Kiley Engle, EHD Medicare Benefits Specialist
Summertime is right around the corner, which means family vacations and travel for many. Whether you’re traveling within the U.S. or internationally, it’s important to understand how Medicare works before you pack your bags so your vacation can be as stress-free as possible.
Traveling Within the U.S.
Original Medicare (Parts A & B) generally cover beneficiaries’ healthcare costs across the United States. Since Original Medicare has no networks, you can see any provider (without a referral) or go to any hospital that accepts Medicare. Coverage with Medicare Advantage plans is typically a bit more restricted and you may be limited to seeing providers or going to hospitals that are in network with your plan. Check-ups or follow-ups that are needed out of your typical coverage area might not be covered. When traveling, it’s best to check what your Medicare Advantage plan covers regarding nationwide services or travel benefits. It’s important to note that emergency and urgent medical care are always covered, regardless of plan, no matter where you go – you do not have to stay in network. Medigap plans often provide more coverage as they work alongside Original Medicare. That said, those with Medigap can see any provider or go to any hospital in the U.S. that accepts Medicare as there are no networks and referrals are not required.
Traveling Outside the U.S.
If you are planning on traveling internationally, your coverage will be more limited. Care is typically not covered by Original Medicare (Parts A&B) – rare exceptions apply. If you have an Advantage plan, some offer limited emergency coverage internationally. It’s important to look at your individual plan to see what may be covered prior to your international travel. Certain supplemental Medigap plans cover up to 80% of emergency costs outside the U.S. Medigap plans are often a good option for those who travel frequently, either within the U.S. or abroad.
Prescription Coverage When Traveling
If needed, beneficiaries can typically fill prescriptions outside of the typical coverage area within the U.S. That said, prescriptions filled at out-of-network pharmacies may cost more. Mail order prescriptions can be a good option for longer trips. Prescription drugs are not covered under Part D outside of the U.S and you generally must pay full price for drugs purchased abroad. Part D does cover U.S. territories (Puerto Rico, U.S. Virgin Islands, Guam, etc.) if the pharmacy is in network with your plan. Unlike the medical portion of Medicare, Part D does not have an emergency exception for prescriptions filled internationally.
Travel Checklist
Before you travel, be sure to:
- Know which Medicare plan you have
- Check your plan’s coverage and provider network
- Confirm coverage for out-of-state or international care
- Bring your Medicare and Advantage or Medigap cards
- Bring extra prescriptions in case of emergency (i.e. delayed flights)
- Have your plan’s customer service number handy – this can often be found on the back of your insurance card
