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. — Almost Retired

Dear Almost: No one likes to think about health problems while on vacation, but medical emergencies happen, and your regular insurance may not cover your care abroad. To avoid any expensive surprises, here are some tips:

Know what’s covered

Your first step is to contact your health insurer to find out exactly what your plan covers.

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

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 or your husband has 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. port, 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 a $250 annual deductible plus a lifetime limit of $50,000 for foreign emergency care.

If you have a Medicare Advantage plan, your coverage outside the U.S. will depend on the plan.

Buy extra protection

To shop and compare travel medical plans, visit sites like InsureMyTrip.com or SquareMouth.com to get a general idea of what insurance costs.

Most plans do not cover costs related to a preexisting health conditions. So if you or your husband has a pre-pexisting condition, 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 pre-arranged 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. Make sure you get copies of these so you can get reimbursed when you get home.

Jim Miller is a contributor to NBC-TV’s “Today” program and author of “The Savvy Senior.” Send your questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070; or visit savvysenior.org.