Medicare Advantage Overseas Coverage in Mexico and Abroad

You may have researched Medicare Advantage plans as a solution to your health insurance coverage needs in Mexico or abroad.  The Medicare Advantage Aetna Explorer, Humana Choice, AARP United Health Care, and Blue Cross Access Flex, among others, include medical emergency coverage overseas.

But, does Medicare Advantage overseas coverage work?

If you plan on moving abroad and establishing residency in Mexico or in another country outside of the US, your Medicare Advantage plan may NOT COVER YOU, because emergency medical coverage is meant for tourists and travelers, not for expats living abroad on temporary or permanent residency visas.

Before settling on a Medicare Advantage plan for protection, consider the following factors:

1. Medicare Advantage plans are for US residents, individuals who live at the address on file with their Medicare Advantage plan.

 2. Medicare Advantage overseas coverage can be limited to a specific number of travel days and / or dollar amount. Check your summary of coverage document for specific benefit details.

 3. Medicare Advantage companies can request proof of travel and a copy of foreign travel visa to verify benefit eligibility.

 4. Any approved medical emergency coverage is subject to Medicare Advantage out-of-network co-insurance charges, which average 45%-50%. Co-insurance is the percentage of the total bill the insured pays.

 5. In Mexico and Latin America, private hospitals don´t normally bill Medicare Advantage companies directly, nor do they provide patients with medical records and documents required to file a Medicare Advantage reimbursement claim. 

If you are an expat with a Medicare Advantage plan with overseas coverage; log into your health portal or call your Medicare Advantage company to request a copy of your summary of coverage document. Read about your coverage details. Don´t rely on your agent assuring you that; “Oh, you are covered”.

Regardless of your situation, consider purchasing an affordable expat health or medical emergency plan. Be aware that emergency hospitalizations in Mexico are not cheap! They cost tens of thousands of dollars in any Latin American country.