Considerations for Traveling with Medicare

Dana Sandoval, CFP®

Jul 19, 2021

Lately, there have been several reports of the staggering number of travelers due to the pent up demand from COVID quarantine. These reports reminded me that now might be a good time to reemphasize the importance of understanding your health insurance coverage when planning to travel, especially if you have Medicare.

Understand Your Health Insurance Before Going Abroad

If you plan to be out of the U.S. for an extended period, your first step should be understanding the coverage provided by your health insurance. If you determine that the coverage is inadequate, visit a travel agent, an underappreciated travel asset these days, to learn about some of the short-term plans that are designed to give you extra emergency benefits while traveling internationally. Also, since you will most likely have to pay completely out-of-pocket for any prescriptions you pick up or fill at a foreign pharmacy, you will want to check your prescription inventory to be sure you have enough supply while you are out of the country.

Don’t forget! Some pharmacies will allow you to obtain a prescription refill early if they are notified you will be traveling abroad for a period of time.

In addition to considering your health insurance when you are planning to travel, your travel habits should also be a consideration when deciding what type of Medicare Coverage is the best option for you. Here are a few things to consider when traveling with Medicare.

Traveling Within the U.S. with Medicare

If you have Original Medicare, you have coverage anywhere in the U.S. and its territories (includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands) and you need to confirm the doctor and/or hospital accept Original Medicare.

If you have a Medicare Advantage Plan, your plan may or may not cover care outside of its service area. Some plans may cover providers that are out-of-network or out of your service area, but with higher cost-sharing (copayments, coinsurances) and can impose other restrictions (like prior authorization). Check your plan or contact your agent to see what rules and costs apply when you travel within the U.S. If you travel outside your service area continuously for more than six months, you will be automatically disenrolled from most plans. You will have a Special Enrollment Period to join a different Medicare Advantage Plan. Some Medicare Advantage Plans do offer special benefits that allow you to stay in the plan if you travel continuously in the U.S. for up to 12 months–again it is recommended to check the rules closely.

Don’t forget! Medicare Advantage Plans are required to cover emergency and urgent care anywhere in the U.S. without charging additional costs or imposing additional coverage rules.

Foreign Travel with Medicare

Medicare generally does not provide for care outside of the U.S. There are some limited exceptions for example, cruise ship while in U.S. territorial waters. However, it is best to plan ahead and not assume any benefits from Medicare while you are outside of the country.

Fortunately, both types of Medicare health insurance options (Original Medicare or Medicare Advantage) offer some foreign travel benefits.

Medigap Plans C, D, F, G, M & N (for those who elected Original Medicare) – these are standard plans and may provide some foreign travel benefits. As an example, Plan F that offers foreign travel benefits will pay up to 80% of your medical emergency costs after a $250 deductible. The benefit has some limits: it will only pay for emergencies during the first 60 days that you are out of the country and has a lifetime benefit of $50K, which can be spent quickly.

Don’t forget! Most Medicare Advantage Plans provide you with worldwide emergency coverage. In many instances a foreign hospital will bill your insurance, so you will want to travel with your Medicare Advantage card. If the hospital won’t bill your insurance, keep the receipts and you can submit them to your Medicare Advantage Insurance company for reimbursement.

Frequent Medicare Travel Questions

1. Can I visit a doctor in a different state?

Since Original Medicare doesn’t have network restrictions you would have coverage at facilities and doctors who accept Medicare. Medicare Advantage Plans will typically have network restrictions.

2. Will Medicare pay for healthcare services in a different country?

Medicare typically doesn’t cover medical services outside of the U.S. and its territories unless it is emergency care.

3. Can I use my Part D plan internationally?

No, Medicare Part D Plans do not cover prescription medications you purchase outside the United States. If you visit an international pharmacy, prepare to pay for 100% of your drug costs.

Suggested Questions to Ask Your Agent or Plan Provider Since Plan Specific

  • Does my Medigap plan have foreign coverage?
  • What coverage would my Medicare Advantage plan provide if I travel abroad?

At TCI we look at your complete financial picture and can offer advice on more than investments. We know that life comes with unknowns which can derail the financial freedom you’ve spent decades working towards. It’s always worth going the extra mile to ensure peace of mind, by doing so you’re doing everything in your power to be protected.

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