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Foreign Travel Medigap Benefits

Happy senior lady smiling at a man with Medigap foreign travel benefits

For the most part, your Medicare coverage ends at America’s borders. If you’re 65 or older, on Medicare, and are considering taking trips abroad now or in the future, you should look into a Medigap plan that can cover in case something goes wrong while you’re abroad. 

Medicare will cover your health care needs in all 50 U.S. states and territories – including Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands, and the Northern Mariana Islands. If you travel elsewhere and want medical coverage, you’re going to need some kind of supplemental insurance plan since Medicare will only cover emergencies in some very limited circumstances. Even if you’re in Canada traveling between the lower 48 states and Alaska

Medicare covers your health care in the 50 states and all U.S. territories — including Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands and the Northern Mariana Islands. Elsewhere, you’ll need supplemental insurance since Medicare will cover emergencies only in some very limited circumstances. 

What Does Medicare Cover While I’m Abroad?

Medicare may pay for some medical services at non-U.S. hospitals if they are closer to your home than an American hospital. For example, if you’re traveling between the lower 48 states and Alaska, you need immediate healthcare assistance and are taken to a Canadian hospital, you will be covered. Or, perhaps you live near the Mexican border and, in an emergency, get taken to a Mexican hospital; in this case, you will be covered. 

Medicare may also cover certain medical treatments on cruise ships that are in U.S. territorial waters. This essentially means that the vessel is within six hours of an American port. 

Beyond these very limited sets of circumstances, you’ll need medical coverage if you are planning to travel abroad. Emergency foreign medical coverage policies generally fall under one of three plans: Medicare Supplement plans, Medicare Advantage plans, or trip-specific travel health insurance. 

Medigap Plans and Foreign Coverage

Almost all Medicare Supplement plans – also called Medigap plans – come with some kind of foreign travel benefit. Medigap plans C, D, E, F, G, H, I, J, M and N, pay for 80% of medically necessary emergency care costs outside of the U.S. and U.S. territories. 

Usually, you’ll be on the hook for a $250 deductible. Further, the medical emergency must occur within 60 days of the start of your trip. In other words, if you plan to leave the country indefinitely or for a long period of time, your Medigap plan will not cover you. Lastly, there is a $50,000 lifetime limit to the amount your benefit will payout. 

Remember, Medigap policies do not replace your Original Medicare. These policies are additional supplements to your existing Medicare coverage. You should also know that Medicare Part D prescription benefits do not extend beyond American borders and territories. 

Passenger airplane flying overseas carrying seniors that are discussing their foreign travel Medigap benefits.
If you have a Medicare Advantage plan instead of a Medigap plan, you may still have some overseas coverage.

Medicare Advantage Plans and Overseas Travel

If you have a Medicare Advantage plan instead of a Medigap plan, you may still have some overseas coverage. Oftentimes, though, these plans have restrictions on certain health services. 

For one, your policy may require that you inform your carrier of any upcoming trips far in advance. When you let them know of your plans, they will then explain to you how claims and reimbursements work. 

If you plan on traveling outside of your Advantage plan’s service locations for a period longer than six months, you could be automatically dis-enrolled from your plan’s coverage. There are only a small handful of Medicare Advantage plans that offer a benefit that will allow you to stay in your health plan even if you’re traveling for up to 12 consecutive months. 

As a general rule, you should check with your policy provider before any foreign trips to find out what is and isn’t covered under your policy. 

What About Travel Health Insurance?

Buying a trip-specific health plan may make sense for you if you don’t want or need the ongoing premiums of a Medigap or Medicare Advantage plan, but you still want coverage abroad. Trip-specific plans vary in scope and price depending on a number of factors, including your trip’s length and the age of the travelers. 

If you do get one of these plans, you should ensure that it covers medical emergencies, including medical team “medevac” evacuations, and not just “trip protection” cancellations due to illness. Also, get up to speed with the plans exclusions, such as pre-existing conditions or penalties for trip cancellations or postponements. 

Many trip advisors and experts will tell you to get insurance for at least $50,000 in medical expenses and $100,000 in evacuation costs. You can get plans that will cover as much as $250,000 in medical coverage and $1 million in evacuations costs. As always, evaluate your options and pick what suits you best. 

How Do I Claim Coverage Abroad?

Foreign doctors, facilities, and emergency services will not submit your Medicare claims; this is your responsibility. To submit a claim, send your patient requests for a medical payment form to the address listed on the instructions of your form. 

Foreign Travel and Medicare

Unfortunately, Original Medicare (Parts A & B) does not give you much coverage if you’re abroad. Only in very specific circumstances can you claim Medicare treatments in foreign hospitals. Fortunately, though, there are options out there for you. 

While Medicare Advantage and trip-specific insurance plans may work for you, perhaps the best way to ensure that you’re covered while abroad is by purchasing a Medicare Supplement Plan. Nearly all Medigap plans come with some kind of foreign travel benefit, and the benefit is rather generous, especially compared to alternative options. You can call or send us an email today to talk with one of our licensed Medicare experts, and we’ll help you enroll in a plan that fits your healthcare, financial, and travel needs.

 

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