Insurance Plan Cover While Traveling: Travel is a priority for many retirees. You finally have the time to visit those once-in-a-lifetime exotic destinations you dreamed about during your working years. But will your medicare advantage health insurance give you coverage on a cruise ship, or in a foreign country?
If you’re covered by Medicare, however, you may have questions about your health care coverage if you leave the United States. Here’s what you need to know about foreign travel with Medicare.
If you’re enrolled in Part A and Part B, the short answer is “no.” Original Medicare doesn’t pay for any medical treatment, even emergency care, if you’re traveling outside the country, except in extraordinarily narrow circumstances.
For example, if you’re traveling between Alaska and the lower 49 and you have a medical emergency, Medicare will cover emergency treatment at the closest hospital. Medicare may pay for emergency a Canadian hospital if it’s closer than a U.S. one. It may also cover you if you’re on a cruise and less than six hours from a U.S. port or are in U.S. territorial waters.
Other than that, your Medicare coverage ends when you leave the U.S. and you should plan accordingly. For example, make sure that you bring all of the prescriptions that you will need during your trip and bring them in your carry-on. If your checked luggage is lost, replacement medicines will not be covered by your prescription drug plan.
If you have a Medicare Supplement Plan, you may have some coverage for foreign travel emergencies. Medigap plans C, D, F, G, and N will pay for some of your care if you have an emergency outside the U.S. You have a $250 deductible and the plan pays 80% up to a lifetime maximum of $50,000.
Keep in mind, foreign hospitals aren’t required to bill your Medigap plan, so you may be on the hook for the full cost of your care at the time of service. When you return home, you can file a claim for reimbursement with your Medigap plan.
Medicare Advantage is private insurance; benefits are determined by the insurance company offering the plan. Many Medicare Advantage plans do pay for emergency medical care outside the U.S., but there may be restrictions and coinsurance amounts. If you have a Medicare Advantage plan, read your plan booklet carefully before you head overseas so you know how your coverage works.
It’s important to understand what Medicare considers emergency care before you seek treatment in a foreign hospital or an urgent care center. If you are in imminent danger of losing your life or a limb, you qualify for emergency care under Medicare definitions. This means things like stroke or heart attack symptoms, a serious accident, or severe viral or bacterial infection would potentially qualify for coverage under your Medigap or Medicare Advantage plan.
Minor illnesses and injuries—things such as a fever, cough, or minor injury—typically aren’t covered. If you seek medical care for a non-emergent issue, your plan likely won’t pay.
It’s generally a good idea to supplement your Medicare coverage with short-term travel insurance. Most travel insurance policies pay for things such as medical evacuation by air ambulance and emergency medical care, and they also pay for trip cancellation or interruption due to illness or injury. They also cover other travel “emergencies” such as canceled flights, lost luggage, damage to your rental car, and the cost of your vacation if your travel provider goes bankrupt.
If you travel frequently in the U.S. or U.S. territories such as Puerto Rico, Gaum, or the U.S. Virgin Islands, Original Medicare with a Medigap supplement may be your best bet. When you have Part A and Part B, you can see any provider in the country that accepts Medicare. That means you can get both routine and emergency care when you travel and know your treatment is covered.
Most Medicare Advantage plans use a provider network, which means you only get full coverage when you see providers within your plan’s service area. Plans may still cover you when you leave your plan’s service area, but your coinsurance rates may be higher.
If you travel overseas, your health coverage under both Medigap and Medicare Advantage is limited to emergency care only.
If you need more help understanding your travel coverage with Medicare, or want to explore your Medicare plan options, contact a licensed Medicare plan specialist at O’Neal Insurance Group today for a free consultation.