All 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands all accept Original Medicare. Medicare Advantage plans don’t operate in the same manner. Except for emergencies and urgent care needs, some plans may not cover treatment received outside of their designated coverage areas.
Medicare Advantage Plans Have a Provider Network
Seniors typically need to visit medical professionals that are part of their Medicare Advantage plan’s network. Seniors should get in touch with their plan before departing the state to see if there are any in-network providers nearby.
Seniors may be required to pay the entire cost of any services they receive when they visit out-of-network providers. Some Medicare Advantage plans could cover services from providers who are not in their network. Seniors may have to pay a higher co-payment or coinsurance for certain services depending on the specifics of the plan.
Urgent situations or emergencies are an exception to these principles. Anywhere in the United States, Medicare Advantage plans must provide coverage under these circumstances. The plans are not permitted to add extra fees for these services.
Some Medicare Advantage Plans Offer Travel Benefits
Certain Medicare Advantage plans offer specialized travel insurance. Depending on the plan, these benefits may be referred to as guest or travel benefits. These plans may allow seniors who are enrolled in them to use their coverage outside of their native state.
Benefits for visitors or travel may differ between plans. Some forms of care may not be covered by the plan, and coverage might only be offered in specific locations. Seniors should review their Evidence of Coverage to find out what travel or visiting perks their plan offers. Details regarding the services that are covered are provided in this paper. For further information, they can also call their plan.
Using Medicare Advantage Plans Outside of the U.S.
While certain Medicare Advantage plans can be utilized outside of their state of residence, these plans often don’t offer coverage abroad. Seniors may decide to get travel medical insurance if they are going abroad.
Medicare Advantage plans may, under certain conditions, offer coverage abroad. For instance, if seniors are passing through Canada on their way from Alaska to another state, Medicare may cover the cost of their emergency care at a hospital there. Seniors’ medical care on cruise ships is also covered by Medicare, provided the ship is in U.S. territorial waters.
