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Medicare and Foreign Travel

Updated: Feb 12, 2021

Once a good, solid Medicare solution is in place, beneficiaries rightly feel that the health insurance part of their life is handled. However, things change when you take that long-planned trip to Mexico, the Bahamas, Italy or Nepal. Leaving the United States requires a close look at what your medical and related needs are and whether you are covered.

Original Medicare has very limited coverage of medical costs incurred outside the US: Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis you get in a foreign country in these rare cases:

· You're in the U.S. when a medical emergency occurs, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.

· You're traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.

· You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.

People who have a Medicare Supplement (Medigap) plan along with basic Medicare (Plans C, D, E, F, G, H, I, J, M or N) have a standardized foreign travel benefit:

· Covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.

· Pays 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.

· Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000.

Medicare Advantage plans commonly have a copay ($90 for most carriers in 2019) that covers foreign as well as US emergencies. Typically, a member who has an emergency on foreign soil will be required to pay for the treatment and then submit a claim to their insurance company for reimbursement about the $90 copay.

Despite these coverages, members may well be concerned about non-emergency health insurance needs, possible out of pocket costs for emergency services, or the need to evacuate to a US hospital. Call Hal to see what your current foreign travel coverage is and discuss whether foreign travel insurance is a good investment before your next trip.

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