For COVID-19 vaccinated individuals in the 65-and-over crowd, hitting the road (or sky) may become more alluring than it’s been in nearly a year. 

Be sure to consider whether your Medicare plan will travel with you. 

While coverage when you’re away from home depends partly on your destination, it also hinges on the specifics of your Medicare plan. 

In other words, it’s worth knowing what to expect so there are no surprises. 

What to know 

Basic, or original, Medicare consists of Part A (hospital coverage) and Part B (outpatient care). 

If this is your situation, coverage while traveling in the U.S. and its territories is fairly straightforward: You can go to any doctor or hospital that accepts Medicare (most do), whether for routine care or an emergency. It’s when you venture beyond U.S. borders that things get trickier. 

“If you travel outside the U.S., Medicare doesn’t cover you except in very limited or rare circumstances,” said Danielle Roberts, co-founder of insurance firm Boomer Benefits.

If you are eyeing a different country for a vacation, pairing basic Medicare with a supplement policy- aka Medigap – may give you some coverage abroad.

Those policies, which are standardized across states but vary in cost, offer some coverage for the cost-sharing that goes with basic Medicare, such as copays and co-insurance. Some of them also have limited coverage for foreign travel. 

Be aware that this coverage applies to medically necessary emergency care and there may be other restrictions, according to the Centers for Medicare & Medicaid Services. 

Advantage Plans 

For beneficiaries who get their Medicare benefits through an Advantage Plan, it’s worth checking to see if you get any coverage for emergencies while abroad. And even if you don’t leave U.S. soil, you should see what your plan would cover. 

While Advantage Plans are required to cover your emergency care anywhere in the U.S., you may be on the hook for routine care outside of their service area. 

“With a traditional HMO plan, when you travel outside the network, you have emergency coverage only,” Roberts said. “With a PPO, you have both coverage for emergencies and out-of-network coverage for non-emergencies but will pay more for these out of network services.

OHB would recommend purchasing travel medical insurance for trips overseas.

Not sure what to do with your Medicare choices while traveling? That’s what we’re here for.

Call us toll free at (866) 235-8378 or click here to email us your name and phone number for us to call you.

Ohio Health Benefits also offers Medicare & Muffins, a free educational seminar to help you understand how Medicare works. These seminars are free and open to the public every Wednesday at 9 am and Thursday at 3pm. For details and registration link click here.

Sarah O’Brien – Published February 25, 2021