Medicare May Not Pay Your Bills
As an agent or broker, you should be aware that Medicare Coverage outside the U.S. is limited.
In most cases, Medicare won’t pay for health care or supplies you receive outside the U.S. So, if your client is traveling anywhere other than the 50 states of the U.S., the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, America Samoa, and the Northern Mariana Islands they will only have very limited coverage.
Basically, to have Original Medicare pay for services you have only 3 situations where Medicare will pay for certain types of services in a foreign hospital.
- You’re in the U.S. when you have the medical emergency, and the foreign hospital is closer than the nearest U.S. hospital that can treat your illness or injury.
- You’re traveling though Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer that the nearest U.S. hospital that can treat your illness or injury. Medicare determines what qualifies as “without unreasonable delay” on a case-by-case basis.
- You live in the U.S. and the foreign hospital is closer to your home than the nearest hospital that can treat your medical condition, regardless of whether it’s an emergency.
Remember, Medicare only pays for it’s share of services covered by Original Medicare. If you only have Part A Medicare only covers inpatient hospital care.
Medicare only pays for dialysis treatments, outside of the U.S., that are covered in the three situations listed above.
Medicare drug plans can’t cover prescription drug outside the U.S.
What happens on cruise ships if I have a medical emergency?
Medicare may cover medically necessary health care services you get on a cruise ship in the following situations:
- The doctor is allowed under certain laws to provide Medicare services on the cruise ship.
- The ship is in a U.S. port or no more than 6 hours away from a U.S port when you get the services, regardless of whether it’s an emergency.
- Medicare doesn’t cover health care services you get when the ship is more than 6 hours away from a U.S. port.
So, except in limited situations Medicare doesn’t pay for health services you get outside the U.S.
What if I have a Medicare Supplement? Your Medigap policy C, D, F, G, M and N may offer coverage for services outside of the U.S. in most instances up to $50,000 of lifetime coverage.
Some Medicare Advantage plans may offer some coverages and you should check with them for full details.
What is important to remember here is that most domestic plans don’t cover air-ambulance and emergency medical evacuation and return of mortal remains to the U.S.
Medicare Coverage Outside The United States
There are a variety of accidents and mishaps that can happen to the overseas traveler. As an agent I have clients who have lost their lives overseas and had the international travel plans help with the return of their mortal remains.
In some countries you must pay the full bill to be discharged from the hospital. With the help of the travel medical companies, you can be treated and, on your way, back home.
Whether it’s helping you with a lost passport or luggage, travel delays or sudden heart attack anyone who is traveling overseas needs to have the safety net of an international travel plan.
Also remember to fully serve your international traveling client there are three types of policies you should consider.
First of course is the International Travel Medical/Emergency Evacuation cover. Then to help them cover the cost of trip delays, interruptions, unexpected death, or illness in the family that would prevent travel you would help them choose a Trip Cancellation plan.
With the world in a constant state of flux I always question my clients to see where they are traveling and help them understand the dangers that they might run across outside of the U.S.
If they are going to a dangerous part of the world or even one where they might be caught in a insurrection or war, I explain to them how Kidnap and Ransom coverage could save their lives and fortunes.
There is literally a whole world of travelers out there for agents and brokers to serve. Those who are going on short trips, expats who live outside the U.S., missionaries and church groups going on mission trips.
And don’t forget the U.S. based companies who have employees who travel internationally and those companies who have foreign guests, consultants and employees traveling to the U.S.
For the past 32 years it’s been my agencies pleasure to help individuals, mission sending organizations and companies find the right coverage worldwide.
If you should have any questions on helping your clients with exploring the world, please feel free to contact me.