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OPINION: TONI SAYS: Which Medicare plans cover emergency medical care overseas?

Moultrie Observer - 5/18/2024

May 16—Hi Toni: I met with you in 2023 for a Toni Says personalized Medicare consultation. I have a quick question regarding travel outside the United States because I'm planning a trip to Italy in September. Which Medicare plans cover emergency medical costs while traveling overseas?

I received Medicare advice from my travel agent that has me very confused. I was informed that some Medicare plans, such as Plan F, give foreign travel medical coverage, but others including Plan G (which I am enrolled in), do not. Is this true?

—Laura from Dallas

Hello Laura: The advice that you were given is not accurate.

Medicare does not cover emergency medical care during foreign travel. It is an added benefit that a Medicare Supplement Plan (Medigap) covers.

Medicare Supplement Plans F and G (as well as C, D, M and N) will all cover the same limited amount of emergency foreign travel. These plans pay for emergency care during the first 60 days of a trip outside of the United States. There is a $250 deductible, and the Medicare Supplement plan "only" pays 80%, up to a lifetime maximum benefit of $50,000. You pay 20% and any amounts over the $50,000 lifetime maximum.

Who knows what an air ambulance anywhere overseas will cost? Laura, discuss with your travel agent or explore online for true travelers' insurance that will take care of any medical needs while traveling in countries worldwide.

But beware, because not all travel insurance plans include medical coverage. It's important to read the plan's conditions and restrictions before purchasing the travel insurance policy.

Another important note: Original Medicare and Medicare Part D plans take care of medical and prescription drug expenses in the United States only. So be sure you bring enough of your prescription medication while you are overseas, or you will have to pay out-of-pocket.

There are, however, new Medicare Advantage (Part C) plans which pay for medical expenses overseas. Be sure that you are covered with that specific MA plan in case you have a medical event with foreign travel overseas. Call the MA plan to verify how to receive emergency medical benefits when out of the United States, because coverage and rules vary depending on which MA plan is selected.

Readers, do not forget there is a Medicare rule that one cannot be enrolled in Original Medicare with a Supplement and a Medicare Advantage plan at the same time.

Laura, the travel agent you were speaking with is also unaware that plan F is no longer available for those enrolling in Medicare Part A as of January 1, 2020. (Chapter 3 of the Medicare Survival Guide discusses the rules of enrolling in a Medicare Supplement plan.) Anyone currently enrolled in a Medicare Supplement Plan F who wants to change to a Plan G or N, which has lower premiums but higher out-of-pocket costs, will have to answer medical underwriting questions to qualify for that specific plan.

The differences between Medicare Supplement Plan G and Plan N are:

— Plan G offers lower premiums and the same Medicare benefits as Plan F except the Medicare Part B deductible is not covered and will be paid for by the enrolled Medicare beneficiary. The Part B deductible for 2024 is $240, which is Plan G's out-of-pocket.

— Plan N generally has a lower premium than Plan G with higher out-of-pocket costs. There is a $20 co-pay for a doctor's visit and a $50 co-pay for the emergency room. The Part B deductible is also not covered, and the Part B "excess charges" are not paid for by the insurance company (which Plan G covers).

Laura, this is not the first time that someone has contacted the Toni Says Medicare team because of inaccurate Medicare information. Readers, always check your coverage before traveling overseas.

Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. The "Medicare Survival Guide Advanced" edition and her new "Confused about Medicare" video series are available at www.tonisays.com.

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