Medicare Coverage When Traveling
What if I spend time in a different state or country?
You always planned to travel during your retirement. Now you are retired, you’re wondering whether your Medicare policy will cover you when you’re traveling out of your state or out of the country. The answer can be complicated – it depends on whether you’re talking about Original Medicare, Medicare Advantage, or a Medicare Insurance Supplement plan.
Frequently Asked Questions
Does Original Medicare cover you when you travel?
Original Medicare is a federal program that includes Medicare Part A and B. Since it’s a federal program that doesn’t use networks, you can use your Medicare coverage anywhere in the U.S. – you just need to go to a healthcare provider or facility that accepts Medicare.
If you want to travel outside the U.S., things are different. Medicare does not typically provide coverage outside of the U.S., which includes the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
However, Medicare.gov says there are three exceptions. Medicare can pay for services you receive in a foreign hospital if you:
- Are in the U.S. when you have a medical emergency, but the foreign hospital is closer than the nearest U.S. hospital that can treat you.
- Live in the U.S. and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat you. (Unlike the previous example, this applies even if you’re not having a medical emergency.)
- Are traveling from through Canada between Alaska and another state, you’re taking the most direct route “without unreasonable delay,” and the Canadian hospital is closer than the nearest U.S. hospital that can treat you. (Medicare decides what counts as “without unreasonable delay” on a case-by-case basis. Be aware that stops in Canada could mean you don’t qualify for coverage.)
Does Medicare Advantage cover you when you travel?
Medicare Advantage plans are sold by private insurance companies and most use networks of providers and facilities. If you go to a facility or provider not in your network, you may not have coverage or you may have higher out-of-pocket costs. Since rules vary, it’s important to find out who’s in your network and how much you’ll pay if you go outside your network.
Network restrictions can be an issue if you’re traveling outside the plan’s service area – you could end up having to pay most or all of any medical costs out of pocket. However, there are exceptions for emergency care.
In addition, some Medicare Advantage plans offer supplemental benefits that cover emergency and urgent services when you travel outside of the U.S. Since not all plans offer this benefit, you should check for foreign travel coverage before you enroll if this is something you want.
Does Medicare Supplement Insurance cover you when you travel?
Some people buy a Medicare Supplement Insurance plan (also called a Medigap plan) to supplement their Original Medicare coverage. These plans are sold by private insurance companies and help control the out-of-pocket costs associated with Original Medicare. Some Medigap plans also provide emergency medical coverage when you travel outside the U.S. According to Medicage.gov, these plans typically have a lifetime limit of $50,000 and pay 80% of billed charges for medically-necessary care outside of the U.S. after you meet a $250 deductible.
However, not all Medigap plans provide foreign travel emergency coverage. If this is something you need, make sure you pick a plan that provides this coverage.
What happens if you don’t have medical coverage?
If you need medical care while traveling and don’t have health insurance, you may be held financially responsible for any medical costs. This is true even in countries that have national healthcare systems with no costs for citizens. As a tourist, you may have to pay the full cost.
As a result, you could face medical bills of tens of thousands or even hundreds of thousands of dollars. You could even be detained in the country. An AP News investigation found that “an astonishing number” of hospitals around the world detain patients who are unable to pay their medical bills. It may be illegal, but this doesn’t stop some hospitals from using armed guards and other measures to keep patients until they’ve paid their bills.
What can I do if I want to travel but my Medicare plan won’t cover me?
Traveling without emergency medical coverage is a huge risk. However, you don’t need to let a lack of foreign Medicare coverage stop you from seeing the world: you can purchase travel health insurance. The CDC says anyone who is traveling should consider travel health insurance. It is especially important if you are traveling for more than six months, have an existing health condition, or are participating in adventurous activities that could result in injury.
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