If you’re going on a big trip, especially overseas, there’s a lot to remember. Are your bags properly packed? Do you have your passport? Did you remember your sunscreen?
Health insurance is probably the last thing on your mind, and that can trip any traveler up.
Unfortunately, most health insurance policies are limited when you travel outside of your home state, especially if you’re visiting another country, and that’s true even if a venerated Medicare policy covers you. So if you’re a senior and have so far been impressed with how your Medicare or Medicare Advantage plan covers your every ache and pain when you go to the doctor, you’ll want to keep your health insurance at the forefront of your mind when you work out your travel plans.
If you’re unsure what Medicare covers when you travel, here’s a primer.
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Medicare Generally Covers Domestic Travel
If you’re traveling around the U.S., even to far-flung U.S. territories such as American Samoa and Guam, you’re going to be in fine shape when using your Medicare plan.
“If you are traveling in the United States, your care is covered by Medicare whether you are traditional Medicare or Medicare Advantage,” says Louis Rossiter, a health economist at William & Mary in Williamsburg, Virginia.
There are some minor travel wrinkles you could encounter with Medicare Advantage plans. If you are traveling to another state, and you suddenly have an interest in seeing a doctor, just to get something checked out (as opposed to actually being sick or hurt), you could run into trouble with your Medicare plan, according to Tony Kiszewski, an associate professor of natural and applied sciences, who specializes in public health, at Bentley University in Waltham, Massachusetts.
“Medicare Advantage Part C usually does not cover non-emergency health services in facilities or with providers outside the provider network associated with your plan,” Kiszewski says. “The extent of this provider network depends on the structure of a given Medicare Advantage plan. Some plans are local and cover only part of a state. Some regional plans cover multiple states.”
It’s essential to know how your Medicare Advantage plan handles travel, especially if you, say, live in one state during most of the year but reside somewhere warmer for the winter. Still, if you’re on a vacation somewhere in the United States, and you break a bone or suddenly need to be rushed to the ER or an urgent care for some other medical reason, your Medicare coverage will kick in. In situations like a medical emergency, even if the place you go to isn’t in your network, your plan has to cover the medical care.
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Medicare Does Not Cover International Travel (Generally)
If you’re traveling overseas, and a health issue suddenly crops up, your life will become financially complicated.
“If you are traveling overseas, traditional Medicare and Medicare Advantage do not generally cover care,” Rossiter says. “There are exceptions. For example, both may cover medically necessary ambulance transport to an overseas hospital. You would pay 20% of the Medicare approved amount.”
Still, in that hypothetical, you would then have to also pay for all of the medical care you received at the hospital in the country you’re visiting. And what if you need evacuation care, beyond an ambulance? Such as air transport to a hospital? That’s the type of unexpected travel expense that is typically impossible to budget for. You really want to make sure you’re protected before traveling overseas, in case something goes wrong.
Another occasional exception sometimes arises is if you’re near the U.S. border but technically in Canada or Mexico. In some cases, Medicare may pay for your coverage at a hospital, even in some situations where something goes wrong with your health in America but the nearest hospital is over the border.
There are other ways to get Medicare to cover your international travel, however. Your Medicare Advantage plan may cover the expenses that accompany some types of illnesses and injuries that you might experience during international travel. But check your policy carefully and read the fine print to make sure you’re comfortable with how much they’ll pay and how they’ll reimburse you.
Rossiter says that you could also look into purchasing a Medigap plan, a supplemental plan that goes along with an original Medicare plan and covers health care while traveling internationally.
“Medigap plans have coverage defined by the federal government into 10 plan coverage types labeled ‘A’ to ‘N.’ Plans C, D, F, G M and N have foreign travel emergency coverage up to plan limits with a 20% copayment,” Rossiter says.
C and F plans, however, are no longer available to new beneficiaries.
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Look Into Short-Term Health Travel Insurance Plans
This is what Scott Maibor, the managing director at Senior Benefits Boston, an insurance brokerage in Haverhill, Massachusetts, that specializes in Medicare, recommends to his clients. “Getting Medicare to pay towards a foreign medical service is cumbersome and time consuming,” Maibor says.
Maibor says that while you can opt for a Medicare Advantage or Medigap plan that pays for health care while traveling internationally, the coverage is still limited when you’re out of the United States. “Expect to pay upfront and submit documentation for reimbursement as well as lifetime benefit limits, which can be easily exceeded,” he says.
That’s why Maibor recommends seniors traveling internationally buy short-term travel health insurance plans, though he cautions against getting it confused with travel insurance.
“Travel insurance protects you financially from trip interruption,” Maibor says.
For instance, if you’ve just spent a fortune buying tickets to a tropical island and before you go, a typhoon causes significant damage to the hotel you have reservations at, travel insurance would protect you from losing nonrefundable expenses.
But short-term health travel insurance, Maibor says, financially protects you in case of a health event on an international vacation. So, if you were injured during a typhoon and you wound up in the hospital for weeks, your short-term travel health insurance plan would financially protect you from costly medical bills.
“I do warn clients that if they are travelling for an extended time, or going to a destination with less than first-rate medical care that the money spent on a travel health plan is worth the piece of mind,” Maibor says.
Maibor says that these policies tend to be affordable. You might spend less than a couple of hundred dollars monthly for each person covered by the policy. Still, Maibor says that the rates always depend on your age, the country you’re visiting and how long you’re staying. Also, the deductible and the maximum coverage amount you are requesting will influence the price. Your age matters a lot, though. You’re going to spend far more on a short-term health travel plan if you’re 90 years old, visiting another country, than a 65-year-old.
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Remember to Pack Your Medications
Even if you do remember to pack your medications, your luggage could be lost or stolen on the trip — and suddenly you need to contact the nearest pharmacy. Will Medicare part D pay for that?
If you’re traveling domestically, yes, it will, although you’ll want to make every effort to go to a preferred pharmacy or at least an in-network pharmacy instead of an out-of-network one. You can call your insurer or look at its website to find what preferred pharmacies are closest to wherever you’re staying.
If you’re traveling abroad? It’s a pretty safe bet that your Medicare plan won’t cover any necessary medications, but a good short-term health travel medical policy will, which is another reason to consider getting a plan if you’re going on an extended international trip.
But all of that said, do your best not to lose your medications or have them stolen. Even traveling domestically, Rossiter says that it can be a hassle to get your medication. But when you travel internationally?
“This is super complicated,” Rossiter says of traveling to another country and discovering you don’t have your medication. “It’s not really Medicare or Medicare Supplemental that is the limiting factor, it is that you will not have a prescription for that country’s pharmacy,” Rossiter says. “I was in England in February with a group,” he says. “We were advised over and over not to pack your medicines in your checked luggage. You must take medicines with you in carry-on luggage or purse and keep them close.”
If something goes wrong, and you are without your medication, and you’re in a group, if you’re taking the same prescription as someone else, Rossiter says that you might be able to share your medication. “On your own, you really are stuck,” he says.
Rossiter says that you’ll likely end up having your doctor email your prescription to the closest pharmacy to your hotel or other lodging. Still, cutting through that red tape, especially if you’re dealing with a significant time difference, can take time.
“Your (health) travel insurance is the better source of assistance, versus Medicare supplements or Medicare Advantage,” he says.
The Bottom-Line With Medicare, Traveling and Medicine
You may spend some time strategizing what to do in case of a worst-case scenario before departing on your trip, but the time you spend now, the less time you’ll spend fixing a problem if something does go wrong while you’re on vacation.
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Will Medicare Cover Care If You’re Traveling? originally appeared on usnews.com
