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Be cautious about healthcare coverage when traveling abroad

September 19, 2015
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I am not an expert in healthcare, so you should consult someone who is. However, when you retire and decide to travel abroad, what are you doing for health insurance? If you are enrolled in Medicare, basic coverage is no good as soon as you’re six hours out of port. From there on, any emergency care could be on your dime. Medicare covers enrolled Americans at home, not overseas. Even a short trip across the border may not be covered in most cases. So before you go, you need to talk with your insurance carrier. There are solutions, but they must be purchased in advance. Some Medigap plans offer provisions for overseas travel, but those may have limitations such as 60-day maximum trip duration. There are also short-term travel insurance products, but they may come with restrictions and exclusions in the fine print. For Americans relocating overseas in retirement, there is even more to consider. While Medicare won’t cover care in the new country, dropping Medicare coverage could be a costly mistake if you return to the States. Reenrollment comes with penalties that can add up. Anyone living full-time in another country may need to enroll in that country’s medical system.

Know your insurance. Read your policy. Ask your provider. Understand the limitations. Not all Medicare coverage ends at the border. In rare cases, such as when the nearest hospital is in another country, Medicare may cover expenses (imagine rural, northern towns where the nearest hospital may be in Canada). And coverage extends into Canada for Americans traveling by car (“without unreasonable delay”) between Alaska and the Lower 48. Some Medicare supplement insurance plans and Medicare Advantage plans cover medically necessary services abroad, just as they would here in the States. But it must be a true emergency–a heart attack or broken bone, for example. Even if a traveler has coverage, foreign hospitals aren’t likely to bill the carrier directly. They’ll want their money, so consider carrying an extra credit card with a beefy limit for use in a medical emergency. If you pay for covered care while abroad, obtain good, clear, complete copies of all bills and discharge notes for insurance reimbursement. Your insurance company can help get these documents translated, but just bringing your Visa receipt won’t cut it. Your insurance probably won’t cover prescriptions abroad. For a long trip, order that 90-day supply before travel. For an even longer trip, consider arranging a resupply sent to a trusted person who can forward it to you.

Travel insurance is not health insurance. So a policy may cover a broken arm but not a routine case. And for a worst-case scenario, consider medical evacuation insurance. No Medicare plans will cover transportation, and a medivac back to the States can be very expensive. The Centers for Disease Control and Prevention has a wealth of information for travelers, including a section on health care abroad and the TravWell app that can be downloaded for Apple and Android phone operation systems. The U.S. State Department has an online section devoted to getting medical help abroad and offers the Smart Traveler Enrollment Program that can help an embassy locate you in an emergency and provide you with travel alerts. Be safe!