Can I use Medicare on my Vacation?
Last Updated on September 16, 2024 by Exploring Goose
Individuals enrolled in Original Medicare can travel and use their coverage anywhere in the US and its territories. You’ll be covered from the Virgin Islands to Guam, Puerto Rico, or any other American Territory. But what does your coverage look like if you travel outside the US?
Continue reading to see how your different health insurance plan options will cover you, whether you have a Medicare Supplement or get your coverage through a Medicare Advantage Plan. If you’re wondering what a Medicare Supplement is, you can read more about this type of coverage at https://boomerbenefits.com/medicare-supplemental-insurance/what-is-a-medicare-supplement/
Medicare is the United States federal health insurance program for those aged 65 and older and for specific individuals with disabilities and end-stage renal disease under 65 years of age. This program is made up of different parts, each covering different services.
Part A covers inpatient hospital stays, hospice, skilled nursing care, and home health services. Part B is an individual’s outpatient services, like doctor visits, durable medical supplies, and preventative tests and services.
Part C is another term for Medicare Advantage plans. These plans offer an alternative way to receive your Medicare benefits through a private company. These plans include Part A, Part B, and prescription drug coverage, all in one plan.
Part D is your prescription drug coverage. You can enroll in a stand-alone plan or receive your benefits through a Medicare Advantage plan.
Traveling within the US with Original Medicare
Regarding Original Medicare Part A and Part B, you can expect your coverage to extend anywhere in the US or its territories. Do you live in Texas but plan to visit Hawaii for a couple of weeks and want to see a specialist there? You can rest assured your coverage extends, with no variances, regardless of where you are in The United States of America.
This confirmation of coverage extends to Medicare Supplement plans, also known as Medigap, as well. Since Medigap plans pay on anything Medicare pays, you can use your Supplemental coverage at any provider in the US that accepts Medicare.
When it comes to your Part D prescription drug coverage, you’ll be able to use your plan to pick up any necessary refills. However, you’ll want to ensure you use a preferred pharmacy for the lowest cost-sharing.
Traveling within the US with Medicare Advantage
When it comes to Part C, your country-wide coverage can depend on the type of plan you have. While all Advantage plans offer emergency coverage, regardless of where you are, if you have an HMO plan (Health Maintenance Organization), your plan will likely not cover any non-emergency services outside the network since these plans have strict networks. You can visit doctors and hospitals outside the network if you have a PPO (preferred provider organization) plan. However, you’ll likely have higher cost-sharing unless you have a plan that has a nationwide network.
International travel with Original Medicare
Regarding international travel, Medicare generally provides no coverage outside the US. There are some cases where you may have coverage while en route to the US or on a cruise ship in US territorial waters, and the closest hospital is in another country, like Canada. Still, it’s best to assume you have no Medicare coverage while traveling internationally.
Medicare drug plans will not cover any prescription medication you buy outside the US. Make sure you’re stocked up on your necessary prescriptions. Your pharmacy may even offer an additional refill if you notify them that you’ll be traveling abroad for some time.
Whether purchasing prescriptions or having services done outside the 50 states or US territories, you can expect to pay 100% for services in most cases of international travel.
Medigap
While Original Medicare won’t offer international medical coverage, except for certain rare circumstances, you may find solace in knowing that Medicare Supplement plans can offer limited medical coverage in an emergency while traveling outside of the US or its territories.
Medicare Supplement plans can provide coverage up to 80% for emergency medical costs after a $250 deductible. While this can offer some relief to those who’ve experienced an accidental medical emergency outside of the US, you’ll want to look elsewhere for additional coverage if you plan to travel for more than 60 days. Medigap’s limited international travel coverage will only extend to this time window.
Foreign travel with Advantage plans
Most Part C plans will cover you internationally for emergency services. If you have an incident and require immediate care, the foreign hospital should be able to bill your plan for you. If they cannot, you’ll likely be required to pay upfront, so you’ll want to keep any receipts or paperwork and submit a reimbursement request to your plan.