Going on a Summer Vacation? What you Need to Know About Medicare Coverage When Traveling in the U.S. or Abroad
Post-pandemic traveling still poses health risks, especially for older adults with underlying chronic conditions
As the summer travel season goes into high gear, almost half of Americans say they will be traveling more this year than they did in 2022. While vacationers are taking to the roads and skies less concerned about COVID-19, traveling still poses health risks, especially for older adults with underlying chronic conditions.
It's always a good idea to be prepared in case you experience a health problem or have an accident while on vacation. Part of that preparation should include understanding your medical coverage if you're traveling out of state or to a foreign destination, so you're not surprised by unexpected medical bills.
Here's what you need to know about Medicare coverage, depending on the type of plan you have:
What is my Medicare coverage when traveling out of state?
If you're traveling within the United States or its territories (Puerto Rico, U.S. Virgin Islands, Guam, Northern Mariana Islands and American Samoa) and you're enrolled in the federally managed Fee-For-Service Medicare, your in-patient hospital care (Part A) and doctor visits and out-patient hospital care (Part B) are covered as long as the health care provider is Medicare-enrolled and accepts Medicare.
For those with Original Medicare who have purchased a Medicare Supplement Insurance Plan (also known as Medigap), which is offered through private insurers and helps pay for out-of-pocket costs not paid by Original Medicare, your benefit is also transportable throughout the U.S. and its territories.
Certain Medicare Advantage plans, which are health plans offered through private insurers contracted with Medicare, provide out-of-state coverage while others may be restricted to a defined service area and network of health providers, so check with your plan before heading out on your travels. The same goes for prescription drug plans (Part D) that are either stand-alone PDP or offered through your Medicare Advantage plan, so ask your insurer if you'll have prescription coverage in the area where you're traveling.
What is my Medicare coverage when traveling abroad?
Original Medicare does not provide coverage outside the U.S. and its territories, except in a few rare instances. However, some Medicare Supplement plans provide foreign travel emergency coverage up to a lifetime limit of $50,000. Generally, these plans will cover 80% of the billed charges once you meet a $250 calendar year deductible if emergency care begins within the first 60 days of your trip, and your care is not covered by Original Medicare. Benefits are payable only for emergency care that would have been covered by Medicare to the extent such care would have been covered by Medicare if provided in the U.S.
Medicare Advantage plans must provide the same coverage as Original Medicare, so in those very limited circumstances where Medicare covers international travel, so too will your Medicare Advantage plan. Some Medicare Advantage plans also cover general emergency care for enrollees traveling abroad, but that coverage varies, so it's important to check with your insurance carrier to learn the details.
Medicare Part D plans will not cover any prescription drugs purchased outside of the U.S., so expect to pay the full price of any medications needed abroad.
Before leaving on your travels, find out from your insurer what qualifies as "emergency care." Even if you have some Medicare coverage for international travel, it's likely you'll need to pay the foreign provider yourself at the time you receive care and then submit for reimbursement from your plan.
If your Medicare coverage is not sufficient, you may want to consider purchasing a travel insurance policy that includes health coverage, which you can learn about through an insurance or travel agent. Also, read the fine print —— some policies may exclude pre-existing conditions, have other restrictions and may not include emergency evacuations, which can be vital if traveling to remote areas.
What health practices are recommended before departure?
When traveling abroad, there are a number of preventive measures you should take before setting off on your trip:
- Check the Center for Disease Control and Prevention (CDC) website for information on health risks in your vacation destination and any vaccines and medications that are required or recommended.
- Schedule an appointment with your primary care physician or a travel doctor at least one month prior to your vacation to receive any needed shots and medications, which may require getting or starting weeks before your departure.
- Make sure you’re current with all routine vaccines including COVID-19, flu, pneumonia, shingles, and Tdap (tetanus, diphtheria and pertussis).
- Have an adequate supply of any medications you take regularly to last you through the trip and any unexpected delays.
- When taking long-distance plane flights, wear compression stockings, drink lots of water and stand up, walk and stretch whenever possible.
Traveling can be great for the mind and spirit. Being prepared before you go will help keep you healthy and safe while you're away.
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