Traveling and Medicare: How Am I Covered?
There’s nothing like traveling when you don’t have to worry about rushing back to work the moment you get home—it’s one of the best perks of retirement. And if you’re enrolled in Medicare, you don’t have to worry about health care if something goes wrong on your trip.
Medicare is the leading health insurance program for seniors, and it offers comprehensive coverage for medically necessary services to diagnose and treat most conditions. Depending on your Medicare path (Original Medicare or Medicare Advantage), it might be a bit different from your previous employer plan, but over 90% of Medicare enrollees are happy with their coverage.
If you’re planning to set off on an adventure, here’s what you need to know about traveling and Medicare.
Original Medicare vs Medicare Advantage
Your travel coverage may be different depending on whether you’re enrolled in Original Medicare (Part A and Part B) or a Medicare Advantage plan. Most people have Original Medicare, which means you can get coverage anywhere in the United States without restriction—if the provider accepts Medicare. The good news is that 94% of doctors and hospitals do accept Medicare, so you’ll have no trouble finding someone to treat you.
Medicare Advantage is private insurance; you get your Medicare benefits from an insurance company instead of the federal government. Many Medicare Advantage plans are HMOs or PPOs, which means you need to get care from a network provider to keep your out-of-pocket costs low.
If you have a Medicare Advantage plan, you should check your plan benefits carefully before you travel to see what networks accept your plan in the area you’re planning to visit. If you need any routine care while you’re traveling, you may need to see a network provider in order for your plan to cover your care.
Will Medicare cover emergency care if I’m traveling?
All medically necessary emergency care is covered when you travel whether you have Original Medicare or a Medicare Advantage plan. If you have Original Medicare and the provider participates with Medicare, you won’t need to pay anything at the time of service and the provider will bill Medicare for you.
Medicare Advantage plans also pay for emergency care, even if you’re outside the plan’s network. You may have to pay your normal urgent care or emergency room copayment at the time of service, but most providers will bill your plan for the balance.
Most Medicare Advantage plans offer a nurse-on-call service, which means you can get medical advice at any time no matter where you are. This is helpful if you’re traveling and you feel a little ill or have a minor injury. Your plan’s nurse can advise you about whether to go to an urgent care clinic or the emergency room for treatment and help you find a network provider in your area if necessary. This helps you avoid unexpected medical bills because you either got care from a non-network provider or got services not considered medically necessary by your plan.
Does Medicare cover international travel?
If you have Original Medicare, you have no coverage when you’re traveling outside the U.S., except in extremely narrow circumstances, such as when you’re traveling between Alaska and the lower 48 and the nearest hospital is in Canada. If you plan an overseas trip and you have Original Medicare, it’s a good idea to get travel medical insurance.
If you have a Medigap plan, you may have coverage for emergency care overseas, but benefits are limited to the plan’s lifetime cap, typically $50,000. Check your plan brochure for your foreign travel coverage benefits.
Medicare Advantage plans may or may not cover foreign travel, although most offer some benefits for emergency care overseas. If you’re leaving the U.S., contact your plan’s member services department to check your coverage. You may want to get travel insurance to supplement your plan.
Can I fill my prescription medications when I’m traveling?
You should always fill your daily medications before you travel so you don’t run out during your trip. Of course, if you’ll be away for several weeks or months, you may need to refill your medications during your trip.
Generally, you can fill your medications at any pharmacy that accepts your plan. Most drug plans have a national provider network, so finding a participating pharmacy isn’t usually a problem. Start the refill process a few days before your medications run out; sometimes, it takes time for the pharmacy to verify your prescription and insurance coverage.
If travel is on your retirement bucket-list, you don’t have to worry about health care. Your Medicare benefits travel with you and protect you even when you’re on the go. If you’re not sure about your coverage, talk to a Medicare consultant or your Medicare Advantage member services team before you hit the road. And if you’re traveling overseas, travel medical insurance is always a wise investment.
Danielle K. Roberts is a Medicare insurance expert and co-founder at Boomer Benefits, where her team of experts help baby boomers with their Medicare decisions nationwide.