Dear Savvy Senior,

How does health insurance and Medicare cover health care outside the U.S.? My husband and I have a trip abroad planned this fall and would like to find out if we should buy extra insurance. What can you tell us?

Almost Retired

Dear Almost,

Great question! No one likes to think about health problems while on vacation, but medical emergencies happen, and your regular insurance may not cover your care when you’re traveling abroad. To avoid any expensive surprises, here are some tips to help make sure you’re covered.

Know What’s Covered

Your first step is to contact your health insurer to find out exactly what your plan covers when you’re traveling abroad.

If you have health coverage through an employer, the Health Insurance Marketplace or a private insurance company, the level of coverage can vary widely depending on your policy.

If your plan does provide coverage abroad ask about the specifics, such as whether the plan includes coverage for emergency evacuations to the U.S. and pre-existing medical conditions. You should also find out what your out-of-pocket costs will be if you need medical care while you’re away.

If, however, you or your husband has original Medicare, it does not provide coverage outside the U.S. except in certain circumstances – on a cruise ship within six hours of a U.S., for instance. Some coverage is built in if you have one of the Medigap supplemental plans (C, D, F, G, M, N) that pay 80 percent of bills for emergency care as long as it’s during the first 60 days of the trip abroad. There’s also a $250 annual deductible plus a lifetime limit of $50,000 for foreign travel emergency care.

If you happen to have a Medicare Advantage plan, your coverage outside the U.S. will depend on the plan. Some plans offer emergency care coverage while others don’t. You’ll need to check your plan for details.

Buy Extra Protection

If your policy doesn’t provide health coverage outside the U.S., or if the coverage is limited with high out-of-pocket costs, you can purchase a travel medical insurance policy to cover you, or supplement what your insurer won’t cover.

To shop and compare plans, visit sites like InsureMyTrip.com or SquareMouth.com. To give you a general idea of what travel medical insurance cost. A couple in their sixties planning a two-week trip to Europe, for example, could get a $50,000 medical coverage limit and $100,000 for a medical evacuation for around $100 or higher.

You also need to know that most travel medical plans do not cover costs related to a pre-existing health conditions. So if you or your husband has a pre-existing condition that might require medical care, choose a comprehensive travel policy, which typically covers medical care, medical evacuation, trip cancellation, trip interruption and baggage loss, and then tack on a pre-existing-condition waiver.

Finding Care

If you get sick or injured during your trip, call your travel insurer who can recommend local care options. For extra help, consider joining the International Association for Medical Assistance to Travelers (IAMAT.org), which provides its members access to a worldwide network of physicians who speak English and have agreed to affordable prearranged fees. Membership is free. Also visit Step.State.gov to enroll your trip with nearest U.S. Embassy or Consulate. They too can offer health care referrals.

Reimbursement

If you do have travel medical insurance, and you receive medical care while traveling abroad, you will probably be required to file a claim and show medical records outlining the care you received and receipts. So make sure you get copies of these so you can get reimbursed when you get home.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.