Monthly Archives: May 2014

Medicare coverage when you are in a foreign country

By Sally M. Wagley, Maine elder law attorney

Many retirees look forward to travel, including international travel. But don’t assume that Medicare or your Medicare supplement policy will cover your care in another country, without the purchase of additional insurance.

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Medicare has extremely limited coverage for international travel, even if there is an emergency. Here’s what you need to know:

1. Medicare Part A will not cover care outside the US unless: a) the nearest hospital is in a foreign country rather than in the U.S. (e.g. Canada or Mexico) or 2) you are traveling through Canada to or from Alaska by the most direct route.
2. Medicare Part B will only cover services outside the U.S. if you are on board a ship which is less than six hours away from a U.S. port and within territorial waters adjoining U.S. land.
3. Some Medicare supplement plans and Medicare Advantage plans may cover care while you are traveling outside the U.S. – check your policy –but probably only during the first month or two of your trip.
4. Consider purchasing additional coverage through policies available from private companies. The U.S. Department of State has information on this at http://tinyurl.com/elr-insurance-abroad

Note: Medicare does cover care in U.S. territories such as Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa and the Northern Mariana Islands.

Under no circumstances will Medicare pay for your care if you are living in a foreign country. Consider the following:

1. If the country has a strong national health plan, you pay be able to pay into the plan and receive coverage.
2. Look into “expatriate” health insurance plans available from private companies.
3. If you are moving to a place which is remote or has poor local health care, look into evacuation coverage.
4. Make sure the coverage includes any preexisting conditions for which you might need care.
5. Think twice before cancelling your Medicare “B” coverage. If you later move back to the U.S., you will incur penalties and have to pay a significantly higher premium.

The information provided on this website is for informational and educational purposes only. This information should not be construed as rendering legal advice or offering an answer to a specific legal problem.

Home Care: My Mother’s Story

By Sally M. Wagley, Maine elder law attorney

My mother, pictured here as a young woman, was healthy and active for a long time. But in her mid 80’s, she developed peripheral artery disease, resulting in the amputation of her leg. grandma victory bonds 2

The silver lining in this story is that my mother continued to live independently until her death, just short of her 91st birthday. This, in spite of the dire predictions of her rehabilitation team, who insisted that Mom have 24-hour care, preferably in a facility. Mom wanted to go home and we hired 24- hour care from a local agency. But after three days the workers had little to do. Mom, thanks to years of exercise and a strong will, was able to transfer from her bed to her wheelchair without help and to fix herself simple meals.

We replaced the workers with non-medical help from another agency, Neighbors, based in Brunswick. These workers, who became like family, came in three days a week, two hours a day, to do light housekeeping and laundry and prepare lunch. In addition, an RN from another agency, CHANS, came in once or twice a week to change bandages, take vital signs and check Coumadin levels. It was also helpful that Mom lived in an apartment in senior housing, where the evening meal was served and emergency response was available. Thus, the six to ten hours a week of in-home services (at a far lower cost than institutional care) enabled my mother to remain at home.

This happy ending is not possible for many Maine seniors, who cannot pay privately for services. A recent Portland Press Herald article reported on serious underfunding of home care and long waiting lists. Government reimbursement rates have not increased since 2005. Workers receive low wages, leading to labor shortages in. This short-sighted policy is inhumane and costs the taxpayer more: an average of $558 per person per month, versus an average of $4150 for a nursing home resident.

The information provided on this website is for informational and educational purposes only. This information should not be construed as rendering legal advice or offering an answer to a specific legal problem.