Many clients have been asking how their Medicare insurance, Medicare supplement (and drug plan), or Medicare Advantage plan works when they travel or if they winter/summer away from their home base.
When you travel WITHIN the United States, including all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands:
If you have Original Medicare and a Medicare supplement or Medigap or G or N plan and a Prescription Drug plan:
This is like you never left home. Supplement plans have no network. As long as the facility or provider accepts Medicare and supplements, you can go anywhere in the United States for service or treatment.
Most prescription drug plans are national, so you can fill a prescription anywhere in the United States using preferred or in-network pharmacies. (Reminder: if you move out of Illinois, you will have a special enrollment period to elect a plan based in your new state.)
If you have a Medicare Advantage Prescription Drug Plan (MAPD) or Part C:
These plans are offered by individual insurance companies. Some have travel benefits. Before you travel, call the member services number on the back of your card and ask how that works for the plan you are enrolled in. If you are enrolled in an HMO, some plans include a visitor or traveler benefit that allows you to receive care in other states at in-network costs. If you are enrolled in a PPO, you may see out-of-network providers, but you may experience higher cost-sharing. Finally, there are a couple of companies that have doctors and pharmacies across the country.
Emergency and urgent care are usually covered, but for routine or non-emergency care, either no coverage outside your plan’s service area, or it will require higher out-of-pocket costs.
When you travel OUTSIDE the United States:
Generally speaking, Medicare does not work outside the United States. International Medical Travel Insurance. This is different from the trip cancellation, lost luggage and/or flight disruption insurance. International travel insurance is specifically for medical coverage when you travel internationally. It is fairly inexpensive and provides coverage for when you are traveling or if you need to be transported back to the United States for treatment. I like to call this sleep insurance—I hope you don’t have to use it, but if you do, you have it!
If you have a trip coming up, you can send me your travel dates and age information to receive a quote. I am available to help navigate any of these or if you just have a question.
If there are topics of interest to you, let me know by sending a note through my website.
Mary Hansen is a licensed insurance consultant (broker) with American Republic Insurance Services. She looks forward to answering your questions. You can submit them to her website: maryhansenmedicare.com. Phone: 630.286.9160. You can also find her on Facebook: https://www.facebook.com/foxvalleymedicarehelp/ Look for her daily posts!
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