Can You Use Your Medicare Benefits in Another State?

Depending on your Medicare plan, your coverage may vary when you leave your home state.

Original Medicare

Original Medicare is made up of Part A (hospital insurance) and Part B (medical insurance). You’re covered with doctors and hospitals that accept Medicare anywhere in the United States.

Part D (prescription drug coverage)

Medicare Part D is made up of plans sold through private insurance companies and approved by Medicare. Plan options differ from company to company.

Some offer national coverage so you can go to any location of their in-network pharmacies. However, some have pharmacy networks that are not available in other states/regions. Check to see if your plan allows you to use your coverage in other states before you head out on vacation.

Part C (Medicare Advantage)

If you have a Medicare Advantage plan, your coverage outside your home state is based on the specific plan you have. Some things to check about your plan regarding out-of-state coverage:

• Does your plan have a provider network that you must use to be covered? HMOs are good examples of this type of plan.
• Does your plan allow you to use healthcare providers outside of your PPO? If so, will this trigger a higher copayment or coinsurance?

If you’re planning to travel outside your home state, check with your Medicare Advantage plan to understand your plan’s service area.

There are some limited situations when original Medicare may cover you when you’re traveling outside the United States, including if:

• you live in the United States, have a medical emergency, and a foreign hospital is closer to you than the nearest U.S. hospital
• you’re in Canada, have a medical emergency while traveling on a direct route between Alaska and another U.S. state, and the closest hospital that can treat you is in Canada
• you’re on a cruise ship, need medically necessary care, and the ship is in U.S. waters, a U.S. port, or within 6 hours of arrival or departure from a U.S. port

Medicare Advantage

At a minimum, Medicare Advantage plans must provide the same level of coverage as original Medicare. Some offer additional coverage.

Medicare Part D

If you have Medicare Part D or any other plan that includes prescription drug coverage, prescription medications purchased outside the United States are typically not covered.

Medicare supplement (Medigap)

Medigap plans C, D, F, G, M, and N all offer 80 percent foreign travel exchange (up to plan limits).

As opposed to traveling to or through another state, if you’re planing to move to another state, you need to give Medicare your new address.

The fastest way to update your contact information for Medicare is to use the “My Profile” tab on the Social Security website. You do not have to be receiving Social Security benefits to use this site.

However, to access this site, you must first register. You can only create an account for your own use, and you must be able to verify information about yourself, including your:

• Social Security number
• U.S. mailing address
• valid email address

You can also update your Medicare contact information by calling the Social Security Administration at 800-772-1213. If you’d prefer to update in person, you can go to your local Social Security field office, which you can find here.

You can use your Medicare in another state, but the coverage may vary depending on your plan. There are different rules for using original Medicare, Medicare Advantage, Medicare Part D, or even a Medigap plan in other states or when traveling overseas.

If you’re planning to move out of state and want to update your Medicare contact information, you can:

• use the “My Profile” tab on the Social Security website
• call the Social Security Administration at 800-772-1213
• visit your local Social Security field office