What You Need to Know About Medicare and Foreign Travel Benefit

 I love to travel. And so does my family. In fact, I lived for three years in Mexico with my wife and son.

Of course, we meet a lot of Americans while traveling and living abroad. And many of them have learned some painful lessons about getting medical care abroad. Many Medicare beneficiaries, in particular, didn’t understand that Medicare by itself, or even with a Medicare Advantage plan, provided little or no coverage for medical care needed while traveling abroad. 

That’s why I’m writing this newsletter: if you’re a Medicare beneficiary planning to travel outside of the United States, this article will cover the key things you need to know in order to stay informed and protect your health and finances while traveling overseas.

 Medicare Alone Doesn’t Cover Foreign Travel

First, it’s important to understand that Medicare’s coverage for health services outside the U.S. is very limited. Generally, Medicare by itself does not cover medical services received outside the U.S., except in a few specific situations:

• You are on a ship within six hours of a U.S. port.
• You are in Canada and the medical services are provided in a hospital that is closer to your U.S. residence than any Canadian hospital.
• You are traveling through Canada without unreasonable delay by the most direct route between Alaska and another U.S. state, and a medical emergency arises that requires immediate care.

In these cases, Medicare may cover medically necessary services that you receive while outside of the U.S.

Even in these situations, Medicare will typically only pay for a portion of the cost, leaving you responsible for the remainder. For any other medical services you receive while abroad, you’ll need to pay for those out of pocket – unless you’ve got some other coverage lined up.

For most people on Medicare, you have three basic options if you want medical coverage outside the United States: 

• Purchase a Medicare supplement (Medigap) policy that includes foreign travel benefits (not all of them do).
• Enroll in the Medi-Share 65+ health sharing plan – a more affordable non-insurance alternative that includes foreign travel benefits for all members. This is the most cost-effective solution for most. 
• Purchase a short-term travel insurance policy. 

Medigap Travel Benefits 

The most popular way for Medicare beneficiaries to get foreign travel coverage is to purchase a Medicare Supplement plan, also known as a Medigap plan. 

These plans are designed to fill in the gaps in Medicare coverage, including coverage for foreign travel. Depending on the plan, a Medigap policy may cover up to 80% of the cost of medically necessary emergency care received while abroad, after you’ve paid a deductible.

What Medigap plans cover foreign travel benefits? 

If you want travel benefits you have several choices:

If you have a Medicare Supplement Insurance plan, also known as Medigap, such as Plan C, D, E, F, G, H, I, J, M or N, your plan may cover emergency medical care received outside the United States under certain conditions. Specifically, your plan may cover foreign travel emergency care if it occurs within the first 60 days of your trip and if the care is not covered by Medicare.

For medically necessary emergency care received outside the United States, your plan will typically pay 80% of the billed charges after you meet a yearly deductible of $250. It’s important to note that foreign travel emergency coverage under Medigap policies is subject to a lifetime limit of $50,000.

It’s important to note that Medigap policies are sold by private insurance companies, and the costs can vary widely. We always compare policies from multiple insurers to find the best coverage for your needs and budget.

Note that not all plans offer this coverage. If you are not sure if your Medicare supplement plan covers you outside the United States, just call the number on your card. If the answer is “no”, then  you want to look at some other options, contact your Medigap Advisors Personal Benefits Manager.

Medi-Share 65+ Travel Benefits

The Medi-Share 65+ health sharing plan also pays for medically necessary urgent care for members traveling outside of the United States.

They will pay for up to 80% of billed charges for urgent care services that Medicare itself would have paid if you had been in the United States. 

There’s a lifetime maximum benefit limit of $150,000. This is much higher than the $50,000  lifetime benefit cap for foreign travel available under Medigap.

Also, while Medigap only covers emergency care for the first 60 days of your overseas trip, no such limitation applies to Medi-Share 65+. This is one reason why Medi-Share is popular among Christian missionaries working abroad. It offers better protection for those who spend extended periods of time outside the United States. 

Medi-Share is not an insurance company. Instead, Medi-Share is a non-profit Christian medical health sharing ministry with more than 400,000 members. Each member agrees to help share in the cost of other members’ unexpectedly high medical bills.

Medi-Share 65+ is the organization’s plan designed specifically to work with Medicare. It’s also the only large, nationwide healthsharing plan from a major healthsharing organization available for Medicare beneficiaries. 

Medi-Share and Medigap both serve similar purposes – to help people cover Medicare’s substantial out-of-pocket costs, such as deductibles, copays, and coinsurance. However, Medi-Share 65+ does so for a substantially lower monthly cost in most markets than the best Medigap plans, such as Plan G and Plan N.

Learn more about Medi-Share 65+ or self-enroll today!

Medi-Share 65+ Versus Medigap Plan G: Comparing the Costs

Under Medi-Share 65+, plan members are responsible for the first $500 in out-of-pocket costs for services otherwise covered under Medicare Parts A and B (Original Medicare).

This $500 is called your annual household portion (AHP) and is calculated per household, not per individual.

This includes charges for hospitalization, physician’s fees, lab and imaging facility fees, and durable medical equipment. It does not cover prescription drug charges.

In contrast, Medigap Plan G – the most comprehensive of all the Medigap plans currently available to new Medicare beneficiaries, covers all costs under Original Medicare except for your Part B deductible – which is $216 as of 2023.

With Medigap, this deductible is calculated per individual, not per household.

Meanwhile, the monthly cost of a Medishare 65+ plan is typically much less than the monthly premium for a Medigap Plan G:

Nationwide, plan G premiums average about $165. However, actual premiums can vary widely depending on the insurance carrier and your location. In some high cost-of-living areas, Medigap Plan G policy premiums can run as high as $300 per month or even more.

However, Medi-Share 65+ memberships cost only $99 per month for members aged 65 through 74, and are currently 150 per month for ages 75 and up – regardless of your location.

Learn more about Medicare Supplement Plan G

Consider Private Travel Insurance

Another inexpensive option is purchasing private travel insurance with medical coverage, which can help cover the costs of medical services received while abroad.

It’s important to note, however, that not all travel insurance plans are created equal. Some plans may have exclusions or limitations that could impact your coverage.

For example, some plans may exclude coverage for pre-existing conditions, or may have low coverage limits that don’t fully cover the cost of medical care. Be sure to read the fine print of any travel insurance policy before purchasing it, and if you have questions, don’t hesitate to ask the insurer.

We have access to the best and best-priced travel health insurance available. Contact your Personal Benefits Manager for pricing.

Does Medicare Advantage Pay Travel Benefits?

Generally no. 

Medicare Advantage plans are not required by law to offer travel benefits, and the vast majority of them do not. There are a few exceptions: A few plans do offer limited overseas/foreign travel benefits as an additional option.

For the most part, if you want a plan that offers robust travel benefits or overseas benefits for Medicare beneficiaries, your best bet is a Medi-Share 65 plan, or the best Medigap plan you can afford that includes benefits for Medicare beneficiaries traveling abroad. 

If you have questions about your Medicare Advantage plan, or you want to switch to a plan that includes foreign travel benefits, contact your Personal Benefits Manager.

And if you have further questions or need a more in-depth explanation of anything, check out the Frequently Asked Questions below!

In summary:

• If you have a Medicare supplement plan, check with your carrier to see how you are covered outside the United States.
• If you have a Medicare Advantage plan, you are probably not covered outside the U.S.
• If you will be traveling abroad and need coverage, consider switching to a different Medicare supplement plan, or sign up for an inexpensive travel insurance policy.

Frequently Asked Questions

What is Medigap coverage, and does it cover medical expenses when I travel outside of the United States?

Medigap (also known as Medicare Supplement) is private health insurance that helps cover some of the costs that Medicare does not – including Part A and Part B deductibles, copays, and coinsurance costs.

Not every standard Medigap policy will help pay for care outside the United States. If you want this coverage, you must be enrolled in plan C, D, E, F, G, H, I, J, M, or N. However, Plans F and C are closed to new enrollees. Plan A, a limited benefit Medigap plan, popular because of its low costs, does not provide foreign travel coverage.

Medigap foreign travel coverage lasts only for the first 60 days of your trip. and only for the first 60 days of your trip. This coverage is subject to a $250 deductible. 

What should I do if I need medical care while traveling outside of the United States?

If you need medical care while traveling outside of the United States, you should seek medical attention as soon as possible. 

Depending on the circumstances, you may need to pay out of pocket for any medical expenses you incur. You should also keep all receipts and documentation related to your medical care, as this information may be needed if you decide to file a claim with your Medigap plan. 

Are there any travel insurance options that can supplement my Medicare coverage when I travel outside of the United States?

Yes, there are several private travel insurance options that can supplement your Medicare or Medigap coverage when you travel outside of the United States. 

These options can provide coverage for medical emergencies, trip cancellations, and other unexpected events. It is important to carefully review the terms and conditions of any travel insurance policy before purchasing to ensure that it meets your needs. 

Are there any Medicare Advantage plans that offer comprehensive coverage for beneficiaries who frequently travel outside of the United States?

Yes, there are some Medicare Advantage plans that offer comprehensive coverage for beneficiaries who frequently travel outside of the United States. 

These plans typically provide coverage for emergency medical care, as well as routine care received outside of the United States. However, it is important to carefully review the terms and conditions of any Medicare Advantage plan before enrolling to ensure that it meets your specific needs.  Learn more about Medicare Advantage plans that offer international coverage.

Here’s to your health and wealth,

Wiley P. Long, III
President – MediGap Advisors