Berkshire Senior Online

By Margie Ware, Regional SHINE Director

Even though seniors travel at all times of the year (one of the great joys of retirement!), the word "summer" always seems to connote images of "vacation." But one of the risks of leaving home is the thought: "What happens if I get sick while I’m away?"

Most of us know the basics of traveling with an eye to medical issues. One should always have a copy of prescriptions for pharmaceuticals and eyeglasses, in case either are lost, and we know enough to get shots if we’re traveling to a remote location with diseases we’ve never even heard of. If you’re doing a strenuous trip, you may want to have a physical before you depart. But what are other aspects of "remote healthcare" that we should be paying attention to?

First of all, Medicare does NOT cover a beneficiary outside of the U.S. (but remember that Puerto Rico and the Virgin Islands ARE part of the U.S....!) If one does a fair amount of foreign travel, including travel to Mexico and/or Canada, you may be interested in investigating the purchase of a Medigap policy at the "bronze" level, which does cover foreign travel.

However, one of our SHINE counselors, with extensive knowledge of the insurance industry, opined to me one day "I would never rely on a Medigap policy to cover me overseas...." In part that is because people "in the business" are aware of the most extreme cases, where their insureds ran into difficult situations from which they needed to be extricated. But, in part, the counselor was also aware that there are often ancillary expenses incurred when one is taken ill overseas. The patient may need to be flown home early, or transported to a third location not on the original itinerary. For this reason, many individuals purchase travel insurance that covers accidents and illness.

As a former travel agent, my advice is to ask your insurance agent advice about travel policies. Frankly, travel agents are not well-versed in the intricacies of insurance policies, nor should they be. If you have reason to believe that health concerns may be an issue, or you simply like to play it safe, your insurance agent can give you more detailed information.

In addition to the problems involved in overseas travel, there are also issues if you get sick outside the Commonwealth of Massachusetts. For example, Massachusetts has a "ban on balance billing" in effect for Medicare providers. Not all states have enacted this provision, so you may find you are charged up to 15% more than the "Medicare approved charge" if you are in states like Florida. Individuals who are members of HMOs need to be especially attentive to rules and regulations when they are outside of their service area.

One piece of good news is that the new Prescription Advantage program allows members to fill prescriptions out of state in member pharmacies. Before you depart, call the program and find out which pharmacies in the area you are visiting can accept your card. It will prevent the necessity of paying out of pocket and then asking for subsequent reimbursement.

There’s nothing better than a safe, happy, healthy vacation, and there’s nothing worse than a vacation which is marred by health issues ranging from the inconvenient to the life-threatening. We can’t predict everything, but we can be aware of the basics of planning ahead for a trip with an eye on healthy choices!