Medicare and Foreign Travel

We recently traveled to Costa Rica with our oldest grandson, and I intend to do a few commentaries about that. This first one is a warning to people on Medicare that, according to the Medicare web site, “In general, health care you get while traveling outside the U.S. isn’t covered.” People are provided a more than 120 page booklet titled “Medicare & You” when they reach 65 and go onto the program. The warning about lack of coverage when you are out of the country is somewhat “hidden” under a title “Part B-Covered Services.” The subtitle is “Travel-health care needed when traveling outside the United States.”

There are some very limited cases where Medicare still applies. One is when a medical emergency occurs and a foreign hospital is closer than the nearest U.S. hospital. You also are covered if you are traveling to Alaska “by the most direct route,” a medical emergency occurs, and a Canadian hospital is closer than a U.S. hospital. A final exception is that Medicare Part B “…may cover medically necessary health services you get on board a ship within the territorial waters adjoining the land areas of the U.S.” Medicare will not pay when the ship is more than 6 hours away from a U.S. port. Medicare drug plans do not cover prescriptions bought outside the U.S. in any circumstance.

I suggest you look at the link to the specific section of Medicare.gov to read the full descriptions without my interpretation. There was no doubt we would not have Medicare coverage during our trip to Costa Rica. I called our secondary insurer and was told they provide coverage during foreign travel. We would be required to pay the fees up front and submit claim forms complete with proof of the charges and medical codes to be reimbursed.

The Medicare site does say that “Medicare supplement insurance (Medigap) policies may cover you when you travel outside the U.S. I suggest you call yours if you have one of those and learn whether the “may cover” applies to you. Or perhaps you are less of a worrier and don’t plan on getting sick or injured while on your foreign vacation.

Next week:  A commentary about one Costa Rican tour guide’s negative impression of President Obama’s foreign policy