Travel outside the United States for folks on Medicare requires some careful planning.
That's because Medicare rarely, if ever, covers you when you travel outside our country's borders -- even if it's just for an afternoon visit to Canada or Mexico.
It's not much different if you have a Medicare Advantage Plan. So it's important you read and understand exactly what your coverage options are. If in doubt, check with your insurance representative.
Bill Best of Arlington called me a few weeks ago to talk about this. He'd just finished reading the 2009 Medicare information booklet on the subject. The wording, typical gov-speak, has a few exceptions to the rule but they are carefully parsed.
It's worth noting that if you are in Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa or the Northern Mariana Islands, Medicare considers those places part of the United States and your Plan A and B should cover you in the same way they would if you were at home.
If you have standard Medicare, not a Medicare Advantage plan, your supplemental insurance coverage will include the option of travel coverage. So ask your insurance representative about that coverage and exactly what it involves before you begin travel plans.
Best had been sorting through the fine print in this medical morass even before a recent discussion with his twin sister. She's an avid skier, he said, and envisioned retirement adventures that included skiing and back-country trekking in Canada.
He asked if she was aware that Medicare excluded, for the most part, any medical care needed while she was outside the United States.
She wasn't aware. Since then, he said, she added a supplement to Medicare that includes out-of-country medical care, and it wasn't cheap.
As we talked, we reviewed some of the complex language in the Medicare booklet (and online at www.medicare.gov) that covers travel into Canada or to Alaska via Canada. Here's what it says:
"If you are traveling through 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 than the nearest U.S. hospital that can treat the illness or injury" you may be covered. However, it is up to Medicare to interpret whether you traveled "without unreasonable delay."
Even if it appears Medicare might cover your care, you will still be expected pay first and then submit the forms to Medicare for reimbursement.
If you have a medical emergency while out of the country and do not have insurance, you will be expected to pay cash for your care. And, depending on the country, that may well be cash in advance.
The best approach is to buy special travel/medical insurance in advance of travel. Read all the fine print and understand exactly what's covered. That's the advice of Ann Bunn, a travel agent I know and trust.
Be honest about any pre-existing medical conditions before buying a plan, she said. Not all travel insurance will cover problems related to pre-existing conditions. Even those that do, may provide coverage for someone who fails to identify those problems in advance.
As older folks, we know that even the healthiest among us can experience an unexpected medical emergency at any time.
Should the worst happen, and you or your traveling companion dies in a foreign country, a good travel insurance plan will cover the medical costs as well as the expense of getting the remains home. Plus, the company's representatives handle the hassle of dealing with the governmental regulations in these circumstances, Bunn said.
Bunn told me she had a friend whose cousin died last year in Mexico following an accident. He did not have travel insurance. His family "went through hell trying to get him out of there," she said.
The cost of travel insurance is based on several things including the cost and length of your trip, your age and pre-existing medical conditions. Several companies offer these plans. Bunn often recommends CSA (www.csatravelprotection.com).
The important thing is to gather the insurance information at the same time you plan the trip so you can budget accordingly.
Then relax and enjoy one of retirement's great privileges: freedom to travel.
