Will travel outside of the country affect my Medicare or Social Security benefits?

Dear Olga:

Retirement is the perfect time for foreign travel, but you are wise to consider your benefit programs before you go. You will continue to receive your Social Security retirement benefits while you are gone, but Medicare will not pay for any healthcare costs you may incur while you travel in Finland. If you have a supplemental health insurance policy (also known as a “Medigap” policy or a Medicare C through J supplemental insurance policy), you should check to see if it covers health care costs in foreign countries. If the supplemental policy does not cover health care costs in foreign countries, you can purchase a policy that does.

I will list a few of the common benefit programs and how foreign travel affects a person’s eligibility and/ or receipt of benefits. A wise person will inform every agency that handles their benefits that they intend to be temporarily absent from the country.

Medicare: Generally, Medicare will not pay for health care outside of the United States. The United States includes all 50 states, District of Columbia, Puerto Rico, U.S. Virgin Islands, Guam, Northern Mariana Islands and American Samoa. However, in rare circumstances Medicare will pay for healthcare outside of the United States: (1) emergencies you have while in the United States, but where a Canadian or Mexican hospital is closer than the nearest United States hospital; (2) for healthcare as you travel from a direct route through Canada from Alaska to a U.S. state and a Canadian hospital is the nearest one that can treat you; or (3) a doctor treats you on a ship that is within 6 hours from the United States. As you can see, these exceptions won’t help cover health care expenses during a trip to Finland. As stated above, most people cover themselves with one of the Medigap insurance plans sold by private companies.

Medical Assistance (also known as Medicaid or “MA”): Olga, you did not mention that you are enrolled in Medical Assistance or other Minnesota health care program, but many people are and you may be in the future. Minnesota allows MA recipients to be outside of Minnesota without losing eligibility, as long as the absence is temporary. After the reason for the temporary absence is ended, you have to return to Minnesota. A vacation can be a temporary absence that does not affect eligibility, but you have to tell the county about the vacation before you go. They need to know the dates you intend to leave and return and the reason for the absence.

MA will not pay for healthcare expenses outside of the United States, but it might pay for some health care expenses while travelling in other US states (e.g. medical emergencies or when your health would be endangered to wait to get back to Minnesota for healthcare). Olga, if you are a MA recipient, contact your county financial worker. Because you intend to return home to Minnesota after your trip to Finland, you are gone temporarily, so you should not be kicked off of MA, but MA will not pay for healthcare for you while you are in Finland.

Social Security Retirement and Social Security Disability: As discussed above, these benefits will continue while a United States citizen travels outside the United States. However, the federal government cannot send benefit checks to certain countries. This obviously only affects you if you plan to go to one of those countries and stop your direct deposit of your benefit check to your local Minnesota bank account. The federal government considers you to be outside the United States once you have been outside the country for 30 days. The Social Security Administration will continue to send out benefit checks to U.S. citizens in foreign countries for as long as the U.S. citizen remains eligible for the benefits. However, the SSA can’t send the checks to you in Cuba, North Korea, and generally will not send checks to Cambodia, Vietnam, parts of the former Soviet Union (other than Armenia, Estonia, Latvia, Lithuania and Russia).

Of course, the checks can continue to be directly deposited in your U.S. bank account. The SSA will send your benefit check to you in Finland, and the U.S. embassies in Finland have people that are trained in Social Security services, but perhaps it is better to keep your benefit check directly deposited to your local bank. Even though your trip to Finland will not affect your Social Security retirement benefits, it is wise to contact the Social Security Administration to inform them that you will be out of the country for more than 30 days.

Supplemental Security Income (SSI): The Social Security Administration also handles SSI benefits. In contrast to Social Security Retirement and Social Security Disability benefits, SSI benefits are not based on your work record. SSI is a needsbased program, meaning you have to have low income and low assets to get SSI. If you get SSI and leave the United States for more than 30 days, your SSI benefits will stop and will not start up again until you are back in the United States for at least 30 days. If you need continuous benefits in order to pay for your living expenses (e.g. housing costs), you should limit your vacation to less than 30 days.

It is very important that you tell the Social Security Administration about your vacation if you plan to be outside the United States for more than 30 days. If they don’t know and your SSI benefits continue to be paid to you while you are outside the country for more than 30 days, you will get an “overpayment.” An overpayment will cause the SSA to reduce or stop your benefits altogether until the overpayment is paid back.

If you are on any program based on need (like SSI or MA), you also should not pay for anyone else’s travel expenses. (If you need a nurse to travel with you, their expenses may be okay to pay, but do not do so without speaking to your financial worker and/or an elder law attorney). Do not pay for anybody’s tickets, hotel, dinners, etc. You should only pay for your own expenses. If you pay for other people’s expenses, these payments will be viewed as gifts (also known as “uncompensated transfers”) and will probably cause ineligibility for your needsbased programs.

Finally, if you live in subsidized housing, be sure to inform your landlord that you will be temporarily absent, to see if the length of your planned absence complies with the housing policy governing your housing. In general, it is good to tell any kind of landlord that you will be gone and how they can reach you. Also, continue to pay your rent and/or mortgage while you are traveling.

Have a good time on your travels!