Senior News
Does Medicare cover me if I travel outside the United States? Original Medicare covers all 50 States as well as the District of Columbia, U.S. territories American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands.
Medicare does not provide coverage outside the U.S. and its territories unless it is an emergency.
On cruise ships, you will have Medicare coverage if the ship is in U.S. waters or is within six hours from a U.S. port. If you are traveling from the U.S. to Alaska going through Canada, Medicare will cover emergency services in Canada. If you live in the U.S. and a foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition, Medicare will cover regardless of if an emergency exists.
Some Medicare supplements cover foreign travel for emergencies, as well. There is a deductible that needs to be met. Foreign hospitals are not required to submit bills. The beneficiary can get an itemized bill and submit it themselves to their plan. Coverage only lasts the first 60 days of your trip, and they only pay up to 80 percent of costs.
Medicare Advantage plans may provide foreign travel coverage outside the U.S. However, these plans often restrict specific health services. If you plan to travel outside the U.S., it is important to inform your insurance carrier of your trip. The plan will tell you how your Advantage plan covers emergency travel benefits, if any and how your claim needs to be managed.
Travel insurance is an option for Medicare beneficiaries to cover emergent and non-emergent medical expenses.
If you live overseas, original Medicare will not cover any medical expenses. If you are living overseas full-time, one should consider disenrolling from Medicare part B. You can keep your Medicare part A if you have premium- free part A. If you travel back and forth to the U.S. frequently, you may want to keep both part A and B and continue paying the part B premium.
Coverage For Snowbirds
Original Medicare along with a supplement offer the most flexibility for snowbirds. When you purchase a supplement, you will list your permanent home address, which is the one that is on file with Social Security. You choose a supplement based on your home zip code. However, you can use the supplement anywhere in the country. The part D pharmacy plans can be used at any preferred or standard pharmacy in the country so be sure to find a preferred or standard pharmacy wherever you are. If the pharmacy you use is not either preferred or standard, it’s out-of-network and you will pay 100 percent of the costs. There are regional Advantage Plans.
Since many Advantage plans have a network of providers you must use to get coverage, traveling from one state to another will depend on your plan. You choose your plan based on your permanent residence and choose a plan with out-ofnetwork benefits if you know you will travel often.
Medicare Advantage PPO plans can cover you while you are out of the network if the provider is willing to accept the plan as payment and is willing to bill the plan. However, there are HMO and PPO plans that have national providers. Therefore, as long as you see a provider that participates in your plan’s national provider program, they can be considered in-network.
Knowing your costs can be more expensive when you are outside your plan’s network is essential. You will want to review your plan’s coverage and each year they may change so always read your Annual Notice of Changes.
