Probably the safest solution is to get a basic domestic individual health insurance plan for the US and supplement it with one of the international plans such as those offered by insuremytrip. The domestic plan will cover the usual medical treatments in the US and the interntional plan will cover overseas treatment. Individual plans via bcbs are very expensive, at least $230 a month, so one of the state's subsidized medical plans would be more affordable. Therefore, which state plan do I get? Which international plan do I get? Can I cancel my travelplus insruance, which offers 100,000 evac insurance and get a prorated refund if the other medical plans offer suitable coverage? How does it work if both insurers offer coverage for the same thing?

Traveler's Emergency Network, provides emergency travel services, including $100,000 evacuation insurance for $129 annual individual membership. Limits trips to 90 days.
InsureMyTrip.com, quotes and comparisons of several travel and medical policies; very convenient.
MedicAlert, medical records for $40 1st yr, $25/yr after. For $129 get $100,000 emergency evacuation insurance, but the plan brochure has many exclusions and limits trips to 90 days--unfortunately this information is not spelled out on their website, meaning a big waste of money (very disappointed with lack of prior disclosure).

BCBS of MA individual plans

insuremytrip.com

Travel medical policies at insuremytrip.

Quotes below are for one year coverage $500,000 limit, MA residence, 38 yo, basic $250 deductible, hazardous and/or sports riders, quoted 13/10/2008.

Global Underwriters Diplomat America (Any Country - US Visit Only) $ 1,810.00
Global Underwriters Diplomat International (Any Country - No US Visit) $ 742.00
Global Underwriters Diplomat Long Term (Any Country - w/ US Visit) $ 1,678.00
Global Underwriters Diplomat Long Term (Any Country - No US Visit) $ 1,054.00
International Medical Group Patriot America (Non-US Citizens) $ 936.00
International Medical Group Patriot International (Overseas US Citizens) $ 588.00
MEDEX TravMed Choice (U.S.) $ 784.75
MultiNational Underwriters Atlas America (Non-US Citizens w/US Visit) $ 996.00
MultiNational Underwriters Atlas International (Any Country - No US Visit) $ 624.00
Seven Corners Liaison International (Any Country - w/US Visit) $ 1,168.00
Seven Corners Liaison International (Any Country - No US visit) $ 642.40

Global Underwriters is underwritten by AIG, which is given an "A" rating by insuremytrip--but as we've all heard, AIG is one of those banks that went belly up recently.

Most of the plans have 3-year exclusions for preexisting conditions. Also, what happens if I develop some major disease, like cancer, and need to return to the US for prolonged treatment? How do these plans fit in with HIPAA portability and preexisting condition limitations for continuous coverage when I end my trip and purchase regular health insurance? What if I'm injured in a terrorist attack, would that be excluded by plans--e.g., the old act of war exclusions for some types of insurance?

Travel Health Insurance Recommendations posted to lonely planet provides links to a couple of comparison sites: http://www.quotewright.com/ and http://www.ibackpack.co.uk/compare-backpacker-travel-insurance.htm..

Following these links, I checked out worldnomads.com travel insurance. their policy for the usa has so many exclusions i find it rather less than a proper insurance policy: they exclude, for instance, epidemics and terrorism. so what do i do if i'm traveling around and find myself in a cholera epidemic needing evacuation? or a victim of a terrorist attack needing evacuation? what do they care what the cause of my injury or sickness is, all they should care about are the relative risks, price these into the package, and offer coverage that actually insures me against all risks--possibly charging a rider to cover additional voluntarily assumed risks, such as caving, scuba diving, etc.

quotewright.com did not find any suitable medical evacuation policies covering a resident of massachusetts for a one-year trip. their plan summary for medical insurance is not as convenient as insuremytrip.com, where most of the relevant terms are displayed on a single results page. many of the plans are offered by the same companies, and many of the companies have excessive exclusions, such as exclusions for terrorism.

BCBS MA options

Access Blue Basic $2000ded $225/mo no coverage outside us
Preferred Blue PPO Basic $2000 $233/mo has coverage outside us

Mass Health Connector

Insurance for residents of MA--which now charges residents if they don't have medical insurance and provides low-cost insurance via Commonwealth Care. No information for services out of state and out of country.

http://www.mahealthconnector.org

Call 1-877-MA-ENROLL (1-877-623-6765) Monday - Friday 8 a.m. to 5 p.m.

commonwealth care with nhp seems to cover the most hospitals in mass.

the plans available via commonwealth choice are quite expensive starting at ~$200/mo and up.