Although the great recession has changed many of our retirement plans, traditionally this is the time when foreign travel becomes more popular. Health insurance has never been great about dealing with medical issues that arise during foreign travel but many seniors find themselves asking how Medicare and more importantly, Medicare supplements, treat foreign travel medical issues. Great question so let’s dig a little deeper in the Medicare supplements and foreign travel.

First, what about traditional Medicare? Medicare generally doesn’t cover medical expenses outside of the United States and a few areas which are considered part of the U.S. (Puerto Rico, U.S. Virgin Islands, Guam, Amerian Samoa, and the Northern Mariana Islands). In a few rare cases, Medicare may pay for services in Canada and Mexico based on the following requirements.

You live in the U.S. near a foreign hospital, and you need emergency or non-emergency medical treatment. If a foreign hospital is closer or easier to get to from your home than the nearest U.S. hospital that can treat your condition, Medicare may pay for the services.

You’re in the U.S. when you have a medical emergency. If a foreign hospital is closer or easier to get to than the nearest U.S. hospital that can treat your emergency, Medicare may pay for the services.

You’re crossing through Canada without delay between Alaska and another state, and you have a medical emergency. If a Canadian hospital is closer or easier to get to than the nearest U.S. hospital that can treat your emergency, Medicare may pay for the services.

That’s about it for foreign coverage through Medicare. When Medicare was original crafted, this probably less of a concern or issue than it is now when many people are much more internationally mobile. It just wasn’t crafted in the original Medicare design. It was crafted, however, in the Medicare supplement design. In fact, there’s a specific benefit for Emergency Foreign travel mandated by Medicare for Medigap polices. Let’s take a look at this benefit in more detail.

If your chosen Medicare supplement insurance plan has the Emergency Foreign Travel benefit, it will pay 80% of certain qualified emergency (medically necessary) medical services outside the U.S. after a $ 250 deductible is met. The life time cap for total emergency foreign travel benefits is $ 50K. The care must be initiated in the first 60 days of the trip and not already covered by Medicare. The 60 day rules basically makes sure that it’s foreign travel and foreign residency. If you go on longer trips than 60 days (more power to you), then travel insurance may be the better way to go (we’ll discuss further below).

A few point. First, the care must be emergency. For example, let’s say you go in with chest pains and they run a battery of tests which determine it’s just indigestion. It might be difficult to get this covered. Ultimately, you want to be conservative when contemplating whether something’s emergency or not since you will not be able to get a pre-authorization and the provider may ultimately request payment up front in some form since they don’t deal with Medicare on a routine basis.

Make sure the medical costs aren’t covered through traditional Medicare which may be richer in benefits. Some cruise ships are set up to bill Medicare. Many U.S. residents live in Mexico or Canada either part time or full time and have Medicare coverage. Foreign travel insurance will likely not be the right tool for your coverage while in either country since it’s really designed for “travel” insurance and not residency. This brings us to our next section on Travel medical insurance.

Travel medical insurance is the better approach for either longer stays outside your country of citizenship or for more robust coverage than just emergency based coverage. There are a few solid worldwide carriers that deal extensively in travel medical insurance which we’re happy to quote for you. Otherwise, for pure travel expenses, the Medicare supplement Foreign Emergency Travel Medical coverage can provide some piece of mind while you’re jet-setting around the world (in under 60 day increments of course).