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Some people choose to get their Medicare Part A and Part B benefits through a Medicare Advantage plan. If that’s you, and you love overseas travel, learn about your health benefits when you’re abroad.
The Medicare Advantage program (also known as Medicare Part C) provides an alternative way to receive Medicare Part A (hospital insurance) and Part B (medical insurance) benefits.
Offered by private insurance companies contracted with Medicare, Medicare Advantage plans offer at least the same coverage as Original Medicare, Part A and Part B. (Hospice care remains covered under Medicare Part A.)
First let’s look at Medicare Part A and Part B coverage for care received during overseas travel. Whether you have a Medicare Advantage plan or you stayed with Part A and Part B, here’s what may be covered when you travel:
- A medical emergency that happens while you’re traveling in the United States or its territories, when the nearest hospital is in a foreign country — for example, across the border in Canada or Mexico.
- A medical emergency that requires you receive care in Canada if you’re traveling via a direct route between Alaska and another state.
- Hospital care (regardless of whether it’s an emergency), when you live in the United States or its territories — and the nearest hospital is in a foreign country (for example, Canada or Mexico)
- A medical emergency when you’re on a ship that’s within six hours of a U.S. port.
Some Medicare Advantage plans might provide emergency coverage when you are traveling outside the United States and its territories.
What to ask your Medicare Advantage about overseas travel coverage
If you’re enrolled in a Medicare Advantage plan and want to travel outside the U.S., you might want to ask the plan representative if the plan offers “Worldwide Emergency/Urgent Coverage.” This is emergency or urgent medical care received overseas. You might want to ask your plan representative:
- What emergency medical services overseas are included in worldwide coverage?
- How much will the plan pay for covered services you receive overseas?
- What cost-share amounts will you pay (e.g., deductibles, co-insurance, copayments, charges in excess of the Medicare Advantage plan’s allowed amount)
- What are the plan’s limitations/restrictions on travel coverage?
- Does the plan have a maximum dollar limit to coverage for emergency/urgently needed care received overseas?
- When does the Medicare Advantage plan need to be notified of care you receive overseas?
- How do you file medical claims for reimbursement for medical services you received while overseas?
If you expect to live outside your plan’s service area for more than six months in a row, you may want to tell your plan. A Medicare Advantage plan must disenroll a member who resides outside the plan’s service area for more than 6 consecutive months. If this happens, your Medicare coverage reverts to Medicare Part A and Part B.
Another Medicare plan option for overseas travel coverage
You may be eligible to buy a Medicare Supplement plan to work alongside your Medicare coverage. Medicare Supplement plans (also known as Medigap) are offered by private insurance companies. They may cover some of the “gaps” in Medicare coverage by providing standardized benefits in most states. Six Medicare Supplement plans, labeled plans C, D, F, G, M and N, may cover some of your out-of-pocket covered emergency care costs during overseas travel. Generally this medical care must start within 60 days of leaving the United States.
The Medicare Supplement plan may pay 80% of the cost for covered services after you have paid a $250 deductible (in 2018). Medicare Supplement plans have a lifetime limit of $50,000 in 2018 for covered services received outside the U.S. and its territories.
Medicare Supplement Plans E, H, I, and J are no longer for sale, but if you bought one before June 1, 2010, you generally may keep it. These plans may also provide foreign travel emergency health care coverage as described above.
If you’re currently enrolled in a Medicare Advantage plan that doesn’t include world-wide travel coverage, you may be able to switch to a Medicare Advantage plan that does. Generally, you can make changes in your Medicare coverage during the Annual Enrollment Period, which occurs each fall. Keep in mind, however, that no one is allowed to sell you a Medicare Supplement plan while you are enrolled in a Medicare Advantage plan. The two types of plans don’t work together.
You may also want to consider purchasing travel health insurance to protect you while traveling abroad. Travel health insurance varies in cost and coverage so it’s a good idea to compare plans.
I can help you with your questions about Medicare plan options and overseas travel benefits. To get started, simply click the Get Quotes button to schedule a phone call or to request a personalized email.
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether the plan will cover an out-of-network service, you or your provider can ask the plan for a pre-service organization determination before you receive the service. Please call your plan’s customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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