Episode 94 – How to manage your benefits when moving or traveling
Planning a trip outside Washington? If you’re retired and have PEBB retiree insurance, there are a few things you’ll want to know before you go. We chat with Laura from the Washington State Health Care Authority about how your coverage works when you’re traveling and what you can do to prepare. Find out how to make sure you’re covered while you’re away.
Episode transcript:
[music intro]
Jenny
Welcome back to Fund Your Future with DRS. So, there are a lot of retirees who think about traveling when they’ve finished working and want to obviously spend their retiring years either traveling around or some may even consider moving abroad. And today we’re talking with Laura from the Washington State Health Care Authority about how retiree insurance coverage through PEBB works when you’re in a different coverage area, whether that’s in a different state or potentially in a different country. And so welcome back, Laura.
Laura
Thank you so much. Happy to be here again.
Seth
All right Laura, I think we’re going to start with easy examples and then work to more complicated scenarios. And this can really cover a wide range of situations. So, let’s just start off, you know, a retiree who might be taking a trip abroad and wondering what happens if they have an emergency and maybe not even abroad, but just that they’re traveling.
They’re outside of the state of Washington, outside their normal coverage area. This may be a little bit top of mind for me. I’m not a retiree, but I was out of the state and I had a little accident and wondering like, oh, what do I do for insurance? And so, I imagine retirees who are traveling more frequently might have these questions.
So, what would you say for a person, what their options are for emergency or urgent care, if they’re traveling somewhere in the U.S. or even internationally?
Laura
Yeah. So, the first thing that we always tell people is when you travel, still take your insurance card with you. Make sure you have that insurance card because it’s got the number on the back for your insurance plan. And then, you know, you have everything you need when you call them to let them know your situation. And all of our plans do have some level of international coverage.
The benefits do vary by plan, but they do cover emergency services outside of the United States and its territories. And the way they cover will depend on which plan you have. You might still have some out of network rules that might apply, and most likely you would pay upfront and then submit claims to reimbursement to your plan after the fact.
And then, as always, a quick call out to the Premera Medicare supplement plan, because this one always operates slightly differently. This plan, even though Medicare Proper, A and B, don’t cover outside of the United States or its territories, except for some very, very limited instances, your supplement plan does cover emergency coverage during the first 60 days of a trip outside of the US.
Routine non-emergency care not covered. But that plan is going to still have coverage for those first 60 days if you are in an emergency situation.
Seth
Other than bringing your insurance card, which I think that’s a great reminder. Are there other things that retirees should do when they’re preparing to travel internationally, just in case a situation happens where they would need their insurance?
Laura
Yes, absolutely. So, we would recommend, if you’re leaving the US or its territories for a trip, contact your health plan before you go so that you know exactly what did you where to go, what kind of coverage you have, if you run into a situation where you need it. Because like you said, Seth, I also had a situation once.
I was only in Canada. But even though I do this, all my focus is on retiree coverage. So, when it comes to my own coverage, I was a little bit lost. What do I do if I have to go into the ER? So, it’s a great idea to have that ahead of time, because maybe you’ll never have to use it, and hopefully you never will.
But if you do, it gives you peace of mind that you know what you need to do. So, contact your plan early. Just let them know you’ll be traveling and ask them, you know, maybe, what do I need to know if I run into a situation where I need health coverage? Another big thing is prescription medications. So, it’s a really great idea to make sure that you have all the prescriptions you need before you embark on your trip.
There’s a limited amount of time you can do this per year, but you may be able to request an early refill on your meds. So, if you’re going to be gone long enough that you won’t be home to pick up that prescription, you can get them ahead of time so you can take them with you. So, kind of the ultimate takeaway is bring your card and get some good information ahead of time so that you’ll know how to locate providers if you need them and how to submit international claims. If you do utilize that care.
Jenny
And then how about if a retiree is looking to move to another state, say, to be closer to grandchildren or whatever? The reason may be, but move outside of Washington, but stay within, you know, the United States, and they’re thinking about coverage and more of a long-term situation. Are there particular resources for doing research on that and comparing state coverage?
Laura
Yeah. So, within our portfolio, it depends on which plan you’re enrolled in. Several of our plans are national coverage. So, you can use them in Washington. You can move to Florida. We have snowbirds in Arizona, things like that. The plan will cover you. And some of our plans are regional. The Kaiser plans are specific to certain counties. So, if you were to leave that county, you moved somewhere else that was not included in your Kaiser plan.
That would be an instance where you would have to change plans. It’s very important when any move is made, that you make sure you notify us at PEBB and let us know what your new address is. Likewise, you want to notify Social Security. And of course, Department of Retirement Systems. You want everyone to know where you live so that you can get all that important mail and make sure that you’re still in a plan that’s going to serve you where you live.
Now, if you move somewhere and you have to switch plans because it no longer is going to be available to you where you live, you have what we call a special open enrollment, which can be activated due to a move. So that would be an opportunity where you can make sure that you are covered in a plan that covers your area.
Jenny
Again, hopefully folks are doing that research before they choose to move.
Laura
Right. And really with our plans, the only one, if you’re still within the United States or its territories, the only one that you would not probably be able to take with you if you move outside of Washington state is going to be the Kaiser’s.
Seth
Okay. So, we’ve gotten progressively a little bit more complicated. So, let’s go to maybe the next, more complicated situation where a retiree is moving, let’s say, permanently outside the United States. I think people are sometimes surprised. We have a lot of Canadian citizens who work for the state of Washington or people who have dual citizenship, who may work in Bellingham or have come down across the border.
But then as they retire, they move back to Canada. What sort of options do they have? And maybe not just focus on Canada. There are different health care systems in different countries as well. So, what sort of options would our retirees who are going to live permanently outside the US have?
Laura
Sure. And I’m going to answer this question from the lens that we’re talking about. Retirees who are enrolled in Medicare. Medicare has pretty strict rules about your permanent residence. For anyone who’s in a part to D, which is the prescription coverage, the part D of Medicare, they do have to live within the United States or its territories. So now with all the plans in the PEBB portfolio, all of them, with the exception of the Medicare supplement plan, the prescription benefits are administered as part D.
So, we have to follow that CMS rule, which is you have to have that permanent residential address in the United States. So, if you move and you’re no longer living in the United States or its territories, first thing you’re going to do is please let us know. There is a 60-day limit. I should have mentioned this before when we talked about special open enrollments. The 60-day limit there is the start of the event, which would be the date that you moved. You have that 60 days to notify us and be qualified for the special open enrollment. So, you move to Canada [or] you are wonderfully lucky and you move to Portugal. You want to let us know and then we can defer your PEBB coverage. So, you can essentially put that on hold and then if at some point you decide to move back to the United States, you can return from that deferral.
We typically waive the requirement that you have to provide proof of other continuous coverage that is waived for international living for this specific reason. So, if you move back, you have to tell us you have moved back. And then we will request again that you provide proof that you have enrolled in Medicare, because you may have dis enrolled from Medicare while you were away.
So, you’d have to re-enroll in parts A and B as well. So, the big takeaway really is that you can’t really use your PEBB if you live internationally. So, it’s not going to be a benefit for you to keep paying for it when you can’t use it. So, you’d want to go ahead and defer it.
Seth
I know we’ve talked in previous episodes about reminding people that they do have to defer, or that there are deadlines and things to be aware of that you may then not be able to re-enroll or enroll for a first time if you miss a deferral. So that’s good information to have. And I think frequently retirees leave the country for a set amount of time and then may move back.
So, knowing that that is also an option that you haven’t completely given up on your PEBB coverage, you’re just deferring it. That’s great.
Laura
Right. And this is that one instance where we’re not going to require you provide that proof of continuous coverage. It’s typically waived in this circumstance. So, I’ll just kind of add in the note that if you’re deferring for any other reason, we would request that when you return.
Jenny
Okay. So, it’s good to probably defer the coverage even if you have no intention of moving back to the United States. It’s maybe good to defer just in case so you can have it as a backup option just in case things do change. It obviously doesn’t cost anything to defer. So, it’s like you might as well just say, “hey, I’m letting you know.” So, you just have that as a backup window.
Laura
Absolutely.
Jenny
Great. So, this is all really good information and food for thought for our retirees that are thinking about potentially traveling or moving. Is there anything else that retirees should consider about their insurance in terms of traveling or moving?
Laura
Sure. Yeah. I’ll just speak really quick. We talked about this a little bit in the beginning, but Medicare typically does not cover at all if you are outside of the U.S. or its territories. So, with our plans, you’ve got some additional coverage to Medicare. That’s why our plans do have that emergency coverage that’s available. And then one other thing that I’ll note is the part D prescription plans in all of our plans typically will not cover prescriptions that are filled overseas or outside of the U.S. So, for example, sometimes folks might pick up a prescription in Canada.
Maybe they find something for a better price, but you wouldn’t typically be able to get any of that reimbursed through your part D plan. We have one exception. Our United Health Care Plan actually does reimburse for international part Ds. However, they have a copay and I believe right now it’s about $35. And so far we haven’t really seen anyone that exceeds anything international over 35. So, no one has really taken advantage of that. But in general, just know you’re not going to be able to use your prescription coverage overseas.
Jenny
Yeah. So that you wouldn’t be able to use your Medicare Part D. But if you do have some of those other Medicare plans.
Laura
So, if you have any of our other Medicare plans, then yes, you’re going to have that emergency coverage.
Jenny
The emergency coverage.
Seth
So, I think my takeaways, if retirees are traveling outside of the country or really outside of their coverage area, make sure you have your insurance card with you. If something does happen, you have your contact and you know how to initiate and ask questions about where you should go or what you can do. But also make sure that your prescriptions are up to date or filled as needed.
So that way you have what you need while you’re traveling, and maybe even possibly there’s an option to prefill some of those if you’re going to be gone for an extended period of time to make sure that you’re able to receive that medication, since you frequently can’t fill your prescriptions while you’re outside of the US.
Laura
Yes. That’s right.
Seth
Perfect.
Jenny
Does HCA have a specific spot on its website for kind of that outside of Washington state coverage?
Laura
We have a tool so you can see what plans are available to you. There’s a plan benefit comparison tool and it will walk you through a variety of questions. And the questions will say, do you have Medicare? Which state do you live in? What county do you live in? And that’s one way you can find out. Will this plan serve me in this county?
Because if it filters through that tool and it shows you the plan, then that means it’s available in that specific location. If it’s not showing up, then you’re probably not going to be able to use that plan. But you can certainly call our customer service if you have questions about: “Here’s my plan. Can I use it if I am visiting my daughter in Florida?” things like that. And then, of course, you can call your plan directly as well for those types of questions.
Seth
That’s a great question, Jenny. And I imagine for some of our retirees, they travel to specific areas regularly. They may be visiting family in different areas and knowing what their insurance coverage options are there. Or if you’re thinking about moving to a different area doing that pre work. I was thinking about this, Laura, when you’re talking about the special window, if you do move.
But I can imagine some retirees who might say, “I’m thinking about moving to, you know, some county in Colorado. What are my insurance options there? I’m going to change plans during open enrollment so I can see how this plan works.” And make sure I’m kind of comfortable with that, maybe to help relieve one piece of stress. You know, before you move to make sure you’re you’ve got that taken care of. That sounds like a great research option and tool for people who are thinking about moving.
Laura
Yeah, it is really helpful. And I guess the other thing to say, too, is that almost all of our plans do include national coverage. The outliers are Kaiser simply because those are regional plans. So if you’re someone enrolled in Kaiser, then you need to make sure that you can take that plan with if you move somewhere. But for UnitedHealthcare, the Regence Uniform Plan, the Premera plan F and G, those are all national coverage. So, you’ve got a lot of flexibility there.
Jenny
Good to know.
Seth
Thanks, Laura.
Jenny
Thank you.
Laura
Thank you!
[music outro]
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