Traveling with Medicare
Can I Use My Medicare in Another State?
Short answer – Yes, anywhere in the United States, but you’ll need to find a provider who participates in Medicare.
Can I Use My Medicare in Another Country?
For international travel, Original Medicare offers only limited emergency coverage. Some Medicare Supplement and Medicare Advantage plans offer more protection in foreign countries but are still limited to emergency care.
Medicare and Domestic Travel
When traveling within the U.S. all Original Medicare benefits apply, but only for care by U.S. providers who accept Medicare. It is important to understand provider types and how the provider’s agreement with Medicare can affect your out-of-pocket costs.
Participating providers. This provider accepts Medicare and always accept the Medicare-approved amount for health care services as full payment.
Non-participating providers. This provider accepts Medicare but does not agree to accept the Medicare-approved amount for health care services as full payment. This provider can charge up to 15% more than the Medicare-approved amount.
Opt-out providers. This provider does not accept Medicare at all. This means they have signed an agreement with Medicare to be excluded from the Medicare program.
To pay the lowest out-of-pocket cost for care while traveling, choose a Medicare-participating doctor or hospital. You will be responsible only for copays or deductibles – just like what you would pay your regular providers.
Not sure if a doctor or hospital accepts Medicare? Ask the doctors front desk or hospital admissions desk directly if they are a Medicare-participating provider. When planning your trip, it’s always a good idea to do an internet search for Medicare participating providers in your destination area.
If necessary, you can be treated at a non-Medicare-participating hospital, but you may pay up to 15% of the bill on top of what you would normally owe. This extra amount is called a Medicare Part B excess charge.
If you go to a doctor or hospital that has opted out of Medicare, you will be responsible for the full bill out-of-pocket.
Medicare Advantage and Medicare Supplement plans will also cover you across the U.S., but it is important to understand your coverage network to avoid paying higher fees.
If you have Medicare Supplement Insurance, also called Medigap, you may use it with any provider who accepts Original Medicare. If you are seeing a Medicare-participating provider, don't worry – your Medigap plan will cover you too.
Some Medicare Advantage plans have narrower networks of doctors and hospitals than Original Medicare. If you have a Medicare Advantage plan that is an HMO (Health Maintenance Organization), your plan only pays for care from in-network providers. These covered networks may be local, or may span multiple states. Before traveling, check with your Medicare Advantage plan to make sure you can use your coverage in another state.
If your Medicare Advantage plan is a PPO (Preferred Provider Organization), you may pay more to receive care outside your network than you would pay to see an in-network provider. Generally these plans are less restricted than HMOs in terms of which providers you may see. Before traveling, check with your Medicare Advantage plan to make sure you can use your coverage in another state.
Your Medicare Part D plan may cover you for prescription costs while traveling out of state. Many Medicare Part D plans feature a pharmacy network you must use for coverage, or for the lowest out-of-pocket prices. Pharmacy networks may be local, regional, or national depending on your plan. Check with your plan provider to find out your options for refilling or picking up medications while traveling.
If you move out of state, you may qualify for a Special Enrollment Period to change your Medicare Advantage and/or Medicare Part D coverage, to better cover your health care costs in your new home state.
Medicare and International Travel
Outside of the U.S., Original Medicare offers only limited emergency travel coverage. For the purpose of this emergency coverage, "outside of the U.S." means any country other than the 50 United States, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, or the Northern Mariana Islands.
When does Medicare cover health care services in a foreign hospital?
- You’re in the U.S. when you have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital that can treat your illness or injury.
- You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat your illness or injury. Medicare determines what qualifies as “without unreasonable delay” on a case-by-case basis.
- You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether it’s an emergency.
Remember, in these situations, Medicare will pay only for the Medicare-covered services you get in a foreign hospital.
Medicare Supplement and Foreign Travel
Some Medicare Supplement and Medicare Advantage plans offered through private insurers provide additional protection in foreign countries. While this coverage is still only for emergency care, some of these plans can help reduce out-of-pocket costs associated with international emergency health care.