Three (3) Things You Need To Know Before Switching Medigap Policies - A Foreign Travel Benefits Example
- Gloria Moses
- Mar 28, 2024
- 4 min read
Updated: Mar 30, 2024
After Ann's retirement this year, Ann and John decided that they wanted to travel to all 50 states on their new motorcycles. John retired last year. Before moving forward with their plans, Ann wanted to make sure everything was in order, particularly with her health insurance. She turned 65 years old a few months ago. She was automatically enrolled in Medicare Part A and she enrolled in Medicare Part B. After thoroughly reviewing the benefits of Medicare Advantage and Medigap Plans, she decided that a Medigap Plan would work for her. She selected Medigap Plan A. Ann understood that this benefit does not include several benefits including foreign travel emergencies. But this did not matter to her because Ann was not planning on traveling outside of the U.S.
Later that week, John informed Ann that his former supervisor reached out to him to see if John could return to work for one year and travel to see several global clients while the person that replaced him is out of the office due to a medical leave of absence. Before making a decision, John wanted to speak to Ann first. John was told his wife could travel with him. Ann said, "Yes" to this opportunity! But she thought about her Medigap policy. She remembered that Plan A does not cover foreign travel emergencies. Ann needed to know answers to several questions right away. Are there other Medigap plans that offer foreign travel emergency benefits? If so, what does foreign travel emergency benefits cover? Can she switch from Plan A to another Plan that covers foreign travel emergency benefits?
Does any of the Medigap Plans offer foreign travel emergency benefits?
Yes. The following Plans offer foreign travel emegency benefits: C, D, F, G, M and N. However, Ann would only be eligible for D, G, M and N because she is new to Medicare, "Plans C and F are no p ppl longer available to people new to Medicare on or after January 1, 2020."
2. What does foreign travel emergency benefits cover?
According to GoodRx Health, "the insurance is limited to the costs of treatment in the first 60 days that travelers are outside of the country. Coverage pays 80% of the charges for most “medically necessary emergency care.” Medically necessary is defined case by case by Medicare, but this guide explains what is deemed unnecessary. Don’t expect your Medigap plan to pay for nonemergency surgery. Instead, it will pay to get you in good-enough shape to fly back home. Neither Medigap nor Medicare Part D pay for drugs outside of the U.S., but Medigap will probably pay 80% of the cost of drugs administered in a hospital if they are “medically necessary.”Medigap pays for an ambulance ride to a foreign hospital. It also may pay to airlift you via plane or helicopter to the hospital. In a worst-case scenario, Medigap won’t pay to fly your body home if you die."
Ann and John may want to get additional insurance protection from a private insurance company for travel emergencies outside of the U.S.
3. Can Ann switch to another Medigap policy?
The federal law has specific rules about switching Medigap policies. Switching to another Medigap plan must be taken within the individual's 6-month Medigap Open Enrollment period or if eligible, under a specific circumstance for guaranteed issue. Ann is switching plans within her 6-month Medigap Open Enrollment period.
Before switching plans, Ann should first check to see if her state plan has more generous requirements and she should also confirm that the insurance carrier is willing to sell her a Medigap policy. If so, Ann should compare benefits and premiums before switching. Comparing policies is extremely important particularly for those individuals that have a Plan policy that is no longer sold. The old policy benefit offerings may no longer be available in the market. For instance, "Medigap policies bought before 1992 might not be guaranteed renewable and might have bigger premium increases than newer, standardized Medigap policies currently being sold".
Keep in mind, if Ann decides to switch, she should keep both policies until she is absolutely sure that she wants to keep the second policy. If so, Ann should write on the application of the second policy, that she is cancelling the first policy. By law, she has a 30 day "free look period" to decide whether she wants to keep the second policy. In the meantime, she will need to pay premiums for both policies for one month.
We hope this information is helpful. In our next post, we will provide additional information about switching Medigap policies. Contact Benefits-4-Retirees, if you are interested in Medigap Insurance and/or other insurance policies.
"I can't change the direction of the wind, but I can adjust my sails to always reach my destination." ~ Jimmy Dean
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