Does Medicare Cover Me on Vacation

Does Medicare Cover Me on Vacation

September 14, 2020 Off By John Authen

Many seniors look forward to retirement for one particular reason – to vacation anytime they please. Because they don’t have a boss waiting for them to return to the office, most retirees’ vacations are longer than the average trip. Traveling for an extended period could mean being without health insurance. Find out how Medicare covers you on vacation when planning your next trip. 

Original Medicare

Original Medicare Parts A and B are how most Medicare beneficiaries receive their coverage. Original Medicare is accepted by nearly a million providers throughout the country. You can see any provider in the country who accepts Medicare if you receive your coverage through Original Medicare.

Many Medicare beneficiaries choose to supplement their Original Medicare with a Medicare Supplement plan. Medicare Supplement plans pay for any service that Original Medicare first approves and pays for. Original Medicare will pay its share first and then bill the remainder to the Medicare Supplement plan. Therefore, if the doctor accepts Original Medicare, they must accept any Medicare Supplement plan, regardless of the plan’s carrier. 

Foreign travel with Original Medicare

Original Medicare does not cover you while vacationing in another country, not even in the case of an emergency. The only times Original Medicare will cover you in another country are:

  • if you are driving through Canada to get to or from Alaska and an emergency occurs.
  • if you are driving through the United States near one of the borders and a Mexican or Canadian hospital is closer than a United States hospital when an emergency occurs.

Note that if you vacation in Canada or Mexico, you aren’t covered by Medicare. If you vacation in any other country other than the United States, Original Medicare won’t cover you at all, even in the case of an emergency. 

If you have a Medicare Supplement plan, you may have a foreign travel emergency benefit that does cover you while vacationing in another country. Plan C, D, F, G, M, and N all include this benefit. The coverage can only be accessed during the first 60 days of travel. If you have an extended vacation in another country, your Medicare Supplement plan won’t cover you. The foreign travel emergency benefit comes with a $250 deductible as well as a $50,000-lifetime limit. 

Medicare Advantage

When you have a Medicare Advantage plan, your coverage is provided by your plan’s carrier, not Original Medicare. Medicare Advantage plans are required to cover you as well as Original Medicare. However, cost-sharing expenses, such as copays and deductibles, vary by plan. Therefore, Medicare Advantage plans will cover you outside of your plan’s network in the case of an emergency. 

Some Medicare Advantage plans also have out-of-network benefits for non-emergencies. For example, if you have a Medicare Advantage plan with a PPO network, you can see doctors who aren’t in your network but for a higher price. However, out-of-network doctors are not required to bill your plan, so you should first ask them if they are willing to bill out-of-network. 

Other Medicare Advantage plans, such as those with HMO networks, don’t have out-of-network benefits. So, unless there is an emergency, your HMO Medicare Advantage plan will likely not cover you outside of your plan’s service area. 

Foreign travel with Medicare Advantage

Although Medicare Advantage plans don’t cover you outside the country for non-emergencies, many Medicare Advantage plans have a foreign travel emergency benefit. The costs and rules of the benefit vary by plan. However, if you seek medical care outside of the United States with a Medicare Advantage or Medicare Supplement plan, you may need to pay 100% out-of-pocket for your services. 

Foreign hospitals are not required to bill your Medicare insurance. If they do bill your plan, then you’ll only have your cost-sharing expenses to pay for. However, if they don’t bill your plan, you’ll have to pay out of pocket and request reimbursement from your plan once you’re back home. 

Because it’s never a guarantee that your Medicare plan will cover you, you should purchase a travel health insurance policy for your vacation. These plans are built to cover you all around the world and are more reliable coverage when traveling. Unless there is a loss of life or limb situation, don’t expect Medicare to cover you outside the United States.