One of the benefits of retirement that folks look forward to is travel. But will your Medicare coverage travel with you? The good news yes, it will to select areas. If you have Original Medicare (Parts A and B), you can typically travel anywhere in the United States and its territories and receive adequate medical care coverage from almost any doctor or hospital. The covered areas are:
- American Samoa
- the Northern Mariana Islands
- the Virgin Islands
- Puerto Rico
- all 50 states
- District of Columbia
However, this coverage does not extend to Medicare Advantage plans. Also known as Medicare Part C, these plans might not cover your medical care while traveling aside from emergency services. Advantage plans rely almost entirely on “in-network” doctors, hospitals, and medical facilities. Traveling outside of your plan’s network (which is typically based on your local residence) will probably necessitate paying extra for all medical care that falls outside the “emergency” umbrella. Your Medicare Advantage plan may also require you to follow various rules and regulations relating to prior authorization for care. If you plan to travel, it’s a good idea to consult with your Medicare Advantage plan administrator to see what rules and extra costs may apply.
If you are traveling outside of the United States or its territories, be aware that Medicare usually will not cover any of the medical care that you require. There are a few exceptions to this general rule. Both Original Medicare Part A and Part B plans as well as Medicare Advantage plans are required to provide you with coverage in the following three instances.
- Medicare must pay your medical expenses on a cruise ship if you receive care while the ship is in U.S. territorial waters, which typically means that the ship is either in a U.S. port or within six hours of arrival (or departure) from a U.S. port.
- Medicare might pay for non-emergency services in a foreign hospital, as well as related ambulance and physician fees. Medicare’s coverage depends on whether or not your care facility is closer to your residence than the nearest American hospital that is equipped to treat your condition.
- Medicare will pay for emergency medical care in Canada if you are traveling directly between Alaska and a lower 48 state, and the nearest hospital that can treat you is located in Canada.
Medicare Advantage plans
Some Medicare Advantage plans may provide emergency care coverage when you travel outside of the United States. You should consult with your plan administrator before you travel to learn what rules, restrictions, and costs will apply. Medicare Supplemental Insurance, also known as Medigap, sometimes covers foreign medical care costs. Medigap plans C through G and plans M and N cover up to 80% of foreign emergency care. Medigap only covers this amount if the emergency occurs during the first two months of your trip. You are also responsible for a $250 deductible and limited to $50,000 total coverage for your lifetime.
Contact your local Medicare Advantage and Medigap plan administrators via the contact information provided to you on your policy or the provider company’s website. Contact Medicare at 1-800-633-4227 for further information about Original Medicare Part A and Part B travel coverage. To learn more about Medigap coverage, you can speak to one of our representatives by calling 1-855-MEDIGAP.