Just under a month ago (3/30), a client reached out to let me know she had taken an overseas cruise and unfortunately experienced a serious fall that required medical attention.
During her trip, she paid $1,524.42 out of pocket for her care.
Her Medicare Advantage plan does include foreign travel coverage, but like many plans, it requires you to pay upfront and then submit for reimbursement once you return home.
After she got back and was feeling better, she sent me all her paperwork—itemized bills, receipts, and the required reimbursement form. I submitted everything to the insurance company by both fax and mail to make sure it was received.
In less than a month, she received confirmation that she will be reimbursed $989.42.
The difference is due to three urgent care visits ($130 each), which are part of her plan’s cost-sharing while traveling abroad. There was also one charge for $145 that was denied, and we are currently working on an appeal.
The good news: aside from that one item, her plan covers 100% of the allowable charges.
Even better, she also had travel insurance. This may cover the remaining balance, potentially bringing her total reimbursement close to the full $1,524.42 she originally paid.
This is a great example of why it’s so important to understand your coverage, especially when traveling, and to have someone who can help guide you through the process when something unexpected happens.
If you have questions about how your plan works or what’s covered while traveling, feel free to reach out to the agents of The Health Insurance Store.
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