Whether you travel occasionally or dream of spending winter someplace warm, it’s important to make sure your Medicare health coverage travels along with you. Many Medicare Advantage plans offer additional travel benefits for members. Here’s what you need to consider when shopping for a plan so that wherever you want to go, you’ll know if your health care needs are covered.
What is a Medicare Advantage travel benefit?
Some Medicare Advantage plans include travel benefits for when you need care away from home. These travel benefits usually cover more than just emergency and urgent care and help ensure you have coverage no matter where you are. However, not all plans have the same rules and limitations – it’s important to ask questions when shopping for the right Medicare Advantage plan.
Important questions to ask include:
- What emergency or routine health care services are covered if I vacation in the U.S. or out of the country?
- Do I have to seek services with specific providers?
- How long can I be away from home and receive coverage?
- Will this plan cover both domestic and international travel?
How a Medicare travel benefit works
With a Medicare travel benefit, you’ll pay the same cost sharing amount for out-of-network care as you would close to home with in-network providers. For domestic travel, Medicare requires that a travel benefit covers at least 6 months of out-of-network care no matter where or when you go. Some plans may cover more than 6 months.
If a Medicare Advantage plan doesn’t offer a travel benefit, you may not be able to receive coverage outside of your plan’s provider network. This might mean higher cost-sharing for health care services and different PCP authorization rules if you get care out of the plan’s network.
Medicare Advantage plans and out-of-network care and coverage
One of the many benefits of a Medicare Advantage plan is that you can save money on health care costs if you see doctors, clinics and hospitals that have agreed to provide plan members with health care services. This is called a provider network.
Most in-network doctors, hospitals and clinics are in the state where the plan is offered or in nearby states. If you are thinking of traveling out-of-state, here are a couple of things to keep in mind.
With many Medicare Advantage plans, you’ll have emergency and urgent care coverage when traveling, so you can see out-of-network providers within the United States. That means you don’t have to worry about coverage if you get a sudden illness or break a bone while traveling. If you need non-emergency or non-urgent care while traveling, it may not be covered, and you’ll likely have to pay more out of pocket. That’s where a travel benefit can help.
But what about your medicine? Some Medicare Advantage plans include coverage of prescription medicines by working with a national pharmacy network. If your plan includes this, you’ll be able to pick up your prescription at participating pharmacies.
Medicare Advantage plans and international travel
Some Medicare Advantage travel benefits, such as those for international travel, include coverage for emergency services, urgent care and certain ambulance services. There may or may not be a limit on how long or how much a plan will cover – each plan varies.
However, make sure to confirm with your plan what kind of coverage guidelines and limitations you can expect. For instance, if you’re staying abroad for a long time, many Medicare Advantage plans do no cover prescription medicines or routine health care services overseas. This means you might be paying 100% of the costs of care.
Not all Medicare Advantage plans include a travel benefit
If you vacation often, like traveling south every winter, it’s critical to look for a plan that offers a travel benefit. And because every plan is different, contact your Medicare plan to learn more.
Travel coverage is more than a doctor when you are on the go
Beyond the more standard travel benefits discussed above, some plans will offer additional benefits. These nice-to-have benefits can include access to pre-travel consultations at specialized travel clinics, where you can get required vaccinations and learn important details about the area you’ll be traveling to, like food and water safety concerns or the political situation.
Some plans also offer global logistical support services. These services can include access to a multilingual call center, help finding care when you’re away from home, and medical evacuation.
No matter where you’re headed, be safe, plan ahead and don’t forget to pack your health insurance card. Happy travels!