Your pre-travel to-do list probably has all the basics, but before you pack your bags and hit the road, there's one thing left to check: your insurance coverage. If you have Medicare, there are a few things you need to know about what's covered, what isn't, and how you can protect yourself while you're away from home.
1. Coverage Isn't Universal
Medicare is a U.S.-only policy, meaning it covers a range of healthcare needs anywhere within the United States and its territories, including the U.S. Virgin Islands, Puerto Rico, American Samoa, Guam, and the Northern Mariana Islands. Beyond that, though, you're on your own — aside from a few possible exceptions:
- You're onboard a ship in territorial waters bordering U.S. land, for instance, a cruise ship docked at or on the water within a six-hour sail of a U.S. port
- You have a medical crisis within the United States, but the closest hospital is across the border in Canada or Mexico
- You're on a direct route through Canada to or from Alaska and have a medical emergency that requires treatment at a Canadian hospital
- You reside in the United States, but the closest hospital is over the border (this applies to emergencies as well as some non-emergency medical conditions)
If you use your original Medicare policy, under those circumstances, you may only be on the hook for 20% of approved expenses plus your deductible and typical copays/coinsurance. If your hospital visit or other care is later determined to be uncovered, you will be responsible for 100% of all associated costs.
2. Prescription Drugs Aren't Covered Outside the United States
If you're enjoying a stroll through the streets of Galway when you suddenly realize you've lost your blood pressure medication, you'll have to replace it on your own. Medicare won't pay for prescription drugs acquired outside the U.S. In fact, it can be difficult to get refills regardless of the way you intend to pay. For your safety, it's best to take the necessary medications with you along with a letter from your doctor listing your prescriptions and what conditions they're used to treat and safeguard both items closely.
There are some travel medical insurance plans that include prescription coverage. Those companies often have helplines you can use in an emergency to help mitigate the cost and hassle of replacement.
3. There is Supplemental Insurance Available
Paying out of pocket for medical expenses abroad can result in some reasonably huge bills.
Luckily, there's another option. If your existing Medicare coverage isn't enough to cover your expenses or you know you'll be traveling soon and have concerns about your protection while abroad, you may want to look into Medigap. These policies are not sold by Medicare but by private, state-licensed insurance companies and often ease the policyholder's financial burden by paying for some or all of the things Medicare itself doesn't cover, including co-payments, coinsurance, deductibles and medical care outside the U.S.
To be eligible for Medigap, you must already have Medicare Part A and Part B and you must purchase one policy for each person who requires coverage. Coverage depends on which policy you are buying, but most only cover foreign medical emergencies that occur within the first 60 days of travel, and deductibles and coinsurance still apply.
4. There are Some Differences between Original Medicare and Medicare Advantage
While most people on Medicare have the classic plan, often referred to as Medicare Original, there is another option known as Medicare Advantage, aka Plan C. This more comprehensive plan involves assistance from both the federal government and a private insurance company and requires an extra premium. In return, policy holders are eligible for additional benefits, though you may need prior authorization for certain specialist visits, and procedures and coverage may be limited to a specific service area. One bit of good news is that out-of-network coverage is possible if you're willing to shoulder increased co-pays and coinsurance, and all Medicare Advantage plans cover emergent care at in-network costs no matter where you are in the United States. Again, international destinations are another matter.
Vacations are supposed to a respite from real-world problems. That goal holds true much of the time, but unexpected medical problems and nasty insurance surprises can quickly turn a dream getaway into a nightmare. To avoid unforeseen snags, research your coverage ahead of time, take a copy of your policy with you, and know who to call if something goes sideways mid-trip.
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