There are a few different ways you can get Medicare coverage. Each way covers you slightly differently when traveling. When choosing the most cost-effective type of Medicare coverage for yourself, you should consider how often you plan to travel.
Depending on whether you travel often or if you usually stay within your county lines will help you decide which type of Medicare coverage is more suitable for you.
Original Medicare consists of two parts, Part A and Part B. Once you have enrolled in Original Medicare, you can choose to add a Medigap plan to your coverage.
If you choose to add a Medigap plan, the plan works directly with your Original Medicare and will pay after Part A and Part B.
Domestic travel with Original Medicare and Medigap
Because Medigap plans have to pay after Original Medicare has accepted and paid a claim, the domestic travel coverage is identical for Original Medicare and Medigap plans.
Under Original Medicare, you can see any doctor in the United States who accepts Medicare. If they accept Medicare, they also must accept your Medigap plan no matter the carrier.
Foreign travel with Original Medicare and Medigap
Original Medicare only covers emergencies while you’re traveling outside of the United States.
Also, Original Medicare only covers foreign travel emergencies under a few specific situations. Basically, Original Medicare only covers foreign travel emergencies when you’re in North America, not when you’re overseas.
However, some Medigap plans offer 80% coverage for foreign travel emergencies both in and outside of North America. Plans C, D, F, G, M, and N all offer this benefit.
There is a $250 annual deductible to access this benefit, and coverage is only valid during the first 60 days of travel. Also, there is a $50,000 lifetime limit to this benefit.
Medicare Advantage plans
A Medicare Advantage plan, also called a Part C plan, pays instead of Original Medicare, meaning your coverage is based on the rules of your plan.
Every Medicare Advantage plan is different, so travel coverage can vary from plan to plan. But generally, this is how you’re covered under a Medicare Advantage plan while traveling.
Domestic travel with Medicare Advantage plans
Most Medicare Advantage plans are subject to a provider network, meaning you can only access the plan’s benefits within a certain service area.
However, some Medicare Advantage plans have out-of-network benefits that allow you to be partially covered when using the plan outside of the service area.
Cost-sharing expenses will vary depending on whether it’s an emergency or not and the type of plan you have.
Foreign travel with Medicare Advantage plans
Like Original Medicare, Medicare Advantage plans only cover foreign travel emergencies.
Medicare Advantage plans usually cover foreign travel emergencies with a coinsurance, meaning the plan will cover part of the costs, while you will have a coinsurance of 20%, for example.
Additional things to know
Although there are a few ways Medicare can cover you while traveling, you may have to pay out-of-pocket at the foreign hospital and request reimbursement from your plan later.
Foreign hospitals are not required to bill Medicare plans. Therefore, you may have to cover 100% of the costs at the foreign hospital.
Then, once you return to the United States, you can file a request for reimbursement with your Medicare plan.
Another thing you should always remember is that Medicare coverage while traveling outside of the country is for emergencies only.
Therefore, if you have a Medigap plan that offers foreign travel coverage, you won’t get coverage for a check-up at a doctor’s office so you can get a prescription filled.
You shouldn’t rely on your Medicare coverage while traveling outside of the country. Instead, buy a short-term travel insurance policy before leaving on your trip.