After a few years of lockdowns, traveling is possible again. If you are planning a trip, and you are a retiree on Medicare, then choosing the right Medicare insurance plan before you set off is essential to avoid the potential high costs of an unexpected treatment.
Whether you want to go somewhere in the United States or head overseas, the right Medicare plan will cover any unexpected expenses during your trip. The nature of your care also plays a role when selecting your plan. You may look for something to cover routine checkups or emergencies.
The number of people who fall ill on vacation isn’t that high, but there’s always a chance for it to happen. In fact, about 28% of Americans say that they got sick or got hurt during their vacation, according to a study conducted by ValuePenguin.
The most common were bacterial and food-born illnesses with 33%, followed by respiratory issues at 28%. Bodily injuries of any kind were at the third position with 24% whereas Covid comes in after that with only 12% of people contracting it during their vacation.
Having listed the most common issues, people should have a clear idea on what to look for in their Medicare coverage. With the right coverage, there will be no surprises.
Original Medicare is Suitable for Travel inside the US
Original Medicare Plan that consists of Part A and Part B – hospital and outpatient care – is one of the primary choices among Americans. People who choose this coverage commonly add Advantage Plan or Part D. This plan covers prescription drugs and you can significantly reduce the out-of-pocket costs with this addition.
For everyone that has Original Medicare, traveling around the US shouldn’t be a problem at all. You can visit any doctor or hospital that accepts Medicare – as most do. However, traveling abroad is where potential problems can arise.
There are only a few instances in which traditional Medicare covers the expenses outside the US. These include when you are treated on a ship within six hours of a US port. The other option is when you are traveling from state to state but the closest hospital that can treat you is in a foreign country.
For instance, you may be traveling to Alaska, but you contract a disease in Canada. In this case, you will be admitted to a hospital in Canada.
However, for any other case, the Medicare doesn’t apply. In other words, you don’t have insurance abroad. Just like the Part A and Part B are excluded from abroad travel, Part D plans won’t cover medications filled outside the US. Elizabeth Gavino, the founder of Lewin & Gavino, an independent broker and general agent for Medicare plans suggests that you bring the medication you need or you might need during your trip.
What about Medigap?
Although Original Medicare doesn’t provide insurance abroad, Medigap can give you some coverage, depending on the supplement plan.
These policies, which are standardized across states, offer some coverage for the cost-sharing that goes with basic Medicare, such as copays and coinsurance.
If you travel outside the US a lot, it is worth enrolling in plans such as C, D, F, G, M and N. These plans provide up to $50,000 lifetime maximum benefits. After a $250 deductible, the beneficiaries are paying 20 percent of the costs.
Keep in mind that these plans have you covered for the first 60 days of your trip. If you plan to stay longer than two months, you will need to find some alternative. However, this is quite enough for any vacation outside the USA.
You need to be careful and check with your healthcare provider in which cases the abroad insurance applies. Most of these plans apply only to medically necessary emergency care, but there may be some other restrictions that are worth checking out.
Make sure that you check the policies of each Medigap plans carefully before you enroll. Each of them has their own rules depending on your location, age and other factors. The prices of Medigap plans are different in Dallas, TX, than New York City, for example.
Medicare Advantage Plans and Traveling
The Medicare Advantage Plan is growing in popularity, with more Americans choosing it over the original Medicare. There are some plans within Advantage that cover emergencies abroad.
Just like with any other plan, you need to check carefully each Advantage plan and see what it covers besides emergencies abroad.
“With a traditional HMO plan, when you travel outside the network, you have emergency coverage only,” said Danielle Roberts, co-founder of insurance firm Boomer Benefits.
“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,” Roberts said.
She added that some hybrid plans exist that may allow limited out-of-network treatment under certain circumstances.
If you or a loved one is planning to travel overseas, you should make sure you have the right Medicare Supplement plan that covers expenses. Check out MedicareConsumer today if you want to compare Medicare Supplement plans from top insurance carriers.
Sometimes, you may be required to pay out-of-pocket costs and be reimbursed when you come back to the States, Gavino points out.
“Foreign hospitals will not file a Medicare claim for you,” Gavino said. “Get an itemized bill to submit for reimbursement from your plan.”
Depending on your coverage, you may need a travel medical plan as well, to make sure everything goes out smoothly. These options can be costly, but it also depends on your age and the length of your vacation. You can pay coverage for a single trip or get a multi-trip policy that covers the longer period.
“Be sure to find out if the plan covers pre-existing conditions and Covid,” Gavino concludes.
Finding the travel coverage that fits your needs is what matters the most. That way, you will get the most out of your Medicare insurance plan.