Traveling around the world, discovering new places and meeting interesting people are big perks of retirement. As frequent travelers know, one of the most important elements to consider when planning a successful vacation is factoring in your safety and well-being.

Before you go away, familiarize yourself with customs and traditions—and health restrictions—of the country of your destination. In many cases, traveling may require a physical checkup and certain vaccinations several weeks prior to departure.

Are you covered?

Even if you are in good health and have taken steps against potential ailments, illness during traveling can happen. In many countries your current health insurance may not cover you against unforeseen circumstances during traveling and will require additional coverage to protect yourself and members of your family.

To learn more about your benefits coverage when traveling out of the country, visit shbp.horizonblue.com/node/7407. To get more detailed information about what is offered through Horizon Blue Cross Blue Shield’s Blue Shield Global Core visit bit.ly/bcbsglobal or call 800-810-2583 or collect at 1-804-673-1177. Please have your membership ID card.

Medicare/Medicare Advantage while traveling

Medicare and Medicare Advantage follow the same guidelines and generally do not cover any services provided by doctors and hospitals outside the U.S. Medicare and Medicare Advantage plans only pay for in-patient hospital, doctor or ambulance services in some foreign countries in very rare cases. It may include coverage on board a ship within U.S. territorial waters, but if the ship is more than six hours away from any U.S. port, the coverage is invalid.

Additionally, Medicare drug plans don’t cover prescriptions that are filled outside of the country. For a detailed explanation on what is covered, visit the Medicare website at medicare.gov/coverage/travel.

Filing a claim

Doctors and hospitals outside of the U.S. are not required to file Medicare claims. In the event you must see a doctor, use an ambulance, or go to a hospital while traveling abroad, you must pay upfront for the services. Make sure to ask those providers for an itemized bill for their services.

For all claims, submit the following information:

    Name and address of provider.

    Provider’s tax identification number.

    Name of patient.

    Date of service.

    Diagnosis.

    Type of service.

    CPT 4 code.

    Charge for each service.

    Rate of Exchange at the time of the service.

    Must include an English translation, as necessary.

Eligible services will be reviewed and reimbursed without the need to submit the Explanation of Benefits (EOB) from Medicare.

Where to submit claims

If you have a Horizon plan, whether Medicare is your primary provider or not, when you return home, submit a claim to the School Employees’ Health Benefits Program (SEHBP).

If you are in an Aetna plan, whether it’s Medicare Advantage or not, submit a claim to Aetna. Once it’s completed, send the form to the address on your Aetna/Medicare Card.

Remember to make copies of all your receipts and itemized bills from your provider. Be sure to include your ID number on each receipt and bill. Any materials submitted cannot be returned to you.

Tips for travelers

No matter when or where you travel, medical needs can arise. Here are some tips to ensure that you are prepared in the event of an emergency:

    Bring copies of all your prescriptions and your doctor’s contact information. Stow them in your carry-on luggage to keep the information close by and reduce the possibility that they can be lost.

   Visit the Center for Disease Control’s (CDC) website at www.cdc.gov/travel, which offers information on the recommended or required vaccinations, as well as up-to-date details on country-specific illnesses or other potential health risks.

   Consider buying travel medical insurance for all the things medical insurance will not cover.

NJEA and NJREA continue to work closely with the National Education Association and several health insurance companies on options for additional medical coverage for our members traveling abroad. Be sure to check future issues of the NJREA Newsletter or njea.org for updated information as it becomes available.

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