You may be looking forward to traveling during your retirement years. Whether it’s a trip to visit your grandkids in another state. A tour of the national parks. Or a flight overseas to explore a part of the world you’ve never seen. Whenever you travel, you don’t want to get sick while you’re away from home. If you need medical attention or treatment while you are traveling, understanding your Medicare coverage may help.
Medicare Benefits Solutions
May 4, 2020
If you have Original Medicare Part A and Part B, you can visit any doctor who “accepts assignment.” A doctor, provider, hospital, or supplier who “accepts assignment” agrees to accept the Medicare-approved amount as full payment for covered medical services. If you get sick while you’re in another state, you can get care from any local physician who accepts assignment and is currently participating in Medicare. If you have an emergency or ambulance services while you are out-of-state, your standard Original Medicare coverage will apply.
If you require dialysis when you’re in another state, you can get treatment in one of the 6,000 Medicare-approved dialysis facilities across the United States. Your routine dialysis facility can help find one in the city or state you’ll be visiting.
Original Medicare doesn’t usually cover healthcare outside of the United States, except in certain situations. Medicare will help pay for your Medicare-covered services (emergent or not) if you are in the United States but a foreign hospital is closer than the nearest U.S. hospital. If you are traveling through Canada between a U.S. state and Alaska without unreasonable delay and you have a medical emergency, Medicare will cover services to treat your illness or injury if a Canadian hospital is closer than a U.S. one.
Many Medicare recipients who regularly travel outside of the U.S. choose to purchase supplemental insurance to help cover those costs. Some Medicare Supplement, or Medigap, plans can help cover medical expenses while you are abroad. Several Medigap plans will cover 80% of the cost of your medical expenses while you are traveling outside of the US, including Plans C, D, F, G, M, and N.
Can you purchase a Medigap policy at any time? When you turn 65 and are enrolled in Medicare Part B, you will have a 6-month Medigap Initial Enrollment Period. During this time, you can buy any Medigap policy that’s sold in your state. You have a “guaranteed issue right“ and will not be subject to medical underwriting. If you do not buy a policy during this Initial Enrollment Period, you may be able to purchase one later, but you can be turned down or charged more for coverage based on pre-existing conditions.
If you’re enrolled in a Medicare Advantage (MA) plan, you should contact your plan before traveling outside of its service area. Your plan may or may not help cover the costs of care outside of your plan’s service area, whether it’s in the United States or abroad. Your costs may be higher for seeing providers who are out of network or you may be responsible for all of your medical expenses. Medicare Advantage plans are required to provide the same benefits as Original Medicare Part A and Part B, but some MA plans may offer additional travel coverage.
Medicare may cover medically necessary health care services you get on a cruise ship if the doctor is allowed, under certain laws, to provide medical services on the cruise ship. If the ship is in a U.S. port or no more than 6 hours away from a U.S. port when you get the services, regardless of whether it’s an emergency, Medicare will help cover costs. Medicare doesn’t cover healthcare services you get when the ship is more than 6 hours away from a U.S. port.
Make sure you have your Medicare ID card or Medicare Advantage plan membership card with you when you travel, or better yet, keep your original card at home and take a photo copy with you.
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