Medicare coverage when traveling: What to know

Your ‘golden years’ are often a time for grandchildren, new hobbies and traveling, whether as a couple or solo travel, which is on the rise according to Allianz Partners’ 16th Annual Vacation Confidence Index which reports a 23% rise in solo travel among seniors. 

But, whether you’re traveling in the U.S. or enjoying wanderlust abroad, be sure to know that your Medicare coverage likely won’t travel with you if you leave the U.S., according to Medicare.gov. 

An unexpected illness or accident while you’re on a trip in a foreign country could lead to hefty out-of-pocket expenses even though you’re enrolled in a Medicare plan. However, there are some exceptions, such as some scenarios where Medicare Part B (medical insurance) may pay for services when you get onboard a ship within the territorial waters adjoining the land areas of the United States. 

Here’s what to know: 

Possible Medicare Coverage in a Foreign Country

• You’re in the U.S. when a medical emergency occurs, and a foreign hospital is closer than the nearest U.S. hospital which is able to treat your medical situation.
• You’re traveling through Canada by the most direct route between Alaska and another U.S state when a medical emergency happens, and a Canadian hospital is closer than the nearest U.S. hospital which can handle your medical emergency.
• You live in the U.S. and a foreign hospital is closer to your home than the nearest U.S. hospital which can treat your medical condition. Also, this coverage is not dependent on an emergency situation.

Source: Medicare.gov

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To be best prepared when leaving the U.S, it can make sense to purchase additional coverage like travel insurance, regardless of the type of Medicare plan you have,  Susan Hirshman, director of wealth management at Schwab Wealth Advisory in Phoenix, told FOX Business. Specifically, read your policy documents to understand the scope, limitations and exclusions of a travel insurance policy. She noted that travel insurance generally does not cover prolonged care, and she stated “it’s for short-term emergency medical treatment that will get you well enough to return home.” 

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Smooth Sailing With Medicare 

One vacation choice that many senior travelers opt for is cruises due to value and the convenience of unpacking once and visiting several destinations in one trip. Before you embark on the high seas, medical coverage should also be on your cruise packing list. And, where you are sailing to is important if you are receiving Medicare. 

“To qualify for Medicare parts A and B you must be in a U.S. port or no more than six hours away from one when you get the services,” said Hirshman. If your travels are taking you beyond these geographic terms, then travel insurance is vital. 

Hirshman also said if a senior travels internationally, they should be familiar with the coverage from any Medigap or Medicare advantage plans when they travel. “Evaluate coverage, and analyze if something were to happen to you, what is the risk of high out of pocket expenses?” Hirshman posed. 

“Many put hours into the research and planning of our travels, and you may want to consider taking a little extra time and analyze your health risk, current insurance coverage and possible gaps – because if you don’t pay attention these costs can be much greater than the difference between the price of a hotel on one site or another.”

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How Does Travel Insurance Work Internationally?

Coverage categories and levels of coverage will vary based on the provider and the specific travel insurance policy, but Scott Adamski, CPCU, head of global product development, AIG Travel and Travel Guard who is based in Stevens Point, Wisconsin, said there key ways that a comprehensive travel insurance plan can assist you if you are injured or fall ill in a foreign country:

• If you have a medical emergency while traveling and need a hand finding a medical specialist or even the nearest ER, a company such as Travel Guard’s medical assistance team will have a list of local clinics, plus has experience with referring to the appropriate facility. “And, if the emergency takes place in a foreign country with a language barrier, the assistance team will be all the more critical,” Adamski explained.
• When it comes time for actual treatment, in a foreign country, translation assistance can prove to be very important. Often, said Adamski, travel insurance companies have translators on staff to help ensure that they get every detail of the diagnosis from the treating doctor and are also able to successfully convey any important detail about the patient’s medical history, or instruction from the patient’s primary care physician, back in the U.S. 
• Your travel insurance carrier can also deal with their lost or depleted prescriptions, and can identify a local doctor or pharmacy when needed.
• A hospitalization, itself, can be very expensive, asserted Adamski. “In many cases, some portion of that cost can be paid up front by the travel insurance provider, up to a certain maximum limit, but it might be handled on a pay-and-file basis,” he said. “But, it’s also important that travelers familiarize themselves with the travel insurance plan provisions specific to this point, including limitations and the requirement to reimburse the travel insurance provider for costs not covered under the travel insurance plan.”
• Travel insurance can also get you home if your covered medical emergency has caused you to miss your return date, and the airline is telling you there will be an additional cost to change your ticket. “A Travel Guard travel insurance plan may be able to assist with that; and if your condition requires special arrangements for the flight back home (an upgraded seat, a lay-flat seat, a nurse escort, etc.), the Travel Guard assistance team can help coordinate this,” explained Adamski.
• Coverage is dependent on your specific policy and plan, and it’s vital to review your travel insurance documents for a clear understanding of coverage, limitations and exclusions. If you have any questions about the scope of your coverage, contact your travel insurance carrier for clarification and explanation of benefits.