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Original Medicare covers medical services received in the United States and its territories.
Medicare Advantage plans may have a coverage area, which can limit your options during domestic travel. Check with your provider to confirm coverage at your destination.
Medigap and Medicare Advantage plans can cover international emergencies. You can also purchase short term travel insurance for additional coverage.
Retirement is one of the best times to travel: no work obligations, no kids, just you and the vast, open world. But whether you’re heading to Cancun for the summer, visiting relatives in Toronto, or simply going on a road trip across the country, you’ll want to make sure you’ve got health coverage. Should something unexpected happen, the last thing you need is a huge hospital bill. You can use Medicare while traveling, but the circumstances in which you’re covered vary depending on where you are and what supplemental coverage you have.
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
U.S. Virgin Islands
If you’re in the states, the District of Columbia, or one of the above territories, you can use your Medicare coverage at any qualifying facility. However, there are a few edge cases that might affect your coverage.
Original Medicare, as a federal program, works the same way in every state and territory. However, that isn’t necessarily the case for Medicare Advantage, Medigap, or Medicare Part D. These plans are offered by private companies and may have specific networks and coverage areas. You can travel outside of these coverage areas, but if you’re planning to take a trip lasting longer than six months, you’ll run the risk of losing your coverage entirely!
Before you depart, check to see if your plan will cover you at your destination. Larger providers are more likely to have in-network services at your destination, and more flexible plans like PPOs can pay for out-of-network service. If your plan has a strict service area, you should schedule trips around this limit, or set up new insurance at your destination: you may qualify for a special enrollment period if you plan on staying at your destination for an extended period.
Be Aware: While Medicare Advantage will cover emergency services out of network, it may not cover out-of-network services for routine care. Check with your provider before traveling to ensure you have coverage at your destination.
Under certain exceptional circumstances, Medicare will cover medical treatment received in Mexico or Canada. This typically occurs when you are within U.S. territory, but the nearest hospital is across the border. In these cases, Medicare will prioritize your survival over finding a domestic hospital, and you’ll pay the normal amount for coverage.
This does not typically work in reverse. If you are on the foreign side of the border when suffering an emergency, Original Medicare will not pay to transport you to an American hospital, nor will they pay for treatment in a foreign hospital, though supplemental plans like Medigap might. An exception exists if you are traveling directly between Alaska and another U.S. state without unreasonable delay and suffer an emergency in transit. In that case, Medicare will also cover treatment in a Canadian hospital if it is the closest option available.
If you are planning on crossing international borders during your trip, you’ll need to seek out supplemental coverage. These are privately offered plans designed to step in when Original Medicare cannot or will not help. There are, broadly speaking, three types of coverage a potential traveler can seek out.
Travel insurance is a private service offered independently of Medicare, often via a cruise or travel agency, though insurers can offer it directly to travelers. The term ‘travel insurance’ covers a large spectrum of services depending on the provider, including:
Overseas medical care
Medical and Emergency evacuation
Compensation for lost luggage
Compensation for trip cancellations, missed flights, or trip interruptions
Repatriation of remains
Not all plans offer all of these services, so confirm what is being offered with your travel agent or provider before you set off on your next adventure.
Travel health insurance is the cheapest short-term option, allowing you to pay for just a few weeks of substantial coverage. However, as it is not offered via Medicare or the Affordable Care Act, it is not subject to the same regulations. This means you can face reduced or denied coverage for pre-existing conditions. Depending on your provider and the length of your trip, these services can also become quite expensive. If you’re planning on traveling frequently, you may want to consider a more sustainable alternative.
Medigap is a type of supplemental insurance offered by private companies. As the name implies, Medigap plans ‘fill in the gaps’ of Original Medicare, reducing deductibles and cost-sharing, covering blood transfusions, and providing emergency coverage overseas.
Medigap plans are standardized across providers: if you have Medigap Plan C, D, E, F, G, H, I, J, M or N, Medicare will cover emergency treatment during the first 60 days of your trip, and cover 80 percent of the cost for any medically necessary treatment rendered.
There is a lifetime limit of $50,000 for coverage. As such, the goal isn’t to provide full Medicare hospital coverage, but to stabilize you enough to get evacuated back to the U.S.
Medicare Advantage is another privately offered insurance plan, designed to offer all the benefits of Original Medicare with additional perks. Medicare Advantage plans are required to provide all the benefits of Original Medicare, but can also offer additional benefits like overseas coverage.
It’s important to note that, unlike Medigap plans, Medicare Advantage plans are not standardized. Any additional benefits offered are at the discretion of the insurance provider, and not all plans offer international health insurance. Those that do may also have varying rules regarding lifetime coverage limits, and may also have a limited network.
Be Aware: You cannot combine Medicare Advantage with a Medigap plan. However, you can combine independent travel insurance with Medigap or Medicare Advantage.
If you take prescription medication, be aware that most travel insurance plans (including Medigap) do not cover prescription drugs, even if you have Medicare Part D. It is best to bring a supply of medicine that will last you the entire trip. If your doctor cannot prescribe you a supply to last your entire trip, they may be able to recommend a local alternative. Many countries have lower out-of-pocket costs for prescription drugs than the U.S., but you’ll need to pay out of pocket and provide a valid prescription. Check local regulations and discuss plans with your doctor before departing.
Some medications are controlled substances. Be sure to check local regulations regarding possession before departing. If a controlled substance is critical to your care, contact a US embassy or consulate at your destination a few weeks before departure so you can arrange for a supply. Regardless of your destination, keep all medication in its original packaging with the prescription information fully visible. Do not mix medications in a single bottle, put them into a pill sorter, or keep them loose in a ziplock bag.
If you require special accommodations, such as a refrigerator for storing medications, a wheelchair, or other durable medical equipment, contact your destination in advance. Many hotels and resorts require advanced notice for any special arrangements, so contacting them when planning your trip is essential.
Medigap and Medicare Advantage plans can help keep you healthy, no matter where you are. Contact one of our licensed agents at (800) 950-0608 or enter your zip code to begin comparing plans today.
