Phil B. Says:
My wife and I just returned from a trip to Costa Rica and was told by our guide that Medicare is not available for use in Costa Rica. Is this true?
Medicare Expert Ron Elledge Says:
Hi Phil,
Medicare is a bit tricky to navigate, especially when it comes to international travel. Medicare A and B do not cover you while out of the U.S. except in very specific circumstances, and general travel is seldom one of them.
However, both Medicare Supplement and Medicare Advantage Plans will cover international emergency and urgent care when used according to their guidelines. As a rule, international travel coverage can be used according to the following criteria.
Medicare Supplement Plans: Plans C, D, F, G, M, and N include worldwide emergency and urgent care travel coverage as follows:
- You pay a $250 yearly deductible.
- The plan pays 80% of Medicare-covered international emergency and urgent care.
- The plan has a $ 50,000 lifetime maximum to their benefits.
- Coverage is for the first 60 days of each trip outside the U.S.
- You pay for services up-front and get reimbursed by your carrier!
Medicare Advantage Plans: Most Advantage Plans have worldwide emergency and urgent care coverage. Please be sure to research them before you enroll, as there are still a few Advantage Plans that either do not have worldwide coverage or put limits on their coverage.
- You pay the Plan scheduled Emergency/ Urgent Care Services copayment, normally between $90 to $125, depending on the plan.
- Most have no additional coinsurance.
- Most have no lifetime maximum on benefits.
- With most plans, coverage lasts for 6 months for every trip outside the U.S.
- You pay for services up-front and file for reimbursement.
Maintaining U.S. residency is a requirement for Supplement, Advantage, and Part D Prescription Plans.
- Supplement Plans require residency when you enroll.
- Advantage Plans and Part D Plans require that you maintain continuous residency within the state they are issued in.
If you are maintaining state residency within the U.S., and you will be returning at least every 6 months, you may continue enrollment in an Advantage plan and enjoy coverage while in the U.S. and overseas. However, if your stays are longer than six months, or you change your residence to another country, you will forfeit your Advantage Plan.
The rules can be confusing, but I explain them in an easy-to-follow manner in my book Medicare Made Easy: What Expats, Frequent Travelers, and You Need to Know.
Combined with the correct travel/evacuation coverage, Medicare becomes a valuable overseas travel aid.
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