Since travel is beginning to open, we want to help you understand what you need to know about traveling with Medicare insurance. Medicare’s coverage of healthcare services while traveling depends on where you travel and how you receive your Medicare benefits.
Traveling inside the U.S.
If you have Original Medicare or Original Medicare with Medigap coverage, you will typically have the same level of coverage anywhere in the United States, (including Puerto Rico, U.S. Virgin Islands, and other territories of the U.S.), if services are provided by doctors and hospitals that accept Original Medicare.
If you have a Medicare Advantage Plan, your benefits may or may not cover services received outside of your service area. Some plans may cover providers that are out-of-network or out of your service area, but may have higher cost-sharing, or restrictions such as prior authorization. Some plans offer telehealth services which would allow you to connect with a physician via phone or video chat to receive a medical assessment. All Medicare Advantage Plans are required to provide coverage for emergency and urgent care anywhere in the U.S. without additional cost sharing. You should contact your plan prior to traveling to determine what rules and costs apply when you travel within the U.S. Check the rules closely to determine if your plan offers a visitor or travel benefit. Only certain areas or timeframes may be included, certain services may not be covered, you may have cost-sharing or potentially be responsible for the entire cost of care if you see providers that are outside the plan’s network.
Traveling outside the U.S.
Medicare usually does not cover medical care outside the U.S. However, some Medigap policies provide limited coverage for travel abroad. Medigap plans C through G, M, and N may cover 80% of the cost of emergency care abroad, (with a $250 annual deductible and $50,000 lifetime maximum). Some Medicare Advantage Plans also have limited emergency coverage. Keep in mind, although your plan may provide travel benefits, you may still be responsible for the entire cost at the time of services and then responsible to seek reimbursement upon your return home. Check your policy for specific coverage rules.
Traveling by Cruise Ship
Medicare may pay for medical care you get on a cruise ship if you receive the care while the ship is in U.S. territorial waters. This means the ship is in a U.S. port or within six hours of arrival at or departure from a U.S. port. Medical care received while in a foreign port or foreign waters will likely not be covered depending on how you receive your Medicare benefits.
Travel Health Insurance is strongly encouraged, and sometimes required, when traveling out of the U.S.
We recommend all Medicare beneficiaries call and discuss your health plan benefits and the options for travel insurance with your trusted Medicare insurance advisor when planning any trip outside of your service area.
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