Guest columnist Elsa Nystrom is a frequent cruiser who reads the fine print before buying any sort of travel insurance. This is part two of a series about Medicare options abroad. Find part one here. As always, we recommend that you consult with your travel advisor about insurance and protecting your cruise investment.
Medicare does provide some coverage for travelers, but in almost all circumstances only within the boundaries of the United States and its territories. However, you can add health insurance coverage when traveling abroad through Medicare Part C.
Medicare Part A (hospital care) Part B (doctors, medical procedures and equipment) and Part D (prescriptions) provide basic health coverage for Americans age 65 and older. Unfortunately, as some have found out, these 3 parts of Medicare do not cover co-pays or deductibles, and other medical expenses that could wipe out savings and leave a person in debt. But that’s where Medicare Part C comes into play.
There are two types of supplemental insurance that can ramp up Medicare coverage, protecting an individual against expenses incurred in an accident or through serious illness, and they are found in Part C. The first type is called Medicare Advantage and the second is Medicare Supplement Insurance, also known as Medigap coverage.
Some Medigap policies will cover the 80% of the cost of illness or injury when traveling abroad. Medicare Advantage Plans apply only within the US, just like Medicare.
You must be enrolled in Medicare in order to be eligible for a Medigap policy and you must also pay an additional premium for Medigap coverage. But not all Medigap policies have health insurance coverage when traveling outside the United States. To further confuse the issue, Medigap policies are identified by letter, as you can see in the chart above. What each plan offers is standardized by Medicare but since they are offered by different companies, costs vary. Plan F, the most expensive option is one of the most popular policies because it has the best coverage, however by the end of 2019, Plan F will no longer be open to new Medicare enrollees.
Your Medigap policy may also offer additional coverage for health care services or supplies that you get outside the United States. Medigap policies are generally more expensive than Medicare Advantage policies and, in some cases, considerably more expensive depending on the coverage.
Standard Medigap Plans C, D, F, G, M, and N provide foreign travel emergency health care coverage when you travel outside the U.S.
Plans E, H, I, and J are no longer for sale, but if you bought one before June 1, 2010 you may keep it. All of these plans also provide foreign travel emergency health care coverage when you travel outside the U.S.
Medigap coverage outside the U.S.
If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan:
- 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.
The last line of the chart shows that plans C,D, F, G, M and N cover foreign travel emergencies, however, all have a modest deductible and pay only 80% of the cost. In this case, Medicare A, B, and D pay nothing outside the US.
Keep in mind that if your bills for a medical emergency incurred outside the US amount to $20,000. you will still owe $4,000, after your Medigap Coverage. The cost of adding a medical travel insurance policy for your trip would be much less. Finally, there is a lifetime Medigap policy limit per person for foreign emergencies of $50,000.
What about Medicare Advantage policies?
They tend to be more localized in nature and although their coverage may be better than that of a Medigap policy, most will not cover you outside the area they serve. Medigap policies will cover you at any facility that accepts Medicare patients; if the facility does not accept Medicare patients however, they will not cover any of the costs, unless you are traveling outside the United States and have one of the Medigap policies that covers foreign travel emergencies.
You cannot have both a Medigap and a Medicare Advantage policy, so it is important to study the coverage and costs of individual policies before you make your decision. if you don’t travel outside the US very often, you may find a Medicare Advantage policy is the best choice.
For further information follow this link.