After delaying our vacation plans for more times than I can remember over the last 2 years, my husband and I are finally going to do some travelling. We're both retired and on Medicare. Does Medicare cover us if we're in a different state? How about if we take a cruise or travel overseas?
It's exciting to hear that you and so many other retirees are finally once again able to plan trips—here in the U.S. and overseas. To my mind, nothing beats opportunities to explore new places and connect with interesting people from all walks of life. At the same time, though, you're wise to plan for unexpected glitches. Apart from being unpleasant and a disruption to your travel plans, an illness or accident can lead to big financial surprises and out-of-pocket costs—even if you're covered by Medicare.
The amount of coverage you'll receive depends not only on where you go but also on the type of Medicare coverage you have—so in some cases, it can make a lot of sense to purchase additional insurance. Here's what you need to know before you book your trip.
When you're traveling in the U.S.
If you have Original Medicare, you can go to any physician or hospital that accepts Medicare patients (which most do). This coverage extends to all 50 states as well as all territories such as Puerto Rico or the Virgin Islands.
If you have a Medicare Advantage plan, your policy may or may not provide coverage outside its service area, so be sure to check your plan for details and costs. That said, all Medicare Advantage plans are required to cover emergency and urgent care, regardless of any restrictions on service areas.
This is especially important for people who have two homes or who spend a good part of the year in a different part of the country. Be sure to check with your Medicare Advantage plan provider to understand what is "in-network" for both locations. This can also impact which residence should be your primary address.
When you're traveling overseas
The most important thing to understand is that with a few exceptions, Original Medicare doesn't pay for health expenses outside of the U.S.
Therefore, if you have Original Medicare, you should look into purchasing a Medigap policy if you don't already have one. Some (but not all) Medigap plans will cover emergency services overseas. Along with this coverage, you'll likely have a $250 deductible, coverage limited to the first 60 days of your trip, a co-pay of 20%, and a lifetime limit of just $50,000.
If you have a Medicare Advantage plan, you likely have some coverage for foreign travel, but there may be restrictions. Be sure to research the details of your policy so that you understand exactly what is or isn't covered.
For both Medigap and Medicare Advantage plans, make sure you understand your company's definition of "emergency" vs. "urgent" care. A common distinction is that emergency care is required because of an injury or condition that will place your physical or mental health in serious jeopardy. Urgent care, on the other hand, covers less serious conditions and may not be covered.
When you're traveling in Canada
If you're traveling in or near Canada, there a couple of instances when you can receive emergency treatment:
- You're in the U.S. but the closest hospital in time of emergency is in Canada.
- You have a medical emergency while traveling through Canada as the most direct route between Alaska and another state, and the Canadian hospital is closer than the nearest U.S. hospital.
When you're on a cruise
If you're on a cruise ship in U.S. waters or no more than six hours from a U.S. port, you will have coverage. Medicare won't pay for services when the ship is further away.
Look into supplemental travel insurance
Given all of these restrictions on care, I advise that all international travelers look into purchasing additional insurance—but be sure to do your homework.
Most travel insurance policies have set benefits that can't be changed. In addition to covering things like non-refundable trip costs and trip cancellations, most will also cover emergency medical expenses. If you want more coverage for medical care, including medical transportation and evacuation, you will have to purchase a more comprehensive policy. Before you sign up, be sure you understand all of the covered risks, exclusions and reimbursement policies. The cheapest policy is often not the best way to go.
A few extras before you start packing
In addition to making sure you have adequate coverage for your travels, experts recommend that you carry the following documents:
- Covid-19 vaccination card. At this point in the pandemic, this may seem obvious, but make sure you can easily access your vaccination status—whether it's in paper or digital form.
- Proof of other vaccinations. Depending on where you're travelling, you may also need to show documentation for other vaccines. Check the CDC website for recommended vaccinations by country.
- Covid-19 test result. Again, depending on your destination, you may be asked to show proof of a recent negative test.
- List of your medications and copies of your prescriptions. It's always a good idea to carry extra medication, but also have handy a digital or paper copy of all prescriptions.
- List of your allergies. Especially if you have a potentially life-threatening allergy, be sure to have this information handy in case of emergency.
- Health insurance information. You don't need to carry your complete policies, but do have handy your policy numbers and contact information. You may also want to have a summary of additional coverage from a travel policy.
If all of this sounds like a lot, I suppose it is. But to my mind, once you're fully prepared, you'll be that much better able to take in all the wonderful and exciting aspects of travel. Here's to a safe and memorable journey!
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