Traveling is popular among many people, especially in retirement. Regarding travel plans, there are many factors to consider, such as finances and itineraries. However, one item that many people forget about is health insurance and how you’re covered while traveling. This is especially important if you’re on Medicare. So, can you claim Medicare while on vacation? Well, it depends on where you’re traveling and your Medicare plans.
Traveling in the U.S.
It is possible to have coverage when traveling in the U.S., including U.S. territories like Puerto Rico, Guam, the U.S. Virgin Islands, and more. However, the cost of Medicare and the specifics of your coverage depend on whether you have a Medicare Supplement or Advantage plan.
Medicare Supplement Plans
Let’s say you receive your Medicare Part A and Part B benefits from the federal government and have a Supplement (Medigap) plan. In this case, you can see any healthcare provider in the U.S. as long as they accept Medicare insurance. This means you have a lot of flexibility with a Medigap plan and should not run into any issues while away from home.
To verify whether a provider accepts Medicare insurance, you should be able to ask them directly, and they can confirm this information. If they do not accept Medicare insurance, Medicare and your Medigap plan will not pay, meaning you will be responsible for 100% of the costs.
Medicare Advantage Plans
Advantage plans work differently than Medigap plans as they are much less flexible when it comes to travel. When you have an Advantage plan, you receive your Medicare Part A and Part B benefits through that private plan instead of the federal government.
This also means your plan is limited to a specific network of healthcare providers. You will pay more or have limited coverage when you receive medical care outside your plan’s network. So, if you plan to travel to another state or outside your plan’s network, you should expect to have extra costs. Some Advantage plans can be more flexible than others, so it’s best to verify what your specific plan can cover while traveling.
Traveling Internationally
If you plan to vacation outside the U.S. and U.S. territories, your Medicare coverage is minimal. This is true for both Medigap plans and Advantage plans. When traveling internationally, you should expect and prepare to pay the total cost for medical services, except in emergencies.
Medicare Supplement Plans
In emergencies, Medigap plans can provide some coverage. However, certain guidelines need to be followed. First, emergency care must start within the first 60 days of a trip. If not, you’ll likely pay the full price for medical services. Second, there is a $250 yearly deductible you must meet first. After you’ve met this deductible, your plan should cover 80% of approved emergency services. Lastly, Medigap policies have a $50,000 lifetime limit. In other words, once you’ve used up this $50,000 it’s gone for good and cannot be used again.
Medicare Advantage Plans
Like Medigap plans, most Advantage plans can provide coverage for emergency medical services only. They likely will not cover any standard, routine services. However, each Advantage plan is different since private insurance carriers run them. It’s best to check with your specific plan to verify.
What about Part D plans?
You may be wondering about coverage for your prescription medications. Fortunately, Part D plans can cover you across the U.S. in the different states. Just be sure to use pharmacies accepted by your plan. For example, if your Part D plan has CVS as a preferred pharmacy, you can visit any CVS in the U.S. to avoid extra costs.
However, Part D plans do not provide international coverage, so when you travel outside the U.S., you should prepare to pay the total costs for medications. You’ll want to ensure you have enough of your medications before traveling outside the States.
Final Thoughts
If you plan to travel in retirement, it’s good to understand how your Medicare plans work with national and international travel. Typically, Medigap plans offer more flexible coverage in the U.S. compared to Advantage plans. However, both types of plans do not provide comprehensive coverage for international travel. Whether you have a Medigap plan or an Advantage plan, it’s always a good idea to contact your plan directly for specific plan information.
When it comes to international travel, many people sign up for stand-alone travel insurance instead. Going this route can offer you greater peace of mind, so you don’t need to worry as much about how you’ll be covered should the need arise.
