Retirement opens many opportunities for seniors, one of which is travel. Whether you travel in the U.S. or around the world, you’ll want to know how your health insurance covers you.
Unfortunately, you never know what could happen when you’re traveling, so being prepared and understanding your coverage is critical before you leave.
If you’re 65 and older, you likely have Medicare insurance. Since Medicare is from the federal government, your coverage can differ from employer insurance or Marketplace. You can learn more about Medicare by visiting https://boomerbenefits.com/understanding-medicare/. But when it comes to traveling, here are five facts you need to know when traveling with Medicare in 2024.
Original Medicare consists of Part A and Part B. Part A is your inpatient hospital coverage, and Part B is your outpatient medical coverage. These two parts cover the same services for every Medicare beneficiary enrolled in Original Medicare. Whether you live in Michigan or Texas, your Part A and Part B coverage is the same.
Additionally, your coverage remains the same if you’re traveling from one state to another. As long as you travel to one of the 50 states or a U.S. territory, you can expect Original Medicare to cover the same benefits you’d receive if you were in your home state. However, you must see physicians who accept Medicare or have not opted out of the Medicare program for you to have coverage.
Medicare Advantage Plans Have Provider Networks
Many Medicare beneficiaries enroll in Medicare Advantage plans. An Advantage plan is an alternative way to receive your Medicare benefits. Instead of getting your benefits from the federal government, you get them from the insurance carrier. These plans must offer the same benefits you’d get from Original Medicare, but they can decide your cost-sharing for each service and how the services are covered.
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Another feature of Advantage plans is the provider network. These plans have networks of providers, which can make traveling more difficult. An HMO plan means you’d only have coverage from your plan if you went in-network for your services, so if you receive services outside of your plan’s service area, you may not be covered. However, a PPO plan can offer coverage for in-network and out-of-network services.
Some Advantage plans can cover regional areas or may include nationwide participating providers, which can make traveling easier.
Medicare Offers Limited Foreign Travel Coverage
When traveling outside the U.S., your Medicare coverage is very limited. You are covered by Medicare when traveling to a U.S. territory, en route to the U.S., and the closest hospital is in another country or within six hours of a U.S. port. However, outside of those circumstances, you would not be covered by Original Medicare.
Medigap Plans And Advantage Plans Can Cover Foreign Travel Emergencies
While Original Medicare doesn’t provide comprehensive coverage when traveling overseas, a Medigap plan or Medicare Advantage plan may cover you.
If you enroll in a Medigap Plan C, D, F, G, M, or N, you can have some coverage for emergencies that happen when you’re traveling. However, there is a $250 deductible that you would pay first before the Medigap plan pays 80% of the cost. With the plan, you are responsible for the remaining 20% and any costs above the $50,000 lifetime benefit limit.
If you enroll in an Advantage plan, you also have worldwide emergency coverage. If a life or limb accident happens while you’re overseas, you can submit the claim to your Advantage plan once you return to the U.S. to see what they will cover for you.
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TIP: Purchasing traveler’s insurance is recommended. Traveler’s insurance can pay upfront when you need medical treatment overseas. Additionally, it can help cover non-emergent services, whereas a Medigap plan or Advantage plan will only cover life or limb emergencies.
Part D Plans Cover Drugs In The U.S. But Not Out Of The Country
A Medicare Part D drug plan can help cover the drugs you get from a pharmacy. Each plan has certain pharmacies they are in-network with, so when you’re traveling, you can go to any pharmacy in the U.S. as long as they are in-network with your plan.
If you go to a “preferred” pharmacy, you’ll have more cost-effective copays than if you went to a standard pharmacy.
If you travel out of the country, you will not have coverage from your Part D plan. If you needed medications from a foreign pharmacy or a facility, you would pay out of pocket for those drugs. You will not be able to get reimbursed from your plan when you return to the U.S.
TIP: If you know you will be traveling out of the country, you may try to get a refill of any medications you need.
Wrapping Up
Whether you are traveling within the U.S. or overseas, you’ll want to know how your Medicare coverage will cover you. Each type of Medicare plan, whether a Medigap plan, Advantage plan, or Part D plan, has different rules regarding coverage while traveling.