Guest Post by Cobi B. Gantz
Given COVID’s continuing challenges, it can be hard to imagine traveling abroad now. However, if you are planning ahead for an upcoming trip and are on Medicare, it is important to note that the specific plan you are on can have a significant impact on the type of coverage you are eligible while traveling.
Medicare is the federal health insurance program that is designed for people who are 65 or older and qualifying younger people with disabilities. Those who qualify also include people who have End Stage Renal Disease. Medicare was first created in 1965 and is administered by the Centers for Medicare and Medicaid Services.
Most people who are eligible for Medicare get their plans in two main ways — Original Medicare and Medicare Advantage. We have provided a quick overview below:
Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Part A covers inpatient hospital stays. It also includes care in a skilled nursing facility, hospice care, and some home health care. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. A Medicare Supplement plan (Medigap) helps offset Original Medicare's out-of-pocket costs. People who choose original Medicare will often choose to obtain a separate Medicare drug plan (also known as Medicare Part D or a PDP) in order to ensure they have coverage for their prescription drugs.
*Medicare Part D covers the cost of your prescription drugs. It is a federally created program and most people who opt for Original Medicare (Part A and B) also choose a Part D plan; however, it's optional.
Medicare Advantage is also known as Medicare Part C. Medicare Advantage offers another way to get your Medicare benefits through private insurance companies. Many Medicare Advantage plans include prescription drug coverage as part of the plan. However, when it comes to travel, there are some limitations to note which we will address below.
As there are a number of Medicare coverage options, it is important to note whether the plan you are on includes coverage during your upcoming travel. If you’re planning to travel internationally after COVID subsides, consider getting expert advice from a licensed Medicare Advisor to confirm benefits during your trip.
Original Medicare does not cover health care while you’re traveling outside the United States. (The U.S. Virgin Islands, Puerto Rico, Guam, American Samoa, and the Northern Mariana Islands are considered part of the United States.)
If you are traveling abroad and have a Medicare Supplement plan, you may receive some coverage. Plans C, D, E, F, G, H, I J, M, or N typically cover foreign travel emergency care if it begins during the first 60 days of your trip. These plans pay 80 percent of billed charges for certain medically necessary care after you meet a $250 yearly deductible. This benefit has a lifetime maximum of $50,000.
Medicare Advantage Plans typically don’t cover care outside the United States. They also usually don’t cover non-emergency care you get outside of your plan’s network. However, these plans are required to cover any emergency and urgent care needs people have anywhere in the United States without imposing additional costs or coverage rules.
If you have a Medicare Advantage Plan, triple check coverage from state to state. These plans are required to cover emergency care in America but are not required to cover routine care. In some cases, you may be able to visit out-of-network providers but will have to pay more to see them. Your plan or a Medicare Advisor can help you to find an in-network provider in the area where you are traveling.
People with a Medicare Supplement plan, also known as a Medigap plan, can receive care from any doctor nationwide who accepts Original Medicare. While most doctors accept Original Medicare and Medicare Supplement plans, some do not. Ask the doctor’s office or hospital staff before your appointment.
Try to get your prescriptions ahead of your trip. Or, take the time to double-check that your destination (if based in the United States) has a pharmacy that has “preferred in-network” status with your drug plan to help reduce the cost of your co-pays.
Before you plan travel, consult with a Medicare advisor in order to confirm your current plan includes coverage during your travel.
Cobi B. Gantz is the CEO of Chapter, a Medicare Advisor company that offers Medicare education and assists with Medicare enrollment.
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