When it’s time to enroll in Medicare, there are many things to consider. Your future travel plans should be one of them. If you’re considering international travel during the next year, it can impact your Medicare decisions.
Medicare itself doesn’t cover healthcare during international travel. However, some Medicare Advantage (Part C) plans may cover certain emergencies if they occur outside the United States. In most cases though, you’ll need supplemental travel insurance.
If you plan to travel out of the country, you can explore your options to help fill any gaps in your coverage. We’ll explain the available options, including Medicare supplemental plans (Medigap), short-term traveler’s insurance, or long-term coverage through Medicare Advantage.
Medicare is healthcare coverage for Americans age 65 and older. The government program is broken down into four parts:
- Medicare Part A. Medicare Part A is hospital insurance. It covers you during short-term inpatient stays in hospitals and for services like hospice. It also provides limited coverage for skilled nursing facility care and certain in-home healthcare services.
- Medicare Part B. Medicare Part B is medical insurance that covers everyday care needs like doctor’s appointments, urgent care visits, counseling, medical equipment, and preventive care.
- Medicare Part C. Medicare Part C is also called Medicare Advantage. These plans combine the coverage of parts A and B and aspects of part D into a single plan. Medicare Advantage plans are offered by private insurance companies and are overseen by Medicare.
- Medicare Part D. Medicare Part D is prescription drug coverage. Part D plans are stand-alone plans that only cover your medications. These plans are also provided through private insurance companies.
You aren’t automatically enrolled in these programs — you must sign up during the enrollment periods. You can choose the best plans for your healthcare needs.
Most Americans sign up for Medicare parts A and B. To qualify for other Medicare coverage, you must also be enrolled in parts A and B.
Medicare Advantage plans generally limit you to the doctors and facilities within a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) and may or may not cover out-of-network care.
To buy a Medicare Advantage plan, you must already be enrolled in Medicare parts A and B. Coverage through a Medicare Advantage plan is offered through a private insurance plan.
Medicare Advantage plans may
There are no rules that dictate whether Medicare Advantage will cover a certain percentage of foreign hospital bills. Therefore, it’s important to check with your insurance carrier before you travel to know how much, if any, your individual plan covers international healthcare emergencies.
Medigap is supplemental insurance offered through the Medicare program. It’s different from Medicare Advantage plans in that it doesn’t cover things like long-term care, vision, dental, hearing aids, eyeglasses, or private-duty nursing.
Medigap is another private insurance option within Medicare that’s designed to help cover costs like deductibles, copays, and other medical services not covered by other Medicare parts.
Medigap plans provide coverage for care related to medical emergencies that happen while you’re outside the United States. This type of insurance is often used to provide coverage during international travel.
Medigap can also help offset high deductibles and copays for insurance while you travel. In fact, depending on the plan you choose, Medigap may cover up to 80 percent of international medical emergencies once you’ve met your deductible and you’re within your policy’s maximum limit.
If you plan on traveling on a frequent basis, you may want to pay more up front for a Medicare Advantage or Medigap plan to cover costs away from your home state or out of the country. Below, we’ll go over some of the basic costs you’ll see for these types of plans in 2021.
Medicare Advantage costs
Most of your Medicare Part C costs will be determined by the plan you choose. However, your lifestyle and financial situation can also have an impact on your costs.
Here are some of the common costs you can expect to pay with a Medicare Part C plan:
- Premiums. Some Medicare Part C plans are “free,” meaning they don’t have a monthly premium. Even with a zero-premium Medicare Advantage plan, you may still owe a Part B premium. The Part B premium starts at $148.50 per month in 2021.
- Deductibles. Most Medicare Part C plans have both a plan deductible and a drug deductible. Many (but not all) of the free Medicare Advantage plans offer a $0 plan deductible.
- Copayments and coinsurance. Copayments are amounts you’ll owe for every doctor’s visit or prescription drug refill. Coinsurance amounts are any percentage of services you must pay out of pocket after your deductible has been met.
- Out-of-pocket max. One advantage of Medicare Part C is that all Medicare Advantage plans have an out-of-pocket maximum. This amount varies but can range from the low thousands to upward of $10,000-plus.
Medigap has many of the same types of costs as Medicare Advantage, but these plans have some key difference. Here is a rundown of the typical fees with a Medigap plan:
- Premiums. Each Medigap policy has a monthly premium. The exact amount can vary by individual policy. Insurance companies can set monthly premiums for their policies in three different ways:
- Community rated. Everyone that buys the policy pays the same monthly premium regardless of age.
- Issue-age rated. Monthly premiums are tied to the age at which you first purchase a policy, with younger buyers having lower premiums. Premiums don’t increase as you get older.
- Attained-age rated. Monthly premiums are tied to your current age. That means your premium will go up as you get older.
- Deductibles. Medigap itself doesn’t have its own separate deductible. However, Medigap Plan F and Plan G offer have a high-deductible option. The monthly premiums for these plans are typically lower, but you’ll have to meet a deductible before they start to cover costs. For 2021, the deductible is $2,370 for these plans.
- Copayments and coinsurance. Like deductibles, Medigap itself isn’t associated with coinsurance or copays. You may still have to pay certain coinsurance or copays associated with original Medicare if your Medigap policy doesn’t cover them.
- Out-of-pocket max. Only Medigap Plan K and Plan L have out-of-pocket limits. This is a maximum amount that you’ll have to pay out-of-pocket. In 2021, the Plan K and Plan L out-of-pocket limits are $6,220 and $3,110, respectively. After you meet the limit, the plan pays for 100 percent of covered services for the rest of the year.
If you’re on a budget, another option is to obtain supplemental traveler’s insurance. This isn’t medical insurance, but is instead a short-term plan that covers emergencies while you’re out of the country. You may also be able to buy short-term insurance through a travel planner.
The catch is that you’ll need to buy the coverage ahead of time for a specified itinerary. You can’t buy traveler’s insurance once you’ve already left the country.
Also, not all supplemental plans cover preexisting conditions. If you have chronic health conditions, be sure to review the exclusions before you purchase travel insurance.
Does Medicare cover you if you travel to Puerto Rico?
Puerto Rico is a U.S. territory, so your Medicare plan will cover your travels to the island. Residents of Puerto Rico are also eligible for Medicare.
The same rules apply to other U.S. territories, including:
- American Samoa
- The Northern Mariana Islands
- U.S. Virgin Islands
If you travel, Medicare Advantage (Part C) plans may have advantages over Medicare parts A and B for you. However, since these are private insurance plans, Medicare Advantage doesn’t automatically cover costs during international travel.
It’s important to review your policy before you travel and consider supplemental coverage with either Medigap or traveler’s insurance if you’re concerned about the potential cost of medical care while you’re out of the country.