Traveling Overseas and Medigap Plans
Medicare Foreign Travel Coverage
Whether you are an avid traveler or looking forward to traveling overseas, and a Medicare beneficiary with Original Medicare, Part A and part B, you should take into consideration a supplemental coverage product.
In nearly all cases, Original Medicare doesn’t cover treatment outside the United States and its territories (The District of Columbia, Guam, Puerto Rico, U.S Virgin Islands, American Samoa, and Northern Mariana Islands), but will cover you anywhere you travel in the United States, as long as Medicare approved doctors and hospitals are used.
Here are the limited situations when Medicare may cover you outside of the United States:
- Medicare will cover health care in a foreign hospital if you live in the United States and have a medical emergency, but the nearest foreign hospital is closer to you than the nearest U.S. hospital.
- Medicare will cover health care in a foreign hospital if you live near the border and the closest hospital that can treat you (regardless of whether it’s an emergency) is outside the United States.
- Medicare may also cover you in Canada if you’re traveling between Alaska and another U.S. state on a direct route, without unreasonable delay, and the closest hospital that can treat you is in Canada.
- Medicare may cover you if you’re on a cruise ship within six hours of arrival or departure of a U.S. port, and the physician treating you is legally allowed to provide medical care on the cruise ship.
Note that if you have a Medicare prescription drug plan these plans do not cover outpatient medications purchased outside the United States.
Medigap Foreign Travel Coverage
One option in receiving coverage while traveling outside the United States, is adding a Medigap plan to Original Medicare. More specifically, standard Medigap plans C, D, F, G, M, and N offer additional coverage for health care services and/or supplies. Plans E, H, I and J are no longer sold, but if purchased before June 1, 2010 you may keep it as all of these plans provide foreign travel emergency health care coverage.
If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan will cover:
-
Foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.
- 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.
- Lifetime plan limit of $50,000.
*Medigap Open Enrollment
This is the six-month period that starts on the first day of the month that you are both 65 or older and enrolled in Medicare Part B. Throughout this period, you can enroll in any Medigap plan offered in your area with guaranteed issue. This means that insurance companies aren't allowed to use your medical history or pre-existing conditions as the basis for charging you more for coverage or denying you altogether. If you have medical issues or disabilities, it's especially important to take advantage of this period.
Although there are advantages to enrolling in a Medicare Supplement (aka Medigap) plan during Open Enrollment, you may change or enroll in a Medigap plan any time throughout the year. Depending on your age and situation your application may go through underwriting and you will be subject to the insurance company's underwriting guidelines.