Medicare coverage in Europe

Its called Medical and Evacuation Insurance, You can buy it per trip. The evacuation insurance is probably the most important. Get you home if you get severely ill or injured and cannot travel by yourself.

Medicare itself does not cover you outside the US. Many medicare supplemental plans or medicare advantage plans do cover emergencies anywhere in the world but usually on a you pay the provider, save the receipts, and then they reimburse - but often only at at percentage, usually 80%. You need to check your supplemental plan carefully and ask questions if unclear.

Even though my medicare advantage does cover emergency visits overseas, I always get an add'l temporary travel insurance plan - it's a small price to pay especially in the overall cost of the trip and I always get the medical evacuation/repatriation insurance also. I'd rather be safe than sorry.

It has been reported that the cost of medical evacuation can exceed $100,000. That's not covered by ordinary medical insurance.

Insuremytrip.com is a very helpful site to see and compare many different company’s travel medical insurance.

If you are on traditional Medicare, foreign travel is not covered. Some of the supplimental (Medigap) polices have a foreign travel emergency benefit (Plans C, D, F, G, M, N). My Plan F has a $50,000 USD lifetime limit. You can buy travel medical and evalcuation coverage. AIG's MedEvac policy that I recently bought adds an additioan $50,000 of medical and $1M of evacuation and repatriation coverage. The MEdEvac policy is sold on a trip basis, but I beleive that some companies sell annual policies.

The good news is that medical treatment in Western Europe is cheaper than the US.

Unless Chase has cut this benefit, the Sapphire Reserve card includes coverage for medical evacuation if you used the card to pay for a trip. Some emergency medical coverage as well.

https://www.ricksteves.com/travel-tips/health/medical-care-in-europe

Perhaps the above link will answer some of your questions.

This won't answer your question but it's worth knowing nonetheless.

You don't say where you're travelling but in Europe, many countries have what's called "universal health care" -offered by the National Public Health Service of the country- which means everybody is covered. If you're a resident you're included for whatever treatment you need, all free of charge. If you're visiting, you are covered in emergencies. This is the case in Spain, which has one of the most efficient healthcare systems in the world.

For more details.

My supplemental plan works abroad, not as a supplemental, but as a primary insurance plan for the under-65ers. If I need treatment abroad, the company that provides my supplemental plan switches me for that period of treatment to their standard health plan and treats me like a brand new customer. My previously-paid deductible amounts don't count anymore, but I at least have coverage and some protection against any really expensive treatment. Medical invoices must be kept and claims submitted, of course.

What do y'all do to ensure that you are insured?

Since Medicare (and possibly your supplement) will not cover you in Europe, you'll have to get travel insurance on your own that will cover medical expenses. They usually cover a lot of other things also. There are many companies that offer a variety of coverages. Do some comparison shopping to see what will best serve your needs. Most of the policies include medical evacuation coverage. But many policies will only evacuate you to the nearest facility that can treat you. There is a company called Med Jet Assist that will evacuate you back to your home hospital if you are hospitalized abroad. It is not medical insurance per se, just evacuation back home. They also have a variety of plans.

But many policies will only evacuate you to the nearest facility that can treat you.

Here are the T&Cs from a recent AIG MedEvac policy re evacuatation:

Emergency Evacuation - means:

(a) Transportation from the place where the Insured is
Injured or sick to the nearest adequate licensed medical
facility where appropriate medical treatment can be
obtained; and/or

(b) Transportation from a local medical facility to the
nearest adequate licensed medical facility to obtain
appropriate medical treatment if the onsite attending
Physician certifies that additional Medically Necessary
treatment is needed but not locally available; and the
Insured is medically able to travel; and/or

(c) Transportation to the adequate licensed medical facility
nearest the Insured’s home to obtain further medical
treatment or to recover, after being treated at a local
licensed medical facility, and the onsite attending
Physician determines that the Insured is medically able
to be transported; or

(d) Transportation from an adequate licensed medical
facility to an adequate licensed medical facility of the
Insured’s choice for further Medically Necessary
treatment if the onsite attending Physician certifies that
the Insured is medically able to travel.

... I do insist...

Non-European visitors to Spain

Nevertheless, all Spanish state hospitals are required to provide vital primary healthcare to any patient that is admitted to hospital with life-threatening injuries or illness, regardless of their ability to pay.

This applies to a number of countries in the EU.

But many policies will only evacuate you to the nearest facility that can treat you.

This is so true, but most people don't read this closely enough. I have MedJetAssist so I can fly home to the hospital of my choice as soon as I am stabilized. It's not left up to the doctor regarding when or where...it's up to me. So be careful.

It has been reported that the cost of medical evacuation can exceed $100,000.

It's an interesting figure, but it's impoverished by the lack of a reference to an authoritative source describing what set of conditions might lead to such an expense.

Here is some information from the squaremouth.com website, which is a respected website for finding and comparing travel insurance. Note the information under the paragraph about how much insurance to get.

Bob, there have been a few first- or second-hand reports of such instances on this forum. It seems that just about any illness/injury that requires one to lie flat can be very costly, because it can mean three first-class one-way seats for the patient, purchased at last-minute prices, plus a round-trip ticket for an accompanying medical person. I think additional space might be required if specialized medical equipment is needed (such as a respirator). Of course one could charter a jet for the trip, but I imagine that would not be cheaper.

Section #5 of this 2015 article in USA Today says that "Medical evacuation and transport costs typically start at $25,000 and can exceed $250,000." The $25,000 is probably within the US, and the "can exceed $250,000" might be for a more obscure location than Europe. I do not know.

I'm happy to state that I have no personal experience of my own to back those figures up.

Thanks, yet still no specific references, just an "I don't know."

Perhaps that quarter-million figure is from Antarctica?

Regardless, taking your comment at face value, it sounds as if it would be a low-probability event to reach that level. We all have to weigh risks in our decision-making. Personally, I generally don't pay large sums of money to guard against low-probability events. But I can understand if others might do so.

I don't insure against costs I could absorb, so I would never consider something like trip-cancellation insurance for a trip to Europe. But medical evacuation is a different beast. The potential cost there is incredibly high, and all it might take is a carelessly-driven car that hops onto a sidewalk.

It's the difference between insuring a car against damage or theft (a relatively fixed cost) vs. liability insurance that would protect me if I injured someone else (a nearly unlimited cost). Americans typically have million-dollar insurance coverage for the latter. We are a litigious society.

The thing about very unlikely but costly expenses is that it usually doesn't cost a huge amount to insure against them.

My wife was hospitalized for two days during our recent trip to Belgium. They never said a thing about payment or insurance.

My former boss suffered a tramatic brain injury in France shortly after he retired. He was initially in a coma. After he was stabalized he needed long term full time nursing care for a long recovery and rehabilitation. He had to be flown back to the States on a medical charter flight staffed with on-board doctor and nurse. I'm sure it wasn't cheap - transatlantic air charter plus medical staff and equipment.

Posted this afternoon on the NPR website:
Taken For A Ride: M.D. Injured In ATV Crash Gets $56,603 Bill For Air Ambulance Trip

Total bill: $56,603 for an air ambulance flight. Blue Cross Blue Shield of Texas, Khan's insurer, paid $11,972, after initially refusing altogether; the medevac company billed Khan for the remaining $44,631.
Medical service: Khan was flown from the United Regional Health Care System in Wichita Falls, Texas, to the John Peter Smith Hospital in Fort Worth. (108 miles)

One important point. On a flight from Europe you would have time to get a competitive bid. The ride described above was an emergency flight where the service charged whatever they wanted.

Traditional Medicare will not cover you outside the US. Your supplemental may or may not cover you outside the US. Check the specifics of your policy.

Some credit cards offer some travel insurance - either medical or medical evacuation or both - again, check your cards and their policies. Note that you'll probably need to use that card to pay for your trip if it has insurance and you may wish to use it.

Some companies like MedJet Assist offer medical evacuation polices that are good even inside the US as long as you're X miles from home. This won't cover hospital or doctors. It will get you to a medical facility at home. AARP offers a discount on this service if you have an AARP membership.

Depending on how many times a year you travel, your best bet may be a more comprehensive policy that offers both medical and med evac coverage.

Medicare Supplement (I have plan F, but C, G and N also have foreign travel emergency care) reimburses 80% of emergency medical/dental costs up to $50,000 (lifetime) after $250 deductible. Make sure you apply for Medigap coverage within the guaranteed-acceptance period (within 6 months of enrollment in Medicare Plan B)

I just bought medical and evacuation coverage on Insure My Trip. I believe it was the Liaison policy, but they were all similar in price. For a one week policy for 4 people from 55-68 it was $120. A longer trip and older people will be more. But for $30 per person for a week- a bargain. My kids in their 20s were around $12 a week.

I didn't buy the cancellation coverage, although I believe this includes a small amount of baggage and delay coverage. It does include coverage for terrorism and natural disasters. Also, pregnancy- not that we need that!

We have a Medicare supplement plan from Blue Cross Blue Shield that covers emergency care abroad.

If we continue in excellent health, I don't plan to buy anything else for when we travel because in the 35 years we've been together, neither one of us has had an accident or an emergency hospitalization. We have no ongoing medical issues and we don't do adventure sports. My husband twice fell while running away from home and we went to urgent care clinics in Sitka, Alaska and Kauai, Hawaii, to get him a tetanus shot and stitches. But big deal.

You could say we're self-insured for the extremely unlikely event of a medical crisis on another continent.

Assess your own risk and risk tolerance before buying extra coverage.

Pardon me for a bit of a rant, but the illogical thinking demonstrated by such statements as, “ I have never needed . . ., so I don’t get insurance against it” drives me crazy. Insurance, such as medical evacuation, is for rare but potentially ruinous occurrences, such described by one poster above. Even young and healthy people can have accidents. $50,000 - 100,000 is the price range for for some types of evacuation; e.g., when a medical attendant is needed.
BTW, Alaska and Hawaii, are part of the U.s., so a different kettle of fish when discussing what insurance covers or doesn’t cover.

You only "need" insurance if you cannot afford to pay for the consequences of not having insurance.
on
My dad was in the insurance business and advised that insurance was only necessary if you couldn't pay for the consequence. His example would be if you car has aged to a point where if it were totaled, you are an avoerqage to above average driver, and you could write a check to replace it without too much financial pain, you did not need Collision Coverage. On the other hand, if you were liable for a serious injury accident and would be financially distressed in the event of a $1M settlement, you need an umbrella liablity policy.

My dad't thinking is you pay a premium (sorry for the pun) for the benefit of being insured. That premium includes a profit for the insurance compay and its administrative and selling cost. On average, payments are far less than the cost of writting the policies. If you have an average risk, you would on average save money by going without insurance. To paraphrase Dirty Harry: "How lucky do you feel".

That said, if you are an American One Percenter, with a family annual income of $400K+ and net assets of $10M, you can certainly self insure for medical and medical evacuation.

I will add, if you are an American Ten Percenter, you may want to skip the comprehensive travel policy and just get the Medical and Medical Evaculation policy.

Dave, for medical and evacuation insurance, you might want to check GeoBlue. It’s a plan offered by Blue Cross/Blue Shield specifically for international health and medical only. Check the eligibility requirements and call them if you’re unsure. Oddly, the multi trip plans are less expensive than single trip.