High Deductible F And Foreign Travel Coverage

[Joe R]

My wife and I will be on Medicare soon and are considering a High Deductible F plan from Globe Life of NY. We travel a good amount and I have conflicting information about the plan's foreign travel emergency medical expense coverage. The agent says that once you satisfy the separate $250 foreign travel expense deductible, the plan will pay 80% whether you have met the main $2240 (for 2018) deductible or not. She also says that the 20% that is your responsibility would not go toward the plan's main deductible of $2240. However, documents I see describing Medicare Supplement Insurance on various official state sites, including NY, indicate the High Deductible F plan won't start paying foreign travel expenses (at 80%) until both the main deductible and the $250 special "foreign travel" deductible are met. They also imply that if you haven't yet met the main deductible, 80% of any foreign travel expenses beyond the $250 would count toward the main deductible because they would be "out of pocket expenses that the plan would ordinarily pay." If anyone has had experience with claims of this type under the High Deductible F plan, I would appreciate knowing how it was handled in relation to the main deductible.

 

[MBSC]

In all cases, the policy holder must incur $2240 in cost sharing before HD-F begins to pay. The chart for the HD-F plan linked to below provides a concise summary.

Foreign Travel:

You pay:
1) The first $250 each calendar year in addition to the $2240 deductible.
2) 20% coinsurance.
3) Amounts over the $50k lifetime maximum.

The plan pays:
1) 80% after the $250 deductible and after you pay the $2240 deductible.

Reference: https://www.bcbsnd.com/documents/10181/11554/29314906.pdf/edfacc7f-6098-435c-8fa8-1894deac6d1a

Page 8 of the Globe Life outline of coverage below contains the same information although it is not as clear in stating you have to incur $2240 in cost sharing before HD-F begins to pay. You have to go back to the footnote at the bottom of page 1 to find "Benefits from high deductible Plan F will not begin until out-of-pocket expenses exceed $2240."

Globe Life outline of coverage: https://www.unitedamerican.com/LOGO...of Coverage/GNY/DS-GNYMS2010/DS-GNYMS2010.pdf

 

[Joe R]

Thank you, particularly for the Globe document. This is the same as the other documents I saw. I had forwarded the pertinent sections to the Globe agent, yet she still insisted that the foreign expenses are not dependent on meeting the main deductible. Maybe she will be convinced by the document from her own company. It is hard enough to understand the Medicare morass without people who are supposed to be advisers giving out incorrect information.