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What you need to know about Medicare while traveling

Medicare | Jul 22, 2016

Summer is in full swing, which means plenty of vacations. Your travels, whether within the U.S. or abroad, are meant to be a fun and relaxing way to spend retirement.

But not everything goes as planned, and medical emergencies may show up at the worst moments, even on vacations. If you encounter a situation where you need to visit a hospital, it's important to know how treatments work when you're on Medicare but out of your home state or even out of the country.

When you're out of state

Having Medicare and visiting a doctor in another city or state is not all that different from when you visit your primary care doctor or specialist.

"You're able to receive care from any hospital or doctor in the U.S. and its territories."

According to Medicare Interactive, as long as you have Original Medicare, you're able to receive care from any hospital or doctor in the U.S. and its territories. You are thus able to visit a doctor even if you are vacationing in Puerto Rico, the Virgin Islands, American Samoa, Guam, Northern Mariana Islands and Washington D.C.

But if you have a Medicare Advantage plan, it's in your best interest to contact your Medicare plan provider to learn about coverage options and other rules.

Costs will also have to be factored if you have a Medicare Advantage plan and need to see a doctor while traveling in the U.S. With some Medicare Advantage plans, you might not be able to see doctors out of your network. Though some plans indeed allow this, you may end up paying more for receiving care or treatment, which could become somewhat more tricky because your current plan may only cover urgent care or emergency visits.

Traveling out of the country

If you're traveling abroad and need to visit a hospital, Medicare will not cover costs of any hospital visit or drugs and supplies you get.

"If you're traveling abroad and need to visit a hospital, Medicare will not cover costs."

However, there are three situations, as outlined by the Centers for Medicare & Medicaid Services where medical costs may covered, but in a limited scale. You are eligible to receive care outside of the U.S. if:

  • You live closer to a foreign hospital than a U.S. one and that institution can treat a medical condition, regardless of whether it's an emergency
  • You're currently in the U.S., but a foreign hospital is closer
  • You're traveling to Alaska and going through Canada when a medical emergency arises and a Canadian hospital is closer than a U.S. one

When receiving care from a foreign hospital, Medicare will only cover Medicare-covered services, which will depend on the type of Medicare plan you're currently enrolled in.

For example, if you have Part A coverage, Medicare will cover inpatient hospital care. Part B will cover emergency doctor services you might receive before and during an inpatient hospital stay while abroad.

Part B will also cover non-emergency visits and ambulance services. But there are also some limitations to what Part B covers. Part B will not cover medical costs associated with ambulance trips back home. You also won't be covered if you decide to visit a doctor or receive a treatment outside of the hospital.

Plan ahead

Emergencies can never be planned, but it helps to prepare for all possible scenarios, especially with regard to your health.

Before any vacation, you may want to contact your Medicare plan provider to discuss the finer details and help you understand what to do should you have to go to a hospital while traveling, as well as the potential costs.

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