Travel and Medicare Supplement Insurance

Turning 65 next year and starting to look at medicare supplement insurance. We plan to travel a great deal and most supplements that I've seen thus far seem awfully regional specific. Does anyone have any thoughts on a good supplement policy that doesn't tie one down to a certain area?

dramsey1 said:

Turning 65 next year and starting to look at medicare supplement insurance. We plan to travel a great deal and most supplements that I've seen thus far seem awfully regional specific. Does anyone have any thoughts on a good supplement policy that doesn't tie one down to a certain area?

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I think you are referring to Medicare Advantage plans, not Medicare Supplement plans, like "Plan F" or "Plan N". 

Supplement Plan F or N is good anywhere base Medicare Plan A & B are accepted.

For the last 8 years we have used Medicare Supplement Plan F all over the USA. 

Al is correct, as we found out when my wife needed medical help while out of state last year. I hadn't realized that her Humana Advantage plan is primarily restricted to our home state, and even to a specific hospital group. My Blue Shield Supplemental plan covers me in all states, anywhere that Medicare is accepted. This year we changed my wife's coverage to a Humana Supplemental plan.

The Advantage plans are great money savers, but since they are HMOs, they just don't work for us nomads.

ken

We are lucky being retired military. We have Tricare For Life-good anywhere.

Ken & Sheila said:

The Advantage plans are great money savers, but since they are HMOs, they just don't work for us nomads.

ken

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Absolutely correct and not only that but the HMO's and Advantage Plans are not accepted by many doctors.

A true supplement is the one to get, just decide which letter you want

jack L

DH just got his Medicare information today, and we are looking into our options too. We have definitely decided on a traditional supplement plan, and it will probably be a BCBS plan since it has nationwide coverage. I learned about the nationwide concern with a friend who got a massive infection and discovered he had no coverage. He almost lost his leg, and was saved by individual health providers who went above and beyond, not charging him for dressing changes and multiple visits.

Travelers definitely need nationwide plans.

If you haven't done this already be sure to go to the medicare.gov website.  Follow the instructions and you will get most of the answers to your questions about picking the right plans.  Enter all of your drugs and it will tell you which plan and which pharmacy will cost you the least.  If you pick a pharmacy that is a national chain and it is one of the preferred plans for the insurance you choose you will be able to travel widely and not miss a beat.  You can get 90 day supplies of drugs to make this even easier. This is far more confusing that I would have ever guessed and was glad to have had help with this.

Our Humana Advantage plan just became nationwide as of Jan. 1, 2017.

UTTransplant said:

DH just got his Medicare information today, and we are looking into our options too. We have definitely decided on a traditional supplement plan, and it will probably be a BCBS plan since it has nationwide coverage. I learned about the nationwide concern with a friend who got a massive infection and discovered he had no coverage. He almost lost his leg, and was saved by individual health providers who went above and beyond, not charging him for dressing changes and multiple visits.

Travelers definitely need nationwide plans.

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Just to be clear, you mentioned BCBS "medicare supplement" plan being nationwide.  I believe you would find that any carrier offering Medicare Supplement Plans are bound by Medicare rules for that supplement plan to be in affect anywhere medicare is accepted.  That would be in any of the 50 states.

Now if we are talking about Medicare "Advantage" plans then those are only in affect in the areas defined by the insurance company offering them. 

There is an additional benefit in Supplement Plan F in that there is some coverage in Canada that is in addition to what Medicare Plan A & B provide.

When you go to the Medicare.gov web site mentioned above, you can make choices about various things including a supplemental plan that is available nationwide.  On the site it might show that you have ten plans available in your area but adding some of these choices might cut it down to three plans that meet your criteria.  We originally went with Blue Cross/Blue Shield because it has national coverage but reached a point where many of our local doctors at home dropped out of the plan.  At that time we switched to the AARP/United Healthcare plan which also is available nationwide.  The Part D prescription plan has the same nationwide option and you might choose one that has the prescriptions you use regularly in its formulary.  We've had to use emergency rooms a couple of times while traveling and there haven't been any problems, although I've read recently that some free-standing emergency rooms (e.g. not connected to a hospital) use out-of-plan personnel who charge higher rates than hospitals that are bound by the Medicare rates.

I've found that using the Medicare website can be maddening because it's really cumbersome and not well designed, but you can set up your own account and store the drugs you use in it so you don't have to start over every time you use it.  It also knows your address which simplifies things when choosing a plan.  Don't wait until the fall signup time to check it out because the site gets really busy and search times are a lot longer then.

ArdraF

Medicare ADVANTAGE plans usually REPLACE your Medicare plan with theirs, and most include very strict rules on where you are covered and which doctors and hospitals you may use.

Medicare SUPPLEMENT plans "cover what Medicare does not cover", as one common ad says.  Medicare remains your primary insurance.  If I recall, SOME supplements were PPO plans that limit doctor and hospital choices, but others with the same "letter" are not.  My supplement covers me anywhere Medicare is accepted.  Nationwide.

The Advantage plans are great money savers, but since they are HMOs, they just don't work for us nomads.

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Medicare Advantage plans can be HMOs or PPOs. I know Aetna and UHC both offer PPO Advantage plans (I currently have a nationwide PPO Advantage plan from Aetna). I think BC/BS does too.

Medicare Supplements that are HMOs probably exist.  And regional supplemental plans are definitely allowed as well. The geographic restrictions are separate from the directive that any Medicare provider must also accept Medicare Supplements and Medicare Advantage plans.

We have Kaiser and travel extensively and usually outside of the Kaiser territory.  Kaiser will pay for emergency covered expenses regardless of where they are incurred as long as Kaiser is notified.  Not sure what happens once Kaiser is put on notice or whether their are exceptions to the out of territory coverage. 

https://healthy.kaiserpermanente.org/static/health/en-us/pdfs/nat/nat_care_while_traveling.pdf

A long-time forum member has reported that Kaiser requires him to return to California, other than for emergency.

The problem is that a lot of things need a doctor but aren't really an emergency. Sinus infections, strep throat - these need treatment but are not emergencies. We want to make sure we can take care of them without returning to our home state. I have a terrible memory of a co-worker from California who was visiting my facility for business. She had a miscarriage, and her California HMO would not pay for either an emergency room or just a doctor visit. We had to put her on a plane, by herself while having a miscarriage, to get proper medical care. It was truly heartbreaking. Coverage is still my primary decision criteria for insurance.

ETA My co-worker had already had the miscarriage. She got that confirmed at an ER, but there was follow-up care she needed that would be paid for only in California. A very sad situation.

UTTransplant said:

her California HMO would not pay for either an emergency room or just a doctor visit. We had to put her on a plane, by herself while having a miscarriage, to get proper medical care. It was truly heartbreaking.

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Maybe a little off-topic!
I realize this situation is history so nothing to be done now, but it also prompts me to point out that in some circumstances, seeking medical care that one may have to pay for out-of-pocket may be the wise, or life-saving choice. Please remember this option and don't jeoperdize your well-being if you are faced with this unfortunate choice.  If it had been me, I would have immediately gotten myself to an emergency room hospital and damn the insurance.  I'm old enough to remember the days when going to a doctor, dentist, or hospital ALWAYS meant one paid for the privilage of doing so -- no such thing as always thinking the "insurance company" was the payer. 

The response by some may be that a hospital won't treat you without insurance, but I do believe every community has to have at least ONE hospital that is required to do so.  Think about it, you've been hit by a car, you're unconsicous and bleeding -- what do the EMTs do? leave you there till you can provide proof of insurance?  And, it is NOT that a hospital won't treat without insurance, they won't treat unless you have financial responsiblity for payment. I'd have slapped down my credit cards and said "charge away!"

Insurance companies often have a policy of always saying no to coverage, but afterward, given the facts of a situation, will change their mind.  In this case I think, I'd have taken my chances, because hospitals will negotiate costs depending on circumstances.  And given that she was traveling for business, the employer may have seen their responsbility in this situation, IF the HMO was the only option for coverage they offered, but required her to be out of the coverage area for work.  Then again, maybe she was using a husband/partner's insurance, or maybe she did recognize her choices, and chose to head for home.

One can save on premiums/co-pays with HMOs, but I look at it as if that savings may have to be used for out-of-pocket medical expense someday. Same thing with choosing less coverage and lower premiums for auto insurance for example.  Any way, just a reminder that personal pay is still in option -- especially in critical circumstances.  Linda

The insurers definition of an "emergency" might well not agree with yours. Just needing some medical care does not automatically qualify, even if the root condition is a serious one.  HMOs are not typically lenient in their interpretation of an emergency or any other reason for requesting out-of-network coverage. Ditto for regional PPO's.  Likewise if you have a condition that might require treatment at most any time, i.e. a serious chronic condition.  If you want professional medical treatment for sinus infections, sore throat, cuts and abrasions, etc., you probably want coverage that is not geographically restricted.

There are plans available that have nationwide PPO networks or even no network restrictions at all. Yeah, they probably cost a bit more than a regional HMO. For those that are Medicare-eligible, Medicare is the most widely accepted coverage.  Add a nationwide supplement (Medigap) policy and you are golden most anywhere.

Sorry Gary, there are places  where a  nationwide policy simply  is not available; Fannin County TX For one. We used an independent insurance broker to search for a policy for Tara to replace last years that was canceled ($760/mo & 6, 500  deductible) and he couldn't find one  at any price. There are oddballs, but no conventional policies period. We wound up paying a similar rate and deductible to the single small Nevada company serving Fannin County..

Medicare plans are available w/o problem,

Ernie

The Medicare insurance plan varies as per the different region. If you want to go with the flexible supplement policy than I would suggest you to go with Medicare Supplement Plan G. This is so because it is the most comprehensive plan which will cover all your hospital visits, medical expenses, Medicare Part A and Part B deductible and will also cover you foreign travel emergency. This plan is taking over the Medicare Supplement Plan F because Plan F is likely to disappear in 2020. Medicare Supplement Plan G will give you extra benefits and can act as a great money saver for you. Hope my suggestion can help you in selecting the right plan if you haven't chosen a Medicare Supplement plan yet.