Does Medicare Advantage provide coverage for travel abroad?
For Medicare Advantage (MA) members planning an international trip, it's essential to be aware of the specific rules and additional costs associated with emergency medical services received overseas.
Emergency Care Coverage Outside the U.S. ----------------------------------------
Most MA plans offer coverage for emergency care that begins during the first 60 days of your international trip. However, this coverage is limited to emergency and urgent care services only and typically does not cover routine or non-emergency care abroad.
Reimbursement Policy and Member Financial Responsibility ----------------------------------------------------------
If you receive emergency medical care outside the U.S., the plan will reimburse you based on the amount they would pay for similar care at a Medicare-contracted facility within the United States. This means the foreign provider’s billed amount may be higher, and any amount above the Medicare-equivalent payment will not be covered, leaving you responsible for the excess. You will also still be responsible for your share of coinsurance or copayment for these emergency services, as you would in the U.S.
Some plans have a deductible for foreign emergency services coverage. For example, one mentioned plan has a $250 deductible before Medicare begins paying for emergency care outside the country.
Upfront Payment and Claims Process -----------------------------------
Because you must often pay upfront for emergency services abroad, it's crucial to save all medical and payment documentation for claims. After your trip, you'll need to file a claim to request reimbursement, which involves submitting detailed documentation such as diagnosis, descriptions of services, provider information, and proof of payment.
Secondary Coverage and Non-Emergency Care ------------------------------------------
If you have separate travel insurance, MA plans usually pay secondary, meaning the travel insurance pays first, and MA may cover remaining eligible expenses. It's worth noting that MA plans typically provide little or no coverage for non-emergency care outside the U.S.
Recommended Additional Coverage --------------------------------
Given these limitations, it's often recommended for international travellers to consider purchasing travel insurance or a Medicare Supplement plan with international emergency coverage.
In conclusion, while MA plans do provide emergency medical service coverage internationally, there are specific limitations and potential additional costs to consider. To avoid unexpected expenses, it's advisable to carry travel insurance and save all medical and payment documentation for claims. For more resources to help guide you through the complex world of medical insurance, visit the Medicare hub.
- Medicare Advantage (MA) plans usually provide limited coverage for emergency care received abroad, but they do not typically cover routine or non-emergency care.
- In case of receiving emergency medical care outside the United States, MA plans will reimburse based on the amount they would pay for similar care at a Medicare-contracted facility, leaving the member responsible for any excess costs and the agreed coinsurance or copayment.
- Some MA plans have a deductible for foreign emergency services coverage, such as a $250 deductible before Medicare starts paying for emergency care outside the country.
- Given the gaps in Medicare coverage for international travelers, it's often recommended to consider purchasing travel insurance or Medicare Supplement plan with international emergency coverage for additional protection during overseas trips.
