When traveling abroad, you want to know what kind of insurance you have for medical emergencies. However, for US residents age 65 or older, Original Medicare only provides medical care here in the U.S. or in any of the American territories. It does not provide care outside the U.S. except in limited circumstances.
The circumstances during which Traditional Medicare may cover emergency care are:
- When you are within the country, but there is a foreign hospital closer to you than any U.S. hospital.
- When you are traveling through Canada from one state over to Alaska (or vice versa), and there is a Canadian hospital closer to you than the nearest U.S. hospital.
- You live within the U.S., but there is a foreign hospital closer than any American hospital that can treat you. This one can sometimes be approved for non-emergency care, too.
Of course, this presents quite a great concern for Medicare beneficiaries who want to do some international travel once they retire. Luckily, you can supplement your benefits with Medicare insurance plans that will provide you with the necessary emergency coverage you’ll truly need when you travel outside the country.
Medicare Part C Foreign Travel Coverage
Under the Balanced Budget Act of 1997, Congress created Medicare Advantage plans as an alternative to Medicare and Medigap. These are private Medicare insurance plans that will pay for your medical care instead of Traditional Medicare.
These plans generally have networks of local providers. When you treat with these providers, you will have the same covered services that you would under Original Medicare, except that you will pay copays set by the plan as you use services.
One bonus to Part C Medicare Advantage plans is that they also include worldwide emergency coverage. When you are traveling, please be sure that you take your Medicare Advantage member card along with you in case you need to present it to a foreign hospital at the time of care.
You should also keep all of your receipts if the foreign hospital will not bill your insurance. Once you are back home, your Medicare broker can help you turn in your receipts for reimbursement by your Medicare Advantage plan.
Keep in mind that this benefit is only for medical emergencies. Your plan will not pay for ordinary doctor visits outside the country.
Medicare Supplement Foreign Travel Benefits
Some Medicare beneficiaries choose Medigap plans (also called Medicare supplement plans) to supplement their Medicare. Unlike Advantage plans which pay instead of Medicare, supplements pay after Traditional Medicare first pays its own share of covered benefits under Part A and Part B.
Medigap plans are offered by many different insurance companies and there are 10 standardized options to choose from. These plans offer you access to all Medicare providers across the nation. You can choose to get your care from any doctor or hospital that accepts Traditional Medicare. This makes Medigap plans really great for trips that you take within the United States.
For international travel, though, there are certain plans that include a foreign travel benefit for emergencies as well. Of the 10 standardized plans, there are 6 which offer a benefit of 80% coverage, up to a total of $50,000, for foreign travel emergencies. The benefit has a $250 deductible that you must satisfy first before the benefits kick in.
It’s important to note that this benefit is only available to you in the first 60 days of your travel outside of the U.S. Therefore, if you have a Medicare supplement and you will be traveling for more than 60 days, you should purchase additional travel coverage.