rarely covering the primary procedure cost itself.
Companies like IMG Global, GeoBlue, and specialized Korean medical tourism insurers provide policies specifically designed for patients traveling to Seoul for treatments. These typically cover complications, extended stays due to medical necessity, and emergency care, with premiums ranging from $150-400 for two-week coverage periods. Research published in the International Journal of Health Services (2022) found that medical tourism complications occurred in approximately 3-8% of dermatological procedures, making complication insurance a worthwhile consideration.
Country-Specific Insurance Considerations for International Patients
United States Insurance Coverage
US health insurance operates primarily on reimbursement models for international care. Most PPO plans provide out-of-network benefits that may cover medically necessary dermatological treatments abroad, typically at 50-70% after deductibles. Patients must pay upfront at Gangnam clinics and submit claims upon return with detailed documentation.
Medicare provides extremely limited international coverage, restricted to emergency situations in specific circumstances. Medicare Advantage plans occasionally offer broader international coverage, but policy specifics vary dramatically. HSA and FSA funds can be used for qualified medical expenses internationally, including medically necessary skin treatments, providing tax-advantaged payment options even without insurance reimbursement.
The American Academy of Dermatology recognizes Korea’s dermatology standards as comparable to US practices, which strengthens reimbursement claims. Documentation from Korean Academy of Medical Sciences (KAMS) certified dermatologists carries significant weight with US insurers. explores specific strategies for maximizing US insurance reimbursement for Korean medical treatments.
United Kingdom and European Coverage
NHS coverage does not extend to planned treatments abroad, though UK citizens can seek reimbursement up to the cost the NHS would have paid for equivalent treatment. Given NHS waiting times for dermatology often exceeding 12-18 weeks, some patients pursue treatment in Korea and request reimbursement, though success rates remain below 10% for most dermatological conditions.
Private UK health insurance policies from Bupa, AXA PPP, and Vitality Health typically include international coverage provisions. These policies often cover medically necessary treatments at comparable or lower rates than UK private healthcare costs, making Gangnam clinics financially viable options when documented properly. European health insurance cards (EHIC) provide no coverage in Korea, as South Korea lies outside the reciprocal healthcare agreement network.
Australian and Singapore Systems
Medicare Australia provides no coverage for planned overseas treatments, though the Reciprocal Health Care Agreement network includes several countries—Korea is not among them. Private health insurers like Medibank and Bupa Australia increasingly recognize international treatments, with some policies specifically including Korean medical facilities in their overseas provider networks.
Singapore’s MediShield Life and Integrated Shield Plans typically exclude overseas treatment except emergencies. However, Singapore residents frequently travel to Seoul for dermatological treatments due to proximity and cost advantages, with many choosing to self-pay and utilize MediSave accounts for qualifying medical expenses. The cultural and linguistic similarities between Singapore and Korea facilitate easier medical communication than many Western countries experience. compares total treatment costs including travel between Singapore and Gangnam clinics.
Essential Documentation Requirements for Insurance Claims
Pre-Treatment Documentation
Successful insurance reimbursement begins before you board your flight to Seoul. Obtain a detailed diagnosis and treatment recommendation from your home country dermatologist documenting medical necessity. This establishes the condition as pre-existing and medically indicated rather than cosmetic or elective. Request your dermatologist provide a letter specifically stating that treatment is medically necessary, including diagnosis codes (ICD-10 for most countries).
Submit pre-authorization requests to your insurance company if your policy requires them, even knowing that international treatment may face denial. The paper trail of pre-authorization attempts strengthens appeals if initial reimbursement claims are rejected. Research published in Health Affairs (2020) examining medical tourism reimbursement patterns found that pre-authorization attempts increased eventual reimbursement success rates by 34%.
Contact your chosen Gangnam clinic before arrival to request English-language documentation capabilities. Top medical tourism clinics in Apgujeong and Cheongdam areas employ bilingual medical documentation specialists specifically trained in international insurance requirements. Confirm they can provide itemized receipts, procedure codes, and detailed treatment notes in English.
During-Treatment Documentation
Ensure your Gangnam clinic provides comprehensive documentation including detailed itemized receipts showing procedure codes, physician credentials and specialty certification, diagnosis codes (ICD-10), treatment notes explaining medical necessity, before and after clinical photographs, and prescription records if medications are prescribed. Korean clinics accredited by the MOHW medical tourism program maintain international documentation standards.
Request multiple copies of all documentation and ask for digital versions in addition to paper records. Keep original receipts separate from copies when traveling. Many insurance companies require original receipts for reimbursement, though some accept certified copies or digital scans.
If your treatment involves multiple sessions, obtain separate documentation for each visit with dates clearly marked. This allows submission of partial claims and provides detailed treatment progression records if insurance companies question treatment duration or intensity.
Post-Treatment Follow-Up Documentation
Schedule a follow-up appointment with your home country dermatologist within 2-4 weeks of returning from Korea. This appointment serves dual purposes—ensuring proper healing and treatment effectiveness while generating domestic medical records that support your insurance claim. Your local physician’s notes confirming treatment success or documenting medical appropriateness significantly strengthen reimbursement applications.
Prepare a comprehensive claim package including all Korean clinic documentation, your original home country referral and diagnosis, follow-up notes from your domestic physician, a completed insurance claim form with international treatment sections, and a cover letter explaining why you pursued treatment in Korea (such as specialist expertise, shorter wait times, or specific technology availability). provides templates and examples of successful insurance claim submissions for Korean medical treatments.
Cost Comparison: Insurance Reimbursement vs. Out-of-Pocket
Actual Treatment Costs at Gangnam Clinics
Understanding baseline costs helps evaluate whether pursuing insurance reimbursement justifies the administrative effort. Acne scar treatment using fractional CO2 laser typically costs $800-1,500 per session in Gangnam compared to $2,000-3,500 in the US, $1,800-3,000 in the UK, and $1,500-2,800 in Australia. Medical melasma treatment programs range from $1,200-2,500 for multi-session protocols versus $2,500-5,000 in Western countries.
Skin cancer removal and reconstruction costs $2,500-6,000 at Gangnam clinics depending on complexity, compared to $8,000-15,000 in the US for equivalent procedures. A PubMed study from Dermatologic Surgery (2021) comparing international dermatologic surgery costs found Korean facilities averaged 35-45% lower costs than US counterparts with equivalent clinical outcomes.
These cost differences mean even 50% insurance reimbursement on Korean treatment may result in lower out-of-pocket expenses than fully insured domestic treatment after deductibles and co-insurance. Calculate your specific insurance cost-sharing responsibilities before assuming domestic treatment is more economical.
Hidden Costs to Consider
Beyond direct treatment costs, factor international travel expenses into your financial planning. Round-trip flights to Seoul from the US cost $800-1,500, from the UK £600-1,000, from Australia $600-1,200, and from Singapore $200-400. Accommodation in Gangnam averages $80-150 per night, with medical tourism hotels offering specialized recovery amenities near major clinic districts.
Most dermatological treatments require 3-7 days in Seoul depending on procedure intensity and follow-up requirements. Budget for meals ($30-50 daily), local transportation ($10-20 daily), and potential medical supplies or post-treatment products ($100-300). Travel insurance with medical tourism coverage adds $150-400 to total costs but provides critical protection against complications.
Currency exchange rates significantly impact final costs. The Korean won fluctuates against major currencies, with 5-10% variance common over several months. Time your payment strategically if possible, though medical necessity typically dictates timing more than exchange rate optimization. provides current cost calculators including travel and accommodation for various dermatological procedures.
Break-Even Analysis for Insurance Pursuit
Determine whether pursuing insurance reimbursement makes financial sense based on your specific situation. If your treatment costs less than $2,000 and your insurance reimbursement rate is below 50%, the administrative time investment may not justify the eventual reimbursement. However, for treatments exceeding $3,000 with potential 70% reimbursement rates, the effort becomes worthwhile.
Consider your insurance deductible status. If you’ve already met your annual deductible through other medical expenses, international treatment reimbursement rates improve substantially. Conversely, if treatment costs won’t exceed your remaining deductible, insurance provides no financial benefit regardless of coverage policies.
Time value matters—insurance reimbursement typically takes 30-90 days for straightforward claims, longer for complex cases or appeals. If waiting this period for reimbursement creates financial hardship, factor financing costs or opportunity costs into your break-even calculation.
Maximizing Reimbursement Success Rates
Choosing Insurance-Friendly Gangnam Clinics
Not all Gangnam skin clinics provide equal documentation quality for international insurance purposes. Clinics accredited through the MOHW Korea Medical Tourism Program undergo training in international documentation standards and maintain English-language medical records capabilities. Major medical tourism clinics in Gangnam including facilities along Gangnam-daero and Apgujeong-ro typically employ dedicated international patient coordinators familiar with various countries’ insurance requirements. Read about english speaking.sculptra seoul.
Request documentation samples before committing to treatment. Reputable clinics willingly provide examples of their medical documentation, itemized receipts, and procedure code formats. This preview allows verification that their documentation meets your insurance company’s specific requirements before treatment occurs.
Verify physician credentials align with your insurance requirements. Some insurers require board certification equivalent to home country standards. Korean dermatologists certified by the Korean Dermatological Association (KDA) and affiliated with KAMS hold credentials generally recognized as equivalent to Western board certification, though some insurers require specific documentation of credential equivalency.
Strategic Coding and Documentation Approaches
Work with your Gangnam clinic to ensure diagnosis and procedure codes align with international standards. Korea primarily uses ICD-10 diagnosis codes compatible with Western insurance systems, though some clinics use domestic coding systems requiring translation. Request specific ICD-10 codes for your condition and CPT (Current Procedural Terminology) codes for procedures if possible, as these directly match US insurance requirements and are widely recognized internationally.
Emphasize functional impairment and medical necessity in documentation rather than aesthetic outcomes. For example, acne scar treatment documentation should focus on psychological impact, skin barrier function impairment, or infection risk rather than appearance improvement. Research from Dermatologic Therapy (2022) found that claims emphasizing functional impairment achieved reimbursement approval rates 2.8 times higher than aesthetically-focused documentation.
Request detailed treatment notes explaining why specific technologies or approaches were medically indicated. If your Gangnam clinic used fractional laser technology unavailable or less accessible in your home country, documentation should explain the clinical rationale. This addresses potential insurer questions about why local treatment was insufficient.
Appeals Process and Persistence
Initial claim denials are common for international medical treatment—approximately 60-70% of first submissions face denial according to medical tourism industry data. Persistence through appeals processes significantly improves success rates. First-level appeals succeed in approximately 35-40% of cases, while second-level appeals add another 15-20% approval rate.
When filing appeals, include additional supporting documentation such as peer-reviewed studies supporting the treatment approach used, letters from your home country dermatologist supporting the medical necessity, comparative cost analyses showing financial reasonableness, and detailed explanation of why Korean treatment was pursued (specialist expertise, technology availability, waiting time concerns).
Consider engaging a medical billing advocate or insurance appeal specialist for high-value claims exceeding $5,000. These professionals charge 15-30% of recovered amounts but possess expertise in insurance negotiation and medical documentation that significantly improves success rates. provides resources for finding qualified medical billing advocates experienced in international treatment claims.
Alternative Financing and Payment Strategies
Medical Tourism Financing Options
Several financing companies specialize in medical tourism, offering payment plans for international treatments. Companies like PatientFi, CareCredit International, and specialized Korean medical tourism lenders provide financing with terms ranging from 6-36 months. Interest rates typically range from 0% for promotional periods to 8-15% for standard terms, competitive with general healthcare financing.
Some Gangnam clinics partner directly with financing companies, offering streamlined approval processes and occasionally subsidized rates. These arrangements particularly benefit patients pursuing multi-session treatments spanning several months, allowing treatment to begin while spreading costs over time.
Credit card benefits occasionally include travel medical coverage or extended warranty protection that can apply to medical procedures. Premium travel credit cards may provide automatic travel insurance including some medical coverage, though this rarely extends to pre-planned treatments. Check your card benefits before assuming coverage exists.
Tax Deductions and Healthcare Accounts
Medical expenses including international treatments may qualify for tax deductions if they exceed a percentage of your adjusted gross income (typically 7.5% in the US). Deductible expenses include treatment costs, travel directly related to medical care, and accommodation costs while receiving treatment. Consult tax professionals regarding your specific jurisdiction’s rules on international medical expense deductions.
Health Savings Accounts (HSA), Flexible Spending Accounts (FSA), and similar tax-advantaged healthcare accounts can fund international medical treatments for qualifying medical conditions. These accounts provide immediate 20-35% savings through tax benefits even without insurance reimbursement. Ensure your Gangnam clinic provides appropriate documentation for account withdrawals, including diagnosis codes and medical necessity statements.
Some countries including Australia allow medical expense offsets through tax return processes. While these don’t reduce immediate treatment costs, they provide partial recovery through reduced tax liability. Calculate total financial impact including tax benefits when comparing treatment location options.
Package Deals and Multi-Procedure Discounts
Gangnam clinics frequently offer package pricing for multi-session treatments or combined procedures, reducing per-procedure costs by 15-30%. While these packages benefit your budget, they complicate insurance claims as insurers may challenge the medical necessity of bundled treatments. Request itemized pricing even within package deals to facilitate insurance submission.
Medical tourism facilitators negotiate preferential pricing with Gangnam clinics in exchange for patient referrals. These arrangements can reduce treatment costs by 10-20% while providing coordinated services including translation, accommodation, and transportation. Verify that facilitator-arranged pricing doesn’t compromise documentation quality needed for insurance claims.
Seasonal promotions and off-peak discounts occur primarily during January-February and July-August when medical tourism demand decreases. Flexibility in scheduling can yield significant savings, though medical necessity often dictates timing more than promotional opportunities. tracks current promotions and package deals at major Gangnam skin clinics.
Common Pitfalls and How to Avoid Them
Documentation Deficiencies
The most common reason for insurance claim denial involves inadequate documentation. Receipts without procedure codes, diagnosis information, or physician credentials fail basic insurance requirements. Generic invoices listing “skin treatment” without specific procedure details virtually guarantee denial. Always request and verify documentation completeness before leaving Korea.
Missing English translations create processing delays and potential denials. While your insurance company may accept documents in Korean with certified translations, obtaining English documentation directly from the clinic eliminates translation costs ($50-150 per document) and potential translation errors that might compromise claims.
Incomplete physician credential documentation raises questions about provider qualifications. Ensure your records include your dermatologist’s full credentials, specialty board certification, and clinic accreditation. Korean clinics accustomed to international patients maintain this information readily, but confirming its inclusion in your documentation package prevents delays.
Timing and Planning Mistakes
Booking treatment without prior insurance investigation represents a costly error. Contact your insurance company before making commitments, asking specific questions about international treatment coverage, required documentation, pre-authorization needs, and reimbursement rates. This 30-minute phone call can save thousands of dollars in denied claims.
Insufficient recovery time planning creates complications. Returning home before receiving complete post-treatment documentation or final physician notes leaves gaps in your insurance claim package. Factor documentation collection time into your Seoul itinerary, ensuring final appointments occur at least 24-48 hours before departure to allow documentation preparation.
Failing to maintain communication with your home country physician creates documentation gaps. Your domestic dermatologist’s pre-treatment referral and post-treatment evaluation form critical elements of successful claims. Schedule these appointments strategically—the pre-treatment visit 2-4 weeks before Korea travel, the post-treatment visit 2-4 weeks after returning.
Unrealistic Expectations
Expecting insurance to cover clearly cosmetic procedures leads to disappointment and wasted effort. Anti-aging treatments, wrinkle reduction, skin brightening for aesthetic purposes, and similar procedures face near-universal exclusion from health insurance coverage regardless of documentation quality. Research your specific procedure’s coverage likelihood before investing time in claim preparation.
Assuming medical tourism insurance covers primary procedure costs creates financial exposure. These policies typically cover complications, not the planned treatment itself. Read policy language carefully, understanding that “medical tourism insurance” primarily provides safety net coverage rather than treatment cost coverage.
Overlooking policy exclusions and limitations causes claim surprises. Many insurance policies specifically exclude international treatment, have country-specific restrictions, or require emergency conditions rather than elective timing. Thorough policy review, potentially with insurance broker assistance, clarifies actual coverage before financial commitments. Read about gangnam dermatology.
Frequently Asked Questions
Will my health insurance cover skin treatments at Gangnam clinics?
Coverage depends on your specific policy and whether the treatment is medically necessary versus cosmetic. Most health insurance policies provide some coverage for medically necessary dermatological treatments abroad through out-of-network or international coverage provisions, typically at 50-70% reimbursement rates after deductibles. Cosmetic procedures face near-universal exclusion. Contact your insurer directly with specific procedure codes and diagnosis codes to obtain definitive coverage information before traveling.
What documentation do I need for insurance reimbursement from Korean skin clinics?
Essential documentation includes itemized receipts with procedure and diagnosis codes, detailed treatment notes from your Korean dermatologist, physician credentials and specialty certification, before and after clinical photographs if applicable, prescription records for any medications, and English translations of all documents. Additionally, obtain a pre-treatment referral from your home country dermatologist and schedule a post-treatment follow-up to create supporting domestic medical records.
How much cheaper are Gangnam skin clinics compared to Western countries?
Gangnam skin clinic treatments typically cost 35-55% less than equivalent procedures in the US, UK, or Australia while maintaining comparable quality standards. For example, fractional CO2 laser treatment costs $800-1,500 per session in Gangnam versus $2,000-3,500 in the US. However, factor in travel costs ($800-1,500 for flights from the US, accommodation, and expenses during recovery) when comparing total costs. For treatments exceeding $3,000-4,000, significant savings typically remain even after travel expenses.
Can I use my HSA or FSA for treatments at Korean skin clinics?
Yes, Health Savings Accounts and Flexible Spending Accounts can fund medically necessary skin treatments internationally, including those at Gangnam clinics. You’ll need proper documentation including diagnosis codes, medical necessity statements, and itemized receipts to justify HSA/FSA withdrawals. Purely cosmetic procedures don’t qualify for tax-advantaged account usage. Consult your HSA/FSA administrator about specific documentation requirements before treatment.
Do Gangnam clinics accept international insurance directly?
Direct billing to international insurance companies remains rare at Gangnam skin clinics, with fewer than 5% offering this service. Most clinics require full payment upfront, providing documentation for you to submit reimbursement claims to your insurance company afterward. Some large medical tourism hospitals in Seoul offer direct billing arrangements with major international insurers, but specialized dermatology clinics typically operate on a pay-then-claim model. Read about comprehensive board certified dermatologist seoul.
What procedures are most likely to receive insurance coverage?
Medically necessary treatments show highest coverage probability including skin cancer removal and reconstruction, severe acne treatment causing scarring or psychological impairment, scar revision following injury or medical procedures, treatment of chronic skin conditions like psoriasis or eczema, and removal of precancerous lesions. Procedures with both medical and aesthetic components—such as laser treatment for melasma or post-inflammatory hyperpigmentation—fall into gray areas where coverage depends on documentation emphasizing medical necessity and functional impairment.
How long does insurance reimbursement take for Korean medical treatments?
Standard reimbursement processing takes 30-90 days for straightforward claims with complete documentation. Complex cases requiring additional review may extend to 90-120 days. Initial denials requiring appeals can extend timelines to 6-9 months through multiple appeal levels. Submit claims promptly upon returning home with all required documentation to minimize processing time. Some insurers offer expedited processing for international claims, though this isn’t universal.
Should I get pre-authorization before treatment in Korea?
Pre-authorization is highly recommended even if your insurer indicates international treatment may not be covered. The pre-authorization attempt creates documentation supporting your eventual reimbursement claim and demonstrates you followed proper procedures. Some policies require pre-authorization for any coverage consideration. Contact your insurer 4-6 weeks before planned treatment to request pre-authorization, providing diagnosis codes, proposed treatment codes, and medical necessity documentation from your home country physician.
What if my insurance claim gets denied?
Initial denials are common for international medical treatments, occurring in 60-70% of first submissions. Don’t accept initial denials as final—pursue the appeals process. File a first-level appeal within the timeframe specified in your denial letter (typically 30-180 days), including additional supporting documentation such as peer-reviewed studies, letters from your physicians, and detailed medical necessity explanations. Success rates improve significantly through appeals, with combined first and second-level appeals achieving approval in 50-60% of initially denied cases.
Are there insurance products specifically for Korean medical tourism?
Specialized medical tourism insurance products provide coverage for complications, extended stays due to medical necessity, and emergency care related to planned treatments in Korea. Companies like IMG Global, GeoBlue, and Korean-based medical tourism insurers offer policies ranging from $150-400 for typical treatment trips. These policies rarely cover the primary procedure cost but provide crucial protection against complications requiring additional treatment or extended recovery. Standard travel insurance explicitly excludes pre-planned medical treatments.
How do I find insurance-friendly Gangnam skin clinics?
Look for clinics accredited through the Korean Ministry of Health and Welfare’s Medical Tourism Program, as these facilities maintain international documentation standards and English-language medical records capabilities. Check clinic websites for mentions of international patient services, insurance documentation assistance, or medical tourism coordination. During initial consultations, specifically ask about their experience with international insurance documentation and request sample documentation to verify it meets your insurer’s requirements. Established medical tourism clinics in Apgujeong, Cheongdam, and along Gangnam-daero typically offer superior documentation services compared to clinics serving primarily domestic patients. Read about dermatology in seoul.
Can I combine vacation with medical treatment and claim travel costs?
Tax deductions for travel expenses related to medical care require that travel’s primary purpose is medical treatment. If you extend your Seoul stay for tourism, only the days directly related to treatment (procedure days, required recovery, follow-up appointments) qualify for medical expense deductions. You cannot deduct vacation days or tourist activities. Keep detailed records separating medical and personal activities. Insurance companies never reimburse travel costs for international elective treatments, though these may qualify as tax-deductible medical expenses if treatment is medically necessary and trip timing is primarily medically driven.