As the Dec. 7 Medicare annual enrollment period deadline approaches, millions of beneficiaries are racing to finalize their health care coverage for 2025.

Some of the beneficiaries who are facing extra challenges are retirees who typically spend much or most of the year abroad.

Those retirees need expert advice about Medicare enrollment to avoid potential missteps.

The Coverage Gaps

The Original Medicare Part A inpatient hospitalization plan and the Original Medicare Part B outpatient care and physician services plan generally do not cover medical services received outside the United States, with limited exceptions:

  • Emergency care near U.S. borders, such as in Canada or Mexico.
  • Medical care received onboard cruise ships within U.S. territorial waters.
  • Certain emergencies during travel involving Alaska.
Despite these limitations, it is crucial even for Americans who move overseas to maintain Part A coverage while abroad, to avoid penalties if they return to the United States later.

Dropping Medicare Part B while living overseas is an option, but re-enrollment upon return may lead to lifelong late-enrollment penalties.

For instance, Medicare Part B penalties add 10% to the monthly premium for every 12-month period a person was eligible to get coverage but was not enrolled.

Filling the Gaps

Beneficiaries often explore supplemental options to enhance their Medicare coverage.

  • Medicare Advantage plans: Some include limited foreign travel emergency coverage.
  • Medicare supplement insurance (Medigap) policies: Certain "letter plans" (C, D, F, G, M and N) cover up to 80% of approved foreign travel emergency medical costs, up to plan limits.
  • Travel insurance:Broader coverage, including medical evacuation, is often essential for those who spend significant time overseas.
The prescription coverage provided by Medicare Part D drug plans does not extend outside the United States.

Suppose you have a client, Jim, who takes several medications every day and lives overseas.

He should arrange to bring an adequate supply of his medications to his home overseas, using a U.S.-based pharmacy that offers international shipping.

That will ensure that he has continuous access to his prescriptions during extended stays abroad.

If you are not a Medicare plan agent or broker yourself, you could start by referring clients facing these sorts of issues to the Medicare Plan Finder tool at Medicare.gov.

Bethany Cissell is director of business development and Medicare expert at Allsup, a national disability representation provider based in Belleville, Illinois.

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