With retirement usually comes more time to travel and see the world. Whether traveling around the U.S. or going international, you want to ensure you’re covered if an emergency occurs and you need medical services. You also don’t want to worry about receiving a bill for tens of thousands of dollars when you return home.
Before heading out on vacation, make sure you understand what, if any, coverage you have under Medicare. If you have an additional insurance plan, such as a Medicare Advantage plan or a Medicare Supplement, you want to note what other benefits they can provide. To learn more about Medicare Supplements, visit boomerbenefits.com/medicare-supplemental-insurance/what-is-a-medicare-supplement/.
Under Medicare Parts A and B, you can see any provider in the U.S. that accepts Medicare. This coverage applies to all states and U.S. territories with or without a supplement plan.
On the other hand, Medicare generally does not offer any coverage when it comes to foreign travel. There could be exceptions, like if you were on a cruise ship in U.S. territorial waters or found yourself on the way to the U.S., but a hospital in Canada was closer. It is safer to assume you will not have any benefits outside the country under Original Medicare.
How does an Advantage Plan work for U.S. travel?
Traveling with an Advantage plan can be a bit tricky sometimes. It’s important to note which type of plan you have, such as a PPO or HMO, so you understand what coverage you have in and out-of-network.
If you have an HMO Advantage plan, you only get in-network coverage unless there is an emergency. You will be responsible for total costs if you receive service outside your plan’s network and it is not classified as an emergency.
PPO plans are considered more beneficial if you plan to go away often since these plans offer in and out-of-network coverage. One thing to be aware of is that you will likely have higher costs for services found to be out-of-network.
Some Advantage plans offer travel benefits that give you coverage from participating providers nationwide, but not every plan allows this.
Domestic travel with a Medicare Supplement
When traveling with a Medicare Supplement plan, everything should be smooth sailing for any Medicare-approved service you receive while away from home. You can visit any healthcare provider in the country and have coverage as long as they accept Medicare. Your Medicare Supplement plan will pay the remaining costs after Medicare pays.
U.S. travel with a Part D plan
One positive aspect of having a Part D plan is you can get your prescriptions filled wherever you are in the country. Your prescription drugs should be covered as long as you get them filled at a preferred or standard pharmacy.
If you stop at a pharmacy out-of-network, you will be held responsible for the entire cost of your prescriptions, and the amount you pay cannot be applied toward your Part D plan.
Does my Advantage plan have benefits for foreign travel?
Many Advantage plans provide beneficiaries with emergency coverage that can be used worldwide. It is essential you carry your Medicare Advantage card when traveling so that a foreign provider can bill your plan. If they choose not to bill your insurance carrier, you need to make sure you keep all the documents and receipts from the care you received so you can work to get reimbursed on your return home.
Another thing to keep in mind if you have a Medicare Advantage plan is that if you travel abroad for more than six months, you could potentially get disenrolled from your plan.
Going international with a Medicare Supplement plan
You can access foreign travel benefits if you have one of the six Medicare Supplement plans that offer foreign travel emergency coverage. Your plan can pay up to 80% of your emergency medical costs, but you must first pay a $250 deductible.
There are limits to these plans, though. This coverage is only for emergencies during your first 60 days out of the country and has a lifetime limit of $50,000.
Traveling abroad with a Part D plan
Unfortunately, while traveling abroad, you will not have prescription drug coverage under a Part D plan. There could be limited coverage if you are close enough to the U.S. border but expect to pay 100% of the out-of-pocket costs for prescriptions filled at a foreign pharmacy.
Better safe than sorry
It’s important to know how covered you are when it comes to your healthcare needs. Traveling within the U.S. provides Medicare beneficiaries with more peace of mind when it comes to having health coverage while on the move. However, coverage for foreign travel is much more limited. The overseas coverage is meant for unexpected situations, not routine services while out of the country.
Before going international, you should speak with a Medicare expert about your insurance. Travel insurance could be the safest bet for those who don’t want to risk having zero coverage during a trip.