Like many people, you’re probably looking forward to traveling more during retirement. However, even on vacation, it’s good to know how to handle medical situations if needed. For most people, this means understanding your Medicare coverage even while traveling.
The way your Medicare coverage works depends on various factors including which Medicare plans you have and whether you’re traveling nationally or internationally. So, how does Medicare work when you’re on vacation?
Traveling in the United States
When you travel in the U.S., your plans operate by Medicare’s usual guidelines. If you’re new to Medicare, it’s important you learn the basics of how the program works, so you don’t run into unexpected issues.
Original Medicare
Original Medicare consists of Medicare Part A and Part B. Part A is coverage for your inpatient hospital needs like room and board. Part B helps cover outpatient services approved by Medicare including bloodwork, surgeries, preventative services, and more.
If you receive your Part A and Part B benefits through Medicare, rather than an Advantage plan, you can see any doctor or other healthcare provider in the U.S. as long as they accept Medicare insurance. This includes other U.S. territories like Puerto Rico, Guam, the U.S. Virgin Islands, and more.
Medicare Supplement Plans
Supplement plans, also known as Medigap plans, work the same way. If you have a Medigap plan, you can see any provider in the U.S. that accepts Medicare.
In fact, if a healthcare provider accepts Medicare insurance, they are required to accept your Medigap plan as well, with no exceptions. So, if you are traveling in the U.S. for vacation, you shouldn’t have too much trouble finding a doctor if needed.
Part D Plans
Like Original Medicare and Medigap plans, you have national coverage with a Part D plan. However, each Part D plan has a list of preferred pharmacies. So, if you visit a pharmacy for medication while on vacation, make sure you go to a pharmacy included in your plan’s list of preferred pharmacies.
If you don’t, you may pay more out-of-pocket. You can refer to your plan’s Summary of Benefits (SOB) to see which pharmacies are considered preferred pharmacies.
Medicare Advantage Plans
Advantage plans work differently than the rest as these plans operate within regional or local network areas. Some Advantage plans are more restrictive than others. For example, Health Maintenance Organizations (HMOs) usually won’t cover you outside of your network, except in emergencies.
However, other Advantage plans like the Preferred Provider Organizations (PPOs) can be more lenient. With a PPO Advantage plan, you can see a provider outside the plan’s network, but you will likely pay more out-of-pocket.
If you travel nationally with an Advantage plan, you may not have a lot of cost-effective coverage options. You’ll want to check with your specific plan to see what, if any, coverage is offered when traveling outside the plan’s network.
Traveling Abroad
Traveling internationally works differently than vacationing in the U.S. Generally, you only have coverage for emergencies, although there are some exceptions.
Original Medicare
Medicare Part A and Part B typically do not provide coverage outside the U.S. Part B may cover some services if you are on a ship within specific territorial waters near the U.S. However, it’s best to assume that Medicare will not cover you on vacation outside the U.S.
Medicare Supplement Plans
Some Medigap plans can offer coverage for emergency situations while you’re traveling abroad. However, there are specific guidelines that must be followed. For example, Medigap plans only provide coverage if the service is done within the first 60 days of travel.
There is also a $250 deductible you must meet first before your plan pays anything. Once, the deductible is met, your plan will pay for 80% of the emergency charges, leaving you responsible for the remaining 20%. Additionally, you have a lifetime limit of $50,000 to pull from. After the $50,000 is used, it’s gone for good and cannot be used again.
Part D Plans
Part D plans do not cover anything for foreign travel. So, you should expect to pay the full amount for medications while traveling outside the U.S.
Medicare Advantage Plans
Generally, Advantage plans offer limited coverage in emergencies situations only. Otherwise, you may pay for everything out-of-pocket. You should contact your plan directly to verify. However, as with the other parts and plans of Medicare, you should prepare to pay full costs when traveling internationally, even with an Advantage plan.
Final Thoughts
When traveling with Medicare you’ll want to consider which plans you have and whether you’ll be traveling nationally or internationally. You’ll have more coverage opportunities in the U.S. than you would when traveling abroad.