Will Medicare Cover Me While I Travel?
Entering retirement means you have more time to do the things you’ve always wanted to do. Traveling throughout your country and around the world is usually towards the top of the bucket lists for seniors. If traveling is on your schedule for the upcoming year and you are a US resident, you’ll want to learn how Medicare covers you when you are on the move.
Is there a certain country you’ve always wanted to visit? Perhaps Italy, Australia, or maybe France?
Unfortunately, Original Medicare does not cover any routine medical care outside of the United States, with one possible small exception.
There is one special circumstance where Original Medicare may cover you at a foreign hospital even if an emergency doesn’t occur. If you go to a foreign hospital because it is closer to your home than an American hospital, Medicare may cover you regardless of whether an emergency occurs.
In addition, Original Medicare does not cover emergency care outside of the United States, with some very limited exceptions. There are certain specific circumstances where Medicare may cover you in another country if an emergency occurs.
If an emergency occurs and you go to a foreign hospital Original Medicare will help cover your medical services if one of these is true:
- Your emergency occurred within the United States and you went to a foreign hospital for treatment because it was closer than an American hospital.
- You were traveling directly through Canada from or to Alaska when an emergency occurred, and the Canadian hospital was closer than an American hospital.
Medigap (aka Medicare Supplement Plans)
If you have a Medigap plan that has a foreign travel emergency benefit, you can still be covered even if you’re not near the United States. For example, if you are in Europe when an emergency occurs, your Medigap plan may cover you at a foreign hospital.
Medigap plans do not cover routine medical care outside of the United States. However, six out of the ten standardized Medigap plans offer a foreign travel emergency benefit, all of which cover 80% of the costs of emergency care. However, there are limitations to this benefit. First, you must meet a $250 deductible before your Medigap plan will pay anything. Second, there is a lifetime spending limit of $50,000 with this benefit. Also, there is a time limit for when you can use this benefit. If you have been outside of the United States for more than 60 days when an emergency occurs, your Medigap plan will not cover your care.
It’s important to highlight that this benefit is only for emergencies. Your Medigap plan will not cover you at a foreign hospital if it is not an emergency.
Medicare Advantage plans are required to cover at least what Original Medicare covers. Although, they normally add additional benefits to their plans, including coverage for worldwide emergencies. So Medicare Advantage plans may or may not cover you while you travel internationally.
Each carrier is able to set their own costs for each part of their Medicare Advantage plans. Therefore, you’ll need to review your plan’s copay for worldwide emergencies prior to traveling. Similar to Medigap plans, a deductible may need to be met prior to accessing this benefit.
Traveling Within the United States
Of course, Medicare coverage when traveling from state to state is less confusing. This includes travel within the American territories. Which are American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.
Many retirees buy an RV and hit the road during retirement. If this is what you plan to do, you will most likely be covered depending on what type of Medicare you have as long as you remain in the United States.
Original Medicare covers both routine and emergency care in the United States. Your Part A and Part B benefits travel with you wherever you go within the country, which means your coverage will remain the same regardless of what state you are in. This is true for routine health care as well as emergencies.
Medigap (aka Medicare Supplement Plans)
Medigap covers both routine and emergency care in the United States. One of the most beneficial things about Medigap plans is that they don’t have networks. A network is a set list of doctors you must choose from for your medical care. Since Medigap plans don’t have this, you are able to travel with your Medigap plan.
For example, you live in Texas but are in Florida for vacation and need to see a doctor. If Original Medicare pays, your Texas Medigap plan will pay its part as well. Your coverage will be the same as if you were in your home state.
Medicare Advantage plans generally cover both routine and emergency care in the United States but may have network or other restrictions. If you have a Medicare Advantage plan you may have a harder time being covered while traveling. This is because Medicare Advantage plans usually do have networks. You’ll want to stay within your plan’s network when seeking medical attention. Networks are limited to a certain area where the plan operates, so when you travel out of state you may well be outside of your network.
As we mentioned, carriers are able to set their own costs and benefits for their Medicare Advantage plans. Some Medicare Advantage plans may not cover you at all when using an out-of-network provider. Either way, expenses when using an out-of-network provider will always be higher than using an in-network provider.
Because foreign hospitals don’t always submit claims to Medicare, it’s best practice to hold on to all your bills. That way when you return home you can file them with Medicare.
If you would like additional coverage while traveling you can discuss with either your insurance agent or travel agent about purchasing a travel insurance policy. In addition, many credit and debit cards now offer various types of travel insurance coverage.
Danielle Kunkle is a Medicare insurance expert from Fort Worth, TX. She and her team help new Medicare beneficiaries across the nation to learn their benefits and select suitable supplemental coverage. You can learn more about Medicare’s coverage at https://boomerbenefits.com
Stay tuned to BonVoyageurs.com for our writings about other Countries of the World as we share our joie de vivre from around the world. Luxury escapes, cruises and city breaks to Québec City, New York, Washington, Buenos Aires. In Europe and the Mediterranean, places like Paris and Nice in France, Florence, Rome, Napoli and the Amalfi Coast in Italy, Tel Aviv and Jerusalem in Israel. In Asia, countries like China, India, Nepal and so much more!