When people reach their senior years, many have visions of traveling and relaxing. Especially upon retirement, you may have planned an extended vacation outside of the United States.
But now you are on Medicare and have purchased a Medicare Advantage plan. What happens if you need medical help while outside the country? Will the Medicare Advantage plan cover any medical expenses you have while traveling abroad?
This article will detail how Medicare Advantage coverage for foreign travel works as well as travel domestically.
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Medicare Coverage for Foreign Travel
Before jumping into Medicare Advantage plans, does original Medicare coverage by itself cover health expenses while traveling overseas?
Original Medicare doesn’t cover medical services outside the United States and territories, unless:
- You are traveling between Alaska and another state and have a medical emergency that must be treated in Canada.
- If you have a medical emergency while in the US and territories, but the nearest hospital is in a foreign country. An example would be somewhere near the Mexican or Canadian border but the closest hospital is in one of these countries.
- If you are on a ship, such as a cruise ship, need medical services and are within 6 hours of a U.S. port.
Medicare Advantage Coverage for Foreign Travel
Medicare Advantage plans are subject to medical providers willing to accept the coverage. This generally means you must be in-network to receive maximum coverage under this plan. If you are traveling outside the US, you will be out-of-network.
Most Medicare Advantage plans will follow the rules established by Original Medicare. They will only cover the exceptions listed above.
You need to check with your current Medicare Advantage plan to see how they cover foreign travel. Some may offer this coverage, but the way the services are paid can vary. When you are outside the U.S., many doctors and hospitals will require you to pay up front before beginning treatment.
Even if your Medicare Advantage plan provides coverage, you need to make sure that you keep careful records of everything spent outside the US. Having good records will help with reimbursements when you head home. You will have to submit that information to your carrier when you return to the US. Without submitting this information, you will not receive any potential reimbursement from your insurance company.
Timing is everything with Medicare Advantage foreign travel coverage.
Assuming your plan does cover foreign travel, you need to notify your company to activate coverage. Don’t wait until the day before the trip to contact your carrier. You will need to give several weeks’ notice, if not months to notify the carrier. Most carriers will then provide you with information on how claims and reimbursements will work if you need medical care while traveling.
If you travel outside the plan’s service area for more than 6 months at a time, you may be disenrolled from the plan automatically. This applies whether you are traveling domestically or internationally. There are some plans that do allow more travel and the ability to keep your policy.
Does Medicare Advantage cover domestic travel?
Medicare Advantage plans are not as portable as Medicare Supplement policies. Medicare Supplement plans are always portable, but your premium rate may change if you move. Medicare Advantage plans are not Medicare Supplement plans. Portable means whether you can take your policy and find coverage outside of your normal service area.
The portability of your Medicare Advantage plan really depends on the plan and the company you have.
Medicare Advantage policies are identified by different plan types and how the networks work. Some plans offer benefits that are much more restrictive when you get outside of the network.
Here are some general rules of thumbs based on plan type:
Health Maintenance Organization plans are the cheapest Advantage plans and only allow you to see in-network doctors with referrals needed.
This is the HMO Point of Service Plan. The plan requires a referral from your primary care physician (PCP) like a traditional HMO. However, you can see out-of-network doctors if they are willing to accept the coverage, but with higher cost sharing responsibilities.
Preferred Provider Organization plans are similar to HMO-POS as you can see out-of-network doctors willing to accept the coverage, but no referrals necessary.
Private- Fee-For-Service plans allow providers outside of your network an option to accept the terms and conditions of your Medicare Advantage plan. These plans are more flexible for travel and broaden your network of doctors, but tend to have a higher monthly premium.
Many seniors will reside permanently in a Northern state, but travel to Florida during the winter. Companies recognize this dynamic and have adapted what many of their Medicare Advantage cover. For example, some companies have a Passport feature that allows you to split time in multiple states and still be covered.
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Is foreign travel covered by my Medigap plan?
If you travel in your senior years, and want a solid guarantee on foreign travel coverage, you should consider a Medicare Supplement option.
Some Medigap or Medicare Supplement policies will cover emergencies if you are traveling abroad. If you need medical care during the first 60 days of your trip. This timeframe is generous, but there will be costs to you. You will pay a $250 deductible and 20% of the cost of the treatment.
You must have a Medicare Supplement labeled Plan C, D, F, G, M, or N to receive this coverage.
Foreign travel emergency coverage with Medicare Supplement policies do have a lifetime limit of $50,000. This applies to all plans that offer foreign travel emergency coverage.
There are 3 states where the normal Medicare Supplement plans do not apply: Massachusetts, Minnesota, and Wisconsin.
- Massachusetts: If you purchase the state’s Supplement 1 plan, you have foreign travel emergency coverage
- Minnesota: The Extended Basic plan offers 80% of medical care if you are in a foreign country.
- Wisconsin: Some of the insurance carriers will offer this coverage as a rider to your policy. If you are Wisconsin, one of our agents can determine if the carrier has this option for you.
Prescription Drug Coverage (Part D)
Benefits Outside the US under Medicare
Medicare Part D, or Medicare prescription drug coverage, also may have restrictions for use internationally.
Because Part D plans under Medicare are written through private insurance companies, you need to check with the carrier you have coverage with. This is something you should consider when buying a Medicare Part D plan. If you plan on foreign travel, make sure to talk with one of our agents prior to purchasing a plan.
Our agents can provide options with companies that have limited restrictions on using the plan internationally. If you don’t know what your current plan offers, and this is a concern, we can help you investigate the details of the policy.
These travel restrictions for Part D under Medicare can even apply when traveling within the United States. Make sure to check with your plan and how coverage applies when in other states. You wouldn’t want to be on vacation and then realize you can’t get the prescriptions you need because of coverage issues.
There are options for Medicare Part D with many insurance carriers:
- Vacation Override
You can ask many Part D plans for a vacation override or a vacation medication supply. The plan will give you an early refill prior to your vacation.
- 90 day Prescriptions
You can talk with your doctor about your travel plans and may be able to receive an extended 90-day prescription for your medication.
- Purchase Foreign travel insurance
For peace of mind while travelling abroad, you may want to consider foreign travel coverage that has a prescription drug component.
International Travel Requirements for Health Coverage
Due to the pandemic, many countries have changed the way they allow visitors to enter their countries.
One of the requirements is medical coverage.
We are seeing this especially in many Caribbean nations. Costa Rica for example even requires a special policy that will cover up to $2000 for the expense due to quarantining if you test positive for COVID-19 while in their country. This could even include up to $50,0000 of expenses related to coronavirus care.
Currently, Western European countries have not adopted the requirement. However, the following countries require you to buy COVID-19 coverage from a local company.
- The Bahamas
- British Virgin Islands
- St. Martin
- The Seychelles
- Sri Lanka
The cost can vary and you should check with a travel agent before venturing outside the US. In many cases, the costs are lower than expected, but they need to be part of your travel budget. Cambodia for example will charge you $90 for a 2-Day policy.
Other Options for Foreign Travel Coverage
If your current plan does not have medical coverage for Foreign Travel, you need a backup plan. Even if you do have coverage that will extend internationally, it doesn’t hurt to investigate your other options.
You can find plans that will offer this coverage, and should check with a travel agent for options. You will normally need to purchase the policy after paying for your trip. Make sure to read what the policies will cover. Some policies will exclude coverage from adventure activities such as skydiving or scuba-diving.
Many companies that offer Medicare products will also offer international travel plans.
One thing to remember is that foreign hospitals are not required to file Medicare claims for any travel medical costs. You must submit the itemized bill to Medicare to receive any reimbursement.
You have also seen that Medicare Advantage Foreign Travel coverage can vary from plan to plan and company to company.
If you want to be secure in your coverage, please talk with one of our agents at Medicare Nationwide prior to any travel. We can review your current policies to determine what coverage is available and make any recommended changes in coverage to protect you abroad.
Prefer to chat by phone? Give us a call at 1-888-559-0103.
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