Medicare May Not Pay Your Bills

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Caution Traveling Outside of the U.S.

As an agent or broker, you should know that Medicare Coverage Outside the U.S. is limited.

In most cases, Medicare won’t pay for health care or supplies you receive outside the U.S. So if your client is traveling anywhere than the 50 states of the U.S., the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, America Samoa, and the Northern Mariana Islands they will only have minimal coverage.

Medicare Coverage Outside The United States

To have Original Medicare pay for services, you have only three situations where Medicare will pay for certain types of services in a foreign hospital.

  1. When you have a medical emergency, you’re in the U.S., and the foreign hospital is closer than the nearest U.S. hospital that can treat your illness or injury.
  2. You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs. The Canadian hospital is closer to the nearest U.S. hospital that can treat your illness or injury. Medicare determines what qualifies as “without unreasonable delay” on a case-by-case basis.
  3. You live in the U.S., and the foreign hospital is closer to your home than the nearest hospital that can treat your medical condition, regardless of an emergency.

Remember, Medicare only pays for its share of services covered by Original Medicare. If you only have Part A, Medicare only covers inpatient hospital care.

Medicare only pays for dialysis treatments outside the U.S., covered in the three situations listed above.

Medicare drug plans can’t cover prescription drugs outside the U.S.

What happens on cruise ships if I have a medical emergency?

Medicare may cover medically necessary health care services you get on a cruise ship in the following situations:

The doctor can provide Medicare services on the cruise ship under specific laws.

Cruise Ship going into port showing how Medicare may not pay your bills if your are more than 6 hours out.
Medicare doesn’t cover health care services you get when the ship is more than 6 hours away.

The ship is in a U.S. port or no more than 6 hours away from a U.S port when you get the services, regardless of whether it’s an emergency.

Medicare doesn’t cover health care services you get when the ship is more than 6 hours away from a U.S. port.

So, except in limited situations, Medicare doesn’t pay for health services you get outside the U.S.

What if I have a Medicare Supplement? Your Medigap policy C, D, F, G, M, and N may offer coverage for services outside of the U.S. in most instances, up to $50,000 of lifetime coverage.

Some Medicare Advantage plans may offer some coverages, and you should check with them for complete details.

What is important to remember is that most domestic plans don’t cover air ambulance and emergency medical evacuation and the return of mortal remains to the U.S.

There are a variety of accidents and mishaps that can happen to the overseas traveler. As an agent, I have clients who have lost their lives overseas and had the international travel plans help return their mortal remains.

In some countries, you must pay the total bill to be discharged from the hospital. With the help of the travel medical companies, you can be treated and, on your way, back home.

Whether it’s helping you with a lost passport or luggage, travel delays, or a sudden heart attack, anyone traveling overseas needs to have the safety net of an international travel plan.

Also, remember to serve your international traveling client fully; there are three types of policies you should consider.

First, of course, is the International Travel Medical/Emergency Evacuation cover. Then to help them cover the cost of trip delays, interruptions, unexpected death, or illness in the family that would prevent travel, you would help them choose a Trip Cancellation plan.

With the world in constant flux, I always question my clients to see where they are traveling and help them understand the dangers they might run across outside of the U.S.

If they are going to a dangerous part of the world or even one where they might be caught in an insurrection or war, I explain how Kidnap and Ransom coverage could save their lives and fortunes.

There is a world of travelers out there for agents and brokers to serve. Those are going on short trips, ex-pats who live outside the U.S., missionaries, and church groups going on mission trips.

And don’t forget the U.S.-based companies with employees who travel internationally and those companies with foreign guests, consultants, and employees traveling to the U.S.

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