Traveling in the United States
If you are a Medicare beneficiary and you have Original Medicare (Part A & B) then you can travel anywhere within the United States and still be covered by Medicare as long as you use doctors and hospitals that accept Medicare. If you have Medicare Advantage (Part C) then you may have to pay more out of pocket for visiting an out of network provider.
You should always check with your plan before traveling within the U.S.
Traveling outside the United States is generally not covered by Medicare. The District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S.
Medicare may pay for inpatient hospital, doctor, ambulance services, and dialysis in rare cases such as:
- You’re in the U.S. when a medical emergency occurs, and a foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
- You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
- You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.
In some cases, Medicare Part B may cover medically necessary health care services you would get on board a ship within the territorial waters adjoining the land areas of the U.S. Medicare won’t pay for health care services when a ship is more than 6 hours away from a U.S. port.
Medicare drug plans don’t cover prescription drugs you buy outside the U.S.
Your Medigap policy may cover additional coverage for health care services or supplies you get outside the U.S. The standard Medigap Plans C, D, F, G, M, and N provide foreign travel emergency health care coverage. Plans E, H, I, and J are no longer available for purchase but if you bought one before June 1, 2010 then you are still covered for emergency situations outside the U.S. All of these Medigap Plans cover 80 percent of the medical bill when traveling abroad after you meet a $250 deductible for the year. These policies cover foreign travel emergency situations if it begins during the first 60 days of your trip. Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000.
It’s a good idea to talk with a Medigap policy provider before you travel outside of the U.S.
Medicare Advantage, also known as Part C, is Medicare coverage that’s provided by a private health insurance company. Since it’s a private health plan, it depends on which health care policy you’ve chosen if you’re covered for traveling outside the U.S. Some of the general rules for traveling with Medicare Advantage are:
- Emergency services may be covered by your plan, wherever you are.
- If you see a doctor for non-emergency services and he/she is not in your plan’s network, you may have to pay more than usual.
- You’ll need to check your plan’s Summary of Benefits or Evidence of Coverage documents-or call your plan directly-to know what’s covered and what isn’t.
You should always check with your plan before traveling outside of the U.S.
Living Outside the U.S.
If you live outside the U.S. when you turn 65 you cannot enroll in Medicare Part B until you return to the United States. You will not have to pay a late enrollment fee as long you sign up for Part B within 3 months of returning to the U.S.
If you are nearing or already 65 and would like more information on Medicare Plans in Washington State, please visit our Overview of Medicare, as well as our guide for those who are New to Medicare. For assistance in choosing a Medicare plan, contact us to get in touch with a licensed insurance agent today!