Don't Travel Until you Have the Right Medicare Plan
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Frequently Asked Questions
After a lifetime of working hard, many folks turn their thoughts to travel once they retire. After all, one of the benefits of this stage in life is the added time to enjoy the fruits of those years of labor. But one worry might be plaguing retirees: Will Medicare cover any medical expenses while traveling? Certainly no one wants to get ill or hurt while visiting different states or countries, but it is a possibility. The fears of unexpected expenses might even deter some from traveling altogether. However, knowing what coverage you have before hand can help take some of the worry out of your trip planning.
For travel within the United States, Original Medicare (Part A and Part B) will cover your medical expenses as if you were receiving treatment at home. You can receive treatment at almost any hospital and from almost any doctor. This coverage includes all US territories as well as the 50 states and the District of Columbia. That means your Original Medicare will be also valid in American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands.
Those who have Medicare Advantage Plans must consult with their individual provider for specific details about coverage. Plans that do not allow enrollees to see providers outside of your network or area will likely have to pay more for medical care when traveling. This care will also have to follow plan rules such as obtaining prior authorization. However, emergency and urgent care are the exception: Emergency care is covered regardless of your location within the US and its territories.
While Original Medicare covers travel within the US and its territories, it has very limited coverage internationally. In fact, there are only three instances where Medicare will pay for covered health care services in a foreign hospital. These situations are covered whether you have Original Medicare or a Medicare Advantage plan.
- If the medical emergency is in the US but a foreign hospital is closer than the nearest US hospital.
- If you are traveling a direct route "without unreasonable delay" between Alaska and continental US through Canada when your medical emergency happens and the Canadian hospital is closer than the nearest US hospital. (Medicare determines what qualifies as "without unreasonable delay" on a case-by-case basis.)
- If you live in the United States and the closest hospital that can treat your medical condition (whether or not it's an emerceny) is foreign.
What are the covered health care services? Medicare Part A covers inpatient care when a doctor admits you to the foreign hospital, and Part B covers emergency and non-emergency ambulance and doctor services you get immediately before and during your covered hospital stay. Coverage does not include any care or transportation after the hospital stay ends. Please note that foreign hospitals are not required to file Medicare claims, so you you might have to submit itemized bills to Medicare yourself for all the care you received
Medicare has different qualifications for covering medically necessary health care services on a cruise ship. It may cover services if the doctor is allowed (under certain laws) to provide medical services on the cruise ship and if the ship is in a US port or no more than six hours away from a US port when you receive the services. This coverage includes non-emergency care.
Some Medicare Advantage Plans will also cover emergency care when traveling internationally. To find out if your plan has any additional coverage for foreign health care services, contact your plan representative.
There have been plenty of attempts to repeal or dramatically change medicare in the past. However, Medicare is extremely popular among one of America's largest and most influential voting blocs: senior citizens. Americans age 60 and over vote the most frequently, and in the largest numbers. Many American politicians have seen their careers come to a sudden end for trying to pass Anti-Medicare legislation. If this trend continues, seniors will still maintain the power to influence their representatives in ways that are favorable to Medicare's survival.
Also, the biggest push to dismantle Medicare is currently only coming from a minority of representatives in Congress. The executive and judicial branches aren't exactly mustering a deluge of support for the plan. This lack of passionate support from both voters and 2 of 3 branches of government might be what Medicare needs in order to survive.
Although Original Medicare does not cover much when it comes to foreign travel, many Medigap plans do. These supplemental plans can provide for both services and supplies outside of the United States. Standard Medigap plans C, D, E, F, G, H, I, J, M, and N all provide coverage for emergency care during foreign travel (that Original Medicare doesn't already cover) if it starts during the first 60 days of your trip. These plans pay 80% of the billed charges after the $250 yearly deductible is met. These plans have a lifetime limit of $50,000 of coverage.
New enrollees hoping to purchase Plans E, H, I and J are our of luck; these plans are no longer available. However, everyone who bought and enrolled in one of these plans before June 1st, 2010 can keep it.
Those who have enrolled in non-standard Medigap plans might also have specific coverage for foreign travel. Be sure to contact your plan representative to learn about your coverage.
All 10 available Medicare Supplement Plans are standardized by Medicare - this means that each plan offers identical benefits, regardless of where you live or what company is handling your policy. Therefore, the only difference is in price. And the best way to get the best price is to compare plans online and save!
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