Medicare coverage outside the United States

Lois – N.Y.: I’d like to know if there are any Medicare consequences to travelling abroad for three months if I am maintaining a residence in the U.S. I am enrolled in a Medicare Advantage plan. The second question is trickier. If I apply for residency status in Ecuador (and still maintain my apartment in New York), I will need to be in Ecuador for nine months for each of two consecutive years. If I maintain a residence in New York, can I still maintain my Medicare Advantage plan? Is there a set amount of days or months I can spend out of the country before I lose my Part D prescription plan? And lastly, could I switch gears and get a Medigap policy and maintain that?

Phil Moeller: You can keep your Medicare plans so long as your premiums are paid and up to date. You then can use this coverage when you are back in the U.S. Maintaining it will also allow you to avoid penalties later on when you are back in the U.S. full-time. Anything more than a 63-day break in Part D coverage can trigger lifetime penalties imposed when you once again sign up for a drug plan. As you may know, basic Medicare (Parts A and B) does not cover you outside of the U.S. Some Medicare Advantage plans do provide emergency coverage for foreign travel, so you should check with your current plan to see whether it will be of any use here. If not, you might want to shop for a new Medicare Advantage plan during this year’s open enrollment season, which ends Dec. 7. Some Medigap policies do provide non-U.S. coverage. Here’s a link to Medicare’s Medigap guide. Check out page 11 for details on which plans include coverage for foreign travel emergencies. Because you will not really be traveling outside the U.S., but living in Ecuador, I’d make sure you understand the rules of what qualifies as emergency coverage. To be really safe, you might want to explore health insurance policies in Ecuador. Good luck, and safe travels!