If you have Medicare and plan to travel, it’s essential to check your coverage for potential gaps that could lead to expensive bills. The coverage you’ll have at your destination could vary significantly based on various factors, including your location, type of Medicare plan, and specific needs. You might be tempted to ignore it. After all, what are the chances that you’ll need to use your Medicare coverage while on vacation?
According to a ValuePenguin study, the risks are not insignificant. For example, 28% of Americans said they’d gotten sick or were hurt while on vacation. Of these, 33% suffered from bacterial or food-borne issues, 27% from respiratory conditions, and 24% from bodily injuries. Another 12% stated that they got Covid while traveling.
In other words, it would not be unusual for you to use your Medicare coverage while traveling. And if you don’t have the right coverage, you could be in for a surprise when the bill comes.
Basic Medicare, which includes Part A (hospital insurance) and Part B (medical insurance), will cover you anywhere in the United States. However, if you’re abroad, things get a little more challenging.
With a basic Medicare plan, you’re only covered overseas if you’re receiving treatment on a ship no further than six hours from a US port or traveling between states, but the closest hospital is in another country. If you also have a stand-alone prescription drug plan (Part D), you should know that coverage doesn’t apply to medications you obtain in a foreign country.
Medigap is a supplemental insurance policy that might help cover some of the overseas costs that Medicare doesn’t, such as co-insurance and copayments. For example, Plans C, D, F, G, M, and N cover you for up to a maximum of $50,000 in lifetime benefits. However, you’re responsible for 20% of the expenses after a $250 deductible, and coverage only applies for the first 60 days of travel.
Coverage only applies if you are experiencing a medical emergency. The Centers for Medicare & Medicaid Services specifies that there might also be other limitations. If you have an older Medigap policy (E, H, I, and J), you might have some overseas travel coverage, so check your policy documents. Medigap policies can be expensive depending on your location, age, and other factors. For example, according to the American Association for Medicare Supplement Insurance, a 65-yearold female in New York might pay as much as $278 for the cheapest Plan G policy, whereas the same person in Dallas would pay slightly less than $100.
Some Medicare Advantage Plans include emergency medical care overseas, but it’s essential to check the details of your particular plan. Even if you’re traveling within the US, there might be restrictions on the type of care you can receive.
For example, health maintenance organization (HMO) plans only cover emergency care outside of their network, meaning that you’ll have to cover the costs of routine care on your own. Preferred provider organization (PPO) plans provide coverage for routine and emergency care outside their preferred network, but these services will cost more. Hybrid policies might let you get treatment from a non-network provider in certain situations.
You should also be careful if you plan on traveling outside of your Advantage Plan’s service area for too long as there is a risk you will be disenrolled. Usually, you can only be outside of the service area for six months after which you’re no longer covered and will be automatically enrolled in a traditional Medicare plan.