Emergency Health Care Coverage While Out of TownPosted by Medicare Made Clear
A common concern for older adults is if their health care costs will be covered while traveling out of town, particularly in the event of a health emergency. The answer: “It depends.”
It’s important to understand what your plan will pay for when you are away from home. This is true no matter what type of Medicare coverage you have, like Original Medicare, a Medicare Advantage plan or a Medicare supplement plan.
Original Medicare covers treatment and care that you receive from any provider that accepts Medicare, anywhere in the country. This includes emergency and non-emergency medical care. According to Medicare.gov, all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S. Original Medicare can be a convenient Medicare choice if you spend extended periods away from home, but still remain in the United States. However, in most cases, you are NOT covered by Medicare outside of the U.S.
Most Medicare Advantage plans cover emergency medical care within the United States. In non-emergency situations, some types of Medicare Advantage plans will cover only treatment and care you receive from providers within their contracted network. However, you may be able to get care outside your plan network, but you will probably have to pay a larger portion of the bill. There are other types of Medicare Advantage plans, such as private-fee-for-service plans, that are non-network plans that will cover services you receive from any provider in the U.S. who accepts Medicare and the plan’s terms, conditions and payment rates. Check with your plan for specific coverage information while traveling within the United States and abroad.
Most Medicare supplement insurance (Medigap) plans provide emergency medical coverage within the United States. Medicare supplement insurance can only be used in combination with Original Medicare. It helps pay some of the out-of-pocket health care costs that Original Medicare Parts A and B does not pay. Check with your plan for specific coverage information while traveling within the United States and abroad.
Check Your Health Insurance Before You Leave Home
If your plan doesn’t cover your health care needs out of your network area, you may want to consider buying a separate travel insurance policy to cover emergency medical and dental treatment and for medical evacuation to the United States. Many companies offer short-term health and emergency assistance policies to cover health care expenses incurred overseas, including emergency services such as medical evacuations.
If you’d like general information about plan types, take a look at the Medicare Made Clear Medicare Summary Chart. To compare specific plans side-by-side, check out the Plan Finder at Medicare.gov. This is a helpful resource that shows you all types of plans available in your area. You can compare benefits, costs and other important plan features.
For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
Medicare Advantage Plan Types: You have six Medicare Advantage Plan types to choose from.
Original Medicare Coverage: Learn what’s covered and what’s not, at home or away.
Considerations for Older Travelers US Department of State (travel.state.gov)