Traveling allows us to explore new places, immerse ourselves in diverse cultures, and create memories that last a lifetime. For seniors relying on Medicare for their healthcare needs, the question of coverage often comes up when planning their travels. What happens when you travel? Does Medicare follow you across state lines or even international borders? Understanding how Medicare works while you’re on the go is essential to ensure peace of mind during your adventures.
Our team at Local Medicare Specialists understands the unique needs and concerns of seniors when it comes to healthcare coverage. We’re committed to keeping you up-to-date on the latest coverage and helping you navigate your healthcare coverage while traveling.
Today, we’re going to discuss how Medicare works when you’re on the move - whether you’re planning a cross-country road trip or jetting off to another country.
If you’re traveling within the U.S., you can rest easy knowing that Original Medicare (Parts A and B) will continue to work wherever you are. Coverage extends to all fifty states and U.S. territories, including Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands!
The same rules apply if you have a Medigap policy in addition to Original Medicare. Medigap policies do not have provider networks, so you can hop from one state to another and still have access to any provider of your choosing. About 96% of all healthcare providers accept Medicare (and therefore accept Medigap).
The same may not be true if you have a Medicare Advantage (Part C) plan. Unlike Original Medicare and Medigap plans, these plans rely heavily on provider networks. If you have a Medicare Advantage plan in Arizona with Company X and you decide to travel to Texas, you’ll need to find a provider that also accepts Company X.
Medicare Advantage plans have changed their rules over the last few years. It used to be nearly impossible to have coverage if you traveled outside of your service area. Now, most plans offer national reciprocity, meaning the network applies throughout the country.
Even with the wide acceptance of Medicare in the U.S., it’s a good idea to do a little preparation before you hit the road. Here are a few tips to ensure smooth usage of your Medicare benefits while traveling within the country.
Carry your Medicare card. Always have your Medicare card with you. It contains the necessary information that healthcare providers need to bill Medicare.
Know your plan details. If you have a Medicare Advantage Plan or a Medigap policy, make sure you understand the details of your plan, including what's covered and what costs you may need to pay.
Check provider networks. If you're on a Medicare Advantage Plan, check if your destination has in-network providers.
Traveling beyond the borders of the United States poses a different set of considerations when it comes to Medicare. Original Medicare typically only covers you within the U.S. and its territories. However, there are certain circumstances where Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis you get in a foreign country under limited, emergency situations.
For more comprehensive coverage outside the U.S., you may want to consider a Medigap plan.
Medigap policies are designed to fill the "gaps" in Original Medicare coverage, and some offer additional benefits, including foreign travel emergency healthcare coverage.
If you have a Medigap policy that includes foreign travel emergency health care coverage, it typically covers medically necessary emergency care services beginning during the first 60 days of your trip. Note, however, that these policies usually only cover 80% of the billed charges after you meet the yearly deductible (if one applies).
It's important to know that the foreign travel emergency benefit under Medigap policies has a lifetime limit. Once you reach this limit, your policy won't pay for any more foreign travel emergency health care services.
When choosing a Medigap policy, consider your travel habits. If you frequently travel outside the U.S., a policy with foreign travel emergency health care coverage may be a good fit for you. Remember, though, that terms and coverage can vary between policies, so it's crucial to read the fine print and understand what's covered and what's not.
While Medigap policies can provide coverage for emergency health care during foreign travel, there's another option you might consider – Travel Medical Insurance.
Travel Medical Insurance is a type of coverage designed to protect travelers from unexpected medical emergencies while abroad. These policies typically cover a range of emergency medical services such as ambulance transport, hospitalization, and even medical evacuation back to the U.S. in some cases. Some plans may also cover costs related to trip interruption due to medical reasons.
It's important to note that travel medical insurance is not a substitute for Medicare, Medigap, or Medicare Advantage policies, but rather a complement to these coverages. It can provide additional peace of mind, particularly if you're traveling to remote areas or countries with high medical costs.
When choosing a travel medical insurance policy, consider the following factors:
Coverage Limits. Look at the maximum coverage limit of the policy. Ensure it's sufficient to cover potential medical expenses in the country you're visiting.
Medical Evacuation. Check if the policy covers medical evacuation, which can be very costly.
Pre-existing Conditions. Understand how the policy handles pre-existing conditions. Some policies may not cover medical services related to pre-existing conditions.
Duration of Coverage. Make sure the policy will cover the entire duration of your trip.
Destination. Some policies may exclude certain countries or regions, so ensure your destination is covered.
Whether you're covered by Medicare or Travel Medical Insurance, preparation is key to ensuring a smooth and enjoyable journey. Here are some practical tips to keep in mind before you embark on your trip:
Check with healthcare providers. Before traveling, discuss your travel plans with your healthcare providers. They can provide personalized advice based on your health status and needs.
Ensure prescriptions are filled. Make sure you have enough of your prescription medications to last the entire trip. It's also a good idea to carry a list of your medications and their generic names in case you need to purchase more while you're away.
Carry important health documents. Carry a copy of your Medicare card and any other insurance cards. It's also beneficial to have a list of your health conditions, allergies, and emergency contacts.
Understand your coverage. No matter what kind of coverage you have, make sure you fully understand what is covered, what costs you may need to pay, and what steps you need to take if you require medical care.
Plan for emergencies. Know the emergency numbers in the countries you're visiting and have a plan for what to do if a health emergency occurs.
Ready to learn more about how to ensure healthcare coverage while you're on the go? Contact our team at Local Medicare Specialists today. We're here to help, answer your questions, and provide the guidance you need to travel with confidence.
Safe travels, and we look forward to being part of your journey!
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LocalMedicareSpecialists.com is privately owned and operated by LMS Insurance LLC. LocalMedicareSpecialists.com is a non-government resource for those who depend on Medicare, providing Medicare information in a simple and straightforward way.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area which are United Healthcare, Aetna, Humana, Cigna, Blue Cross Blue Shield of Arizona, Centene, Devoted, and Scan. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.