Seniors often have many things listed on their bucket list for retirement, such as skydiving, riding in a hot air balloon, and traveling. According to RBC Wealth Management, 63% of American seniors say travel is an important goal in retirement. With traveling being a top retirement objective, there are some things you must consider before you hit the road, such as healthcare coverage. Now, you might be thinking, “Will Medicare cover me when I travel?” It depends – let’s discuss below.
Medicare is American healthcare coverage for seniors aged 65 years and older and individuals who qualify for certain disabilities. Medicare consists of Part A (inpatient coverage) and Part B (outpatient coverage). Since Medicare is American coverage, can you use it anywhere in the United States?
United States Travel
If you are traveling within the United States, you can use your Medicare insurance at any doctor or hospital that accepts Medicare. Original Medicare does not have a network of doctors; therefore, if a United States doctor accepts Medicare, you can visit them and be covered without a problem.
The United States also has territories: Puerto Rico, Guam, American Samoa, U.S. Virgin Islands, and the Northern Mariana Islands. If you visit any of these countries, you can also use your healthcare coverage if the doctor accepts and is willing to bill Medicare.
Now, if you are outside the United States and its territories, you will likely only be able to use your Medicare in certain emergencies.
Since Medicare is American healthcare coverage, Medicare will likely not cover you when receiving healthcare outside the United States. However, there are three scenarios where Medicare may cover you in another country.
- If you have a medical emergency in the United States and a foreign hospital is closer than an American hospital, you can visit the foreign hospital to treat your injury or illness.
- If you are traveling through Canada without unreasonable delay to get to Alaska through a direct route and a medical emergency occurs, you can visit a Canadian hospital if it is closer than an American hospital. Medicare determines on a case-by-case basis if your “unreasonable delay” qualifies.
- You live in the United States, and an international hospital is closer to your home than an American hospital that can treat your medical conditions, regardless if it’s an emergency or not.
Medicare may also cover you if you are on a cruise ship and require medically necessary treatment. However, Medicare will not provide coverage if your cruise ship is more than six hours away from a U.S. port, where you could get your healthcare services.
Medicare Supplements, also known as a Medigap plan, are sold by private health insurance carriers. These plans pay secondary to Medicare and help cover the “gaps” you have with Medicare, such as copayments and deductibles. As of 2021, there are ten Medicare Supplements on the market, and each one provides a different set of benefits.
United States Travel
As mentioned above, Medigap plans are secondary to Medicare. Similar to Medicare, Medigap plans do not have networks. Therefore, you can visit any doctor in the United States with your Medigap plan. If a doctor accepts Medicare, they must accept your Medigap plan, regardless of plan and carrier.
A Medicare Supplement is ideal for snowbirds since you can travel throughout the United States with your plan. However, the coverage is different once you leave the states.
Depending on your Medicare Supplement plan, you might have a foreign emergency travel benefit. Medigap Plans C, D, F, G, M, and N provide a $50,000-lifetime coverage benefit that you can use internationally. These plans will cover 80% of your service if an emergency occurs and your treatment is medically necessary. Along with this foreign coverage benefit, there is a $250 deductible.
If you do not have one of the following plans that provide a foreign emergency coverage benefit, you will likely have to pay for 100% of your costs when receiving healthcare in another country.
Medicare Advantage plans are also sold by private insurance carriers but are very different than Medicare Supplements. When enrolling in a Medicare Advantage plan, you will no longer receive your Part A and Part B benefits through the government; you will receive them through your carrier, who you purchased your Medicare Advantage plan from. Therefore, Medicare Advantage plans have different rules than Original Medicare and Medigap plans.
United States Travel
Unlike Original Medicare and Medicare Supplements, you will have a network with a Medicare Advantage plan. The two most common Medicare Advantage plans are HMO and PPO plans. With an HMO Advantage plan, you will only receive your healthcare services in your network of doctors. If you go outside your network for non-emergency care, you will pay 100% of your healthcare expenses.
Medicare Advantage PPO plans also have networks, but you can go outside the network to receive your care. However, you will pay more for your services than if you were to receive care in-network. So, if you plan on traveling throughout the United States, you will want to travel with a PPO plan to ensure you have coverage.
There are over 3,000 Medicare Advantage plans in the United States. Therefore, every plan and its benefits vary. However, many Medicare Advantage plans provide a worldwide emergency coverage benefit. If you were to enroll in a plan with this type of benefit, your plan would provide you with coverage for unexpected emergencies.
Please note that an international hospital or doctor does not have to bill your plan since it is an American healthcare plan. If this were to happen, you should hold on to your itemized bill so you can submit it to your carrier for reimbursement when you make it back to the states.
Medicare will cover you when you travel. However, it depends on where you are traveling and your plan’s benefits to know for certain. We recommend reading your plan’s summary of benefits before you pack your bags to know if you will be covered if a medical emergency were to happen.