During the summer months, many of us look forward to traveling with family and friends. We often speak with clients who question whether they will have coverage while traveling, especially in the case of an unforeseen emergency. It’s important to know what your Medicare plan covers just in case.
The good news is that for those with Original Medicare, medical services and supplies are covered when traveling in the U.S., which includes Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
Although Medicare plans vary, they each cover emergency and urgent care in the same way. Whether you use a Medicare Advantage plan or Original Medicare as your primary insurance, you are entitled to urgent care or emergency care anywhere in the United States. This type of care will always be considered “in-network” for you.
If you require follow-up care to an emergency or urgent care visit while traveling, your options are based on your plan. If you are out of your plan’s service area and your doctor certifies that you are unable to travel, your plan may continue to cover your care. However, if you are not in your plan’s network (this can be an issue on HMO plans), then you are responsible for traveling back to your plan’s service area to receive care if your doctor confirms you are physically able to travel. Because Medicare Supplements do not have a network, if you are on a Supplement plan, you can receive follow-up care wherever you are if the provider accepts Original Medicare.
Some Medicare supplement plans include Foreign Travel Emergency coverage, which pays eighty percent of the Medicare-approved amount and up to a lifetime maximum benefit of $50,000. Certain Medicare Advantage plans cover emergency services when traveling outside of the U.S. and may include a lifetime limit. Transportation back to the US from another country is not included in this coverage.
Before traveling abroad, we recommend you review your Medicare plan to understand what it covers. Based on your situation, it may also make sense for you to consider options for a travel policy.
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