As seniors venture overseas whether for recreation or new living arrangements, a key question to ask is what benefits travel with them. While Social Security benefits follow Americans to other countries, basic Medicare likely will not and seniors may need to be prepared for alternate arrangements.
In a recent on-line article from Elder Law Answers at www.elderlawanswers.com, Elder Law News Articles, the author noted that although Medicare does cover residents of Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Northern Mariana Islands, except for some rare cases of inpatient hospital services in Canada or Mexico, traditional basic Medicare does not provide coverage for hospital or medical costs outside the United States.
These rare cases for inpatient hospital services in Canada or Mexico relate to three possibilities. One is that you live in the U.S. near a foreign hospital and need emergency or non-emergency treatment and the foreign hospital is closer or easier to get to from home than the nearest U.S. hospital. Secondly, if you are in the U.S. when you have a medical emergency and the hospital in Mexico or Canada is closer than the nearest U.S. hospital that can treat the emergency, Medicare might cover. Third, if you are crossing through Canada on your way between Alaska and another State and experience an emergency and the Canadian hospital is closer than any hospital in the U.S., there might be coverage.
Since most circumstances do not involve these three exceptions, other alternatives need to be explored.
First, travelers and Americans living overseas should review their Medicare Advantage or Medicare Supplement plans before leaving home. Some Medicare Advantage coverage comes with worldwide travel benefits. Medigap (also referred to as Medicare Supplement) plans C, D, E, F, G, H, I, and J provide Foreign Travel emergency health care for travel outside the United States.
Note that, as to all of these coverages, there is a difference between short term travel and moving to another country. The Medigap benefit, for instance, would apply only during the first 60 days of the trip. It covers 80 percent of emergency care administered outside the country and there is a $250 deductible and $50,000 lifetime maximum. As to Medicare Advantage, the policy terms differ and should be reviewed before leaving home.
Medicare recipients who are traveling might also consider buying a short term travel insurance policy to cover health care expenses in other countries. They might also consider travel coverage that covers evacuations, particularly in remote or difficult areas.
One excellent source for information regarding health insurance for traveling and for living abroad is the U.S. Department of State website, Bureau of Consular Affairs at www.travel.state.gov, Insurance/ Medical/Health Insurance Overseas. The site answers such questions as: Why should I be concerned about medical coverage abroad? What questions should I ask my health insurance company? Can the U.S. government assist me if I become disabled overseas? Where do I find a list of physicians abroad? What’s the difference between Travel Insurance and Travel Medical Insurance? What insurance information should I carry with me abroad? Where do I find a list of U.S.-based Air Ambulance/Med-Evac companies? Or Foreign-based Air Ambulance/Med-Evac companies? Or U.S. Based Travel Insurance Companies? Or Foreign based Travel Insurance companies? Or Personalized Medical Services? Or Medical Escorts?
For Americans considering moving to other countries, options are limited. If the retiree is moving to a country with strong national health insurance coverage, he or she could explore buying into a plan in the country of destination to receive coverage comparable to other residents. Also, some insurers may offer “expatriate” health insurance plans. All of these plans would need to be investigated to insure that they handle the needs of the American moving abroad.
On returning to the United States, Medicare enrollees should keep in mind certain
basic issues. First, they will be covered by Medicare Part A once again on return to the U.S. Medicare Part A covers hospitalization, hospice, some rehabilitative care in nursing homes following a period of hospitalization up to a maximum of 100 days rehabilitation and some home health care.
If the American living overseas did not keep up his or her Medicare Part B payments and Medicare Part D while living or traveling in other countries, he or she would be subject to the same rules regarding penalties as Americans who remained at home. In other words, there are premium penalties for not enrolling in the programs and these penalties continue indefinitely so, if there is a likelihood of return, Medicare B and D premiums should be paid while overseas.
In brief, when leaving home, along with checking your passport and your inoculations, if you are traveling or moving overseas, you should spend some time determining health insurance options. Do not leave home without them.
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.