Medicare coverage can vary when seniors travel, especially abroad. Learn what Medicare covers, the limitations for international travel, and how to prepare for medical care on the go.
Travel is a big part of retirement for many seniors, whether for fun, visiting family, or exploring new places. However, understanding Medicare coverage while traveling is important to ensuring access to necessary healthcare services. While Medicare offers broad coverage within the United States, its benefits may be limited or nonexistent when traveling internationally.
Without proper planning, seniors may face unexpected medical expenses or difficulties finding care. Here is what seniors should know about the role of Medicare when traveling.
Medicare Coverage Within the U.S.
How Medicare coverage operates in the U.S. depends on the type of coverage someone has, whether that is Original Medicare or Medicare Advantage. Medicare Supplement (Medigap) plans also have a role to play, as well as Medicare Part D, which provides prescription cover for medications.
Original Medicare and Traveling Within the U.S.
If someone receives their Medicare coverage through Original Medicare Part A and Part B, they can see any provider in the U.S. as long as that provider accepts Medicare insurance. If they have a secondary Medicare Supplement (Medigap) plan, it will also be valid. This allows for a lot of flexibility for seniors who travel a lot in the States.
Medicare Part D and Traveling Within the U.S.
Medicare Part D covers prescription medications. Fortunately, Part D plans are also flexible regarding travel in the states.
Seniors with Part D can visit any pharmacy in the U.S. as long as it is a preferred or standard pharmacy according to their specific plan. So, it’s important for beneficiaries to check which pharmacies are included in their plan.
Medicare Advantage and Traveling Within the U.S.
If someone has a Medicare Advantage plan (Medicare Part C), their coverage will work differently since these plans have provider networks. Each plan will have a different provider directory, some larger than others. Seniors with an Advantage plan can contact their carrier directly or refer to their plan’s documents for specifics.
Beneficiaries who receive medical care from a provider that does not accept Medicare insurance or is out-of-network are likely to be responsible for most or all the costs unless it is an emergency.
Medicare Coverage for International Travel
Medicare coverage abroad is much more limited compared to traveling in the U.S. The available coverage depends on the type of plans someone has, specific circumstances, or if there is an emergency.
Original Medicare and Traveling Outside the U.S.
Unlike traveling within the states, Original Medicare does not usually cover medical costs internationally unless the trip is within a U.S. territory or fits a specific qualifying circumstance. If a senior with Original Medicare plans to travel outside the U.S., they’ll want to prepare to be responsible for all their medical costs if needed or enroll in travel insurance.
If someone travels within a U.S. territory, including Guam, the District of Columbia, the U.S. Virgin Islands, Puerto Rico, American Samoa, or the Northern Mariana Islands, their Original Medicare coverage should operate the same as it would in the states.
Other qualifying circumstances usually revolve around proximity to U.S. or foreign medical facilities. Coverage on cruises also depends on how close someone is to a U.S. port and if a doctor is legally allowed to provide care.
Medicare Part D and Traveling Outside the U.S.
Part D plans do not cover trips outside the U.S., so seniors should ensure they have all the medications they need for an international trip. Some even choose to bring extra, just in case.
If someone needs to fill a prescription at a foreign pharmacy, they should expect to pay the full cost unless they have other coverage.
Medicare Advantage and Traveling Outside the U.S.
Medicare Advantage plans are required to provide at least the same coverage as Original Medicare, including international coverage. However, some Advantage plans offer additional coverage that Original Medicare does not.
Seniors with an Advantage plan should check with their specific plan to see what their coverage options will be outside of the U.S.
Medicare Supplement (Medigap) and Traveling Outside the U.S.
Although Medigap plans usually only cover services Original Medicare does, these plans can provide additional international coverage. However, this extra coverage comes with certain stipulations and only applies to emergencies.
First, there is a $50,000 lifetime limit. Once a senior has used the $50,000, it is gone and cannot be used again. Second, the plan beneficiary must pay a $250 deductible before their Medigap plan starts to provide coverage. If the $250 is met, the plan will only pay 80% of the costs, leaving the remaining 20% to the plan beneficiary. Third, a Medigap plan will only provide this coverage if it is an emergency within the first 60 days of someone’s trip.
Even with these policies laid out, it’s recommended that seniors still check with their specific Medigap plan on what foreign coverage they may have.
Alternative for Foreign Travel Coverage
Although international coverage is typically limited for Medicare beneficiaries, travel insurance is an option.
Seniors can enroll in standalone travel insurance through various insurance carriers and research their options online. One factor to remember is that not all travel insurance includes health coverage, so it’s important to ensure that medical insurance is included.
Summary
Understanding Medicare’s role when traveling is important for seniors to avoid unexpected medical costs and ensure access to healthcare services. While Original Medicare provides flexible coverage across the United States, including U.S. territories, international coverage is limited.
Medicare Advantage and Medigap plans may offer additional benefits, but the extent of coverage varies depending on the specific plan. For those traveling abroad, obtaining supplemental insurance such as travel insurance or international health coverage is helpful to avoid financial risks.
Careful planning and a thorough review of Medicare benefits and alternative coverage options can help seniors travel responsibly.
