Traveling Can Be Hazardous to Your Pocketbook
When they retire seniors often plan to travel and experience life in other parts of the country and world. Traveling is so much easier and often more affordable than when they were younger and most retirees are no longer limited to vacations of one or two weeks. It is important for everyone when they travel they should be aware of their health insurance and what it does and does not cover, this is especially true if you are on Medicare.
If you are traveling within the U.S. you are always covered in the event of a health emergency (the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa). However, the tricky part is how these events get paid. if you are on original Medicare Part A and B, the hospital and approved Medicare health professionals (that simply means they accept Medicare) will most often bill Medicare directly and you will pay the customary co-pays and deductibles and if you have a Medicare supplement insurance policy even better, depending on your plan terms they may pick up the co-pays and deductibles. It gets a little more complicated if you have Medicare Part C an Advantage plan because these plans do not operate on a national basis but rather regionally and while they have to legally offer coverage equal to or better than original Medicare (A&B) they may have different rules that have to be followed for out of area emergency care. The best advice is to ask your insurance agent or insurance carrier their policy.
Some retirees have children living out-of-state and plan on extended visits that may last for weeks or months and may need non-emergency health care services, which if you have original Medicare with or without a Medicare supplement policy is no problem. The same cannot be said for Medicare Part C an Advantage plan, each insurance company is only allowed to operate in a specific service area, assigned by Medicare, and you usually have provider networks that you must use for routine care and in the case of an HMO Advantage plan you cannot use doctors or health facilities out of the network except in emergencies. Other Medicare Advantage plans are more flexible but may have higher co-pays for services out of the network. Additionally, if you reside outside of your plan's service area for more than six months consecutive a Medicare Advantage plan must dis-enroll you and if this happens your Medicare coverage reverts back to original Medicare Parts A and B and you become responsible for all co-pays and deductibles.
Traveling outside the U.S. or on a cruise ship (outside the U.S. territorial waters, Medicare will NOT pay for health services when a ship is more than six hours away from a port.) it is quite simple YOU HAVE NO MEDICARE HEALTH INSURANCE except in three very specific emergency situations. You live in the U.S. but the foreign hospital is closer to your home than the U.S. hospital. You are traveling through Canada from Alaska to another state in the U.S. and the Canadian hospital is closer (you have to be deemed to be traveling the most direct route). You are in the U.S. when an emergency occurs and the foreign hospital is closest. Medicare is an U.S. health program that is only recognized in the U.S. you have to be prepared to cover all costs yourself and submit an itemized bill (along with proof of any emergency charges) to Medicare for reimbursement. Most Medicare supplement insurance policies offer international health coverage but they often have a lifetime maximum ($50,000), a deductible, and a time-limit on any charges Medicare does not cover (they most often have to be incurred within the fist 60 days of travel). Some Advantage plans cover emergencies again you need to check with your specific carrier.
Do not stop traveling but be smart about it; always before traveling check with your insurance carrier to see what is covered and how it is covered. Medicare.gov can answer any Medicare questions you may have. Probably the best solution is to buy Travel Health Insurance, but again check to see what is covered and is not, be informed and be prepared.