Are You Covered by Medicare When You Travel?

Retirement is the time to take advantage of your free time and check things off your bucket list. A top retirement goal is to travel; whether it’s in the United States or to another country, seniors want to travel! Traveling in retirement requires planning, but many seniors do not plan for a medical emergency.

Medicare is health insurance for American citizens 65 years and older and for those with certain disabilities. If you aren’t familiar with your Medicare plan coverage, keep reading to find out if you are covered by Medicare when you travel.

Traveling with Original Medicare

Travel inside the country

Seniors with Original Medicare can travel to any state in the United States and receive healthcare services from any doctor or hospital that accepts Medicare. Medicare does not have any network restrictions, so if a U.S. doctor accepts Medicare, you can visit them for your healthcare services.

Medicare also covers you when traveling in the U.S. territories, such as Guam, American Samoa, Puerto Rico, the U.S. Virgin Islands, and the Northern Mariana Islands. You can visit any of these territories for healthcare services and be covered if the physician is willing to bill Medicare.

Travel outside the country

Medicare is American healthcare coverage. Therefore, Medicare generally will not cover you when traveling outside of the United States. There are a few limited circumstances where Medicare will likely cover you when traveling outside of the country.

  1. You’re traveling in the U.S. when a medical emergency occurs, and a foreign hospital is closer to a U.S. hospital that can treat your injury or illness.
  2. You’re traveling through Canada without unreasonable delay using a direct route between Alaska and another state when a medical emergency occurs. In this case, you can visit a Canadian hospital to treat your injury or illness if it’s closer than a U.S. hospital.
  3. You live in the U.S., and a foreign hospital is closer to your home than a U.S. hospital, and they can treat your health condition, regardless of an emergency or not.

Medicare only covers medically necessary emergency services. So, don’t expect to visit a foreign hospital for cosmetic surgery and Medicare to cover it, because Medicare will not.

Medigap coverage when traveling

Travel inside the country

Medigap plans work with Original Medicare when it comes to covering your healthcare services. Medicare is primary, and Medigap plans pay as secondary. If Medicare will not cover a procedure, then neither would a Medigap plan.

You can travel to any doctor in the United States and use your Medigap plan if the doctor accepts Medicare. When doctors accept Original Medicare, they must take a Medigap plan, no matter the carrier or type of plan.

A Medigap plan could be ideal coverage for seniors who plan on traveling throughout the states in retirement.

Travel outside the country

There are a few different Medigap plans that offer foreign coverage benefits. If you have Medigap Plan C, D, F, G, M, or N, you have access to $50,000 in lifetime foreign coverage. However, this coverage is for emergencies only.

If a medical emergency were to occur within the first 60 days of your travel outside of the country, you would pay a $250 deductible, and then your Medigap plan would cover 80% of your healthcare services. So, you would still pay a 20% coinsurance for your services. But, if you do not have Medigap Plan C, D, F, G, M, or N, you are responsible for 100% of the cost of your services when outside of the country.

Travel with a Medicare Advantage plan

Travel inside the country

Medicare Advantage plans are sold by private insurance carriers and separate from Medicare and Medigap plans. Medicare Advantage plan enrollees receive their healthcare services from doctors and pharmacies that are in the plan’s network, which the carrier sets.

If you purchase an HMO Medicare Advantage plan, then you can only visit doctors in that network. If you were to go outside of your network and it’s not an emergency, then you would be responsible for your services in full.

Medicare Advantage PPO plans are more flexible since you can go out of network for your care. However, if you visit an out-of-network doctor, you would likely pay more for your services than an in-network service. So, if you plan on traveling often in the states, you could consider a PPO Medicare Advantage plan.

Travel outside the country

As it’s mentioned above, Medicare Advantage plans have networks. Therefore, your plan would likely not work outside of the country. However, there are plans available that offer a foreign emergency travel benefit. The foreign emergency travel benefit will vary from carrier to carrier. If you have a Medicare Advantage plan, check your plan’s Summary of Benefits to see if you have this travel benefit available to you.

Final point

Retirement offers you opportunities to do things you’ve never done before but always wanted to try. If you find yourself wanting to travel often in retirement, read over your plan or chat with your Medicare agent to be sure how you will be covered by Medicare when you travel. Safe travels!