Did you know that Medicare alone does not cover medical services you receive outside the United States? That's true even if you have a medical emergency in a foreign country. The only exception is if you need medical services while you are in Canada while traveling between Alaska and another state.

How about coverage outside of Minnesota but still in the United States? These are important questions to have answered before you finalize plans for a trip. Medical expenses outside of Minnesota could hit your pocketbook very hard if you haven't planned ahead.

For travel outside of Minnesota but within the United States, coverage depends primarily on two factors: 1) whether you have purchased a Medicare supplement or managed care plan that has a provider network, and 2) whether you are treated for an emergency non-emergency medical condition. All of the individual plans for sale in Minnesota have a defined provider network except for the "Basic" and "Extended Basic" indemnity policies, (Extended Basic policies cover 80 percent of any emergency or non-emergency care by any licensed health care provider throughout the world), and the plans classified as "Advantage Private Fee-for-Service Plans" (specifically, these are Humana Gold Choice, Medica Advantage Private Fee-for-Service Standard, and Unicare SecurityChoice Classic and Plus). You'll need to check with each of the doctors you use to make sure they are willing to bill the Private Fee-for Service plan, however. If your plan does have a provider network, as most do, benefits you receive if you use an out-of-network provider may be very limited or none at all unless you are experiencing a medical emergency. Some plans' provider networks cover certain counties in Minnesota, while other plans' networks include providers from many states.

For non-emergency care, there may be no coverage at all in the case of one of the Advantage HMOs. That's because you have signed your care over to the plan and you will no longer be under Medicare, so that you will have to pay for all regular Medicare Part A and B deductibles, co-pays and coinsurance (as if you didn't have a Medicare supplement policy). For some supplement policies you may have to pay 20 percent of the bill.

One option that some of the Medicare "Cost" type plans have is an "extended absence option." If you live outside of Minnesota for part of the year, you can activate this option so that you will be able to receive the in-network benefits for non-emergency care while you are away. You will need to notify the plan about your travel ahead of time.

For emergency care, there is usually different coverage. All of the Medicare supplements and Advantage plans provide coverage for emergency care within the United States if you use a non-network provider. Benefits range according to plan, from 100 percent payment, to 80 percent payment. Many plans have an emergency room co-pay. What about foreign travel? There is only one Medicare supplement that provides no coverage at all for medical services in a foreign country. The others provide some coverage, but only for urgent or emergency care, and benefits may range from 100 percent coverage to 80 percent. Some pay everything except the foreigh hospital co-pay.

When traveling, bring your Medicare card and your other health care plan's identification card.In a foreign country, you may have to pay the bill and get reimbursement from the plan after you get home. It's crucial to get an itemized bill from the hospital or doctor in the foreign country when you are treated. This is different than a receipt; an itemized bill lists the specific services and supplies you received and cost of each, and the name, address and phone number of the facility or physician. The bill doesn't have to be in English - health plans are able to translate it - but it must be itemized.

So, before you travel, add "health insurance preparation" to your to-do list. Call your plan to ask about provider networks in the place you'll be visiting. Ask about emergency and non-emergency care. If the plan provides coverage, how much will it pay? If you need help in sorting out this information, you can call the Senior Federation's Health Plan Information Center Monday-Friday, 10 a.m.-noon and 1-3 p.m. at 651/783-5045, or toll-free at 866/783-5045. If you have one of our 2006 Health Care Choices booklets, summaries of the plans marketed in Minnesota are provided. Health Care Choices is a free benefit of Senior Federation membership. It can be purchased for $10 by calling the numbers above.