Is travel a big part of your life or your future plans? If you plan to travel, you need to make sure you have the right health plan. There are many Medicare Advantage plans that can help you stay covered while on the road.
Traveling with Medicare in the United States
Medicare can help cover your health care costs while you travel in the U.S. Many doctors and hospitals across the country accept Original Medicare (Parts A and B). But before you get care, you should check that the doctor or hospital accepts Medicare.
Medicare Advantage plans can also help you stay covered when you travel. These plans are sold by private companies, like Aetna. They often cover added benefits like dental, vision and hearing care. They also have a network of providers you can see. In HMO plans (health maintenance organization), you usually need to see a doctor in the network. If you’re in a PPO plan (preferred provider organization), you can see doctors outside the network, but you might pay more.
The good news is that some Medicare Advantage plans have doctors in many parts of the country. If you pick the right plan, you can find a doctor in your network almost anywhere you go in the U.S. In fact, Aetna offers several Medicare Advantage plans that are great for travelers.
Getting your prescriptions while you travel
As you travel around the U.S., you may need to pick up a prescription. Some Medicare Advantage plans have a national pharmacy network. This means there are many stores across the country where you can pick up your drugs.
Check if your plan has a national pharmacy network. It can save you time, money and your health when you’re away.
Leaving the U.S. — Medicare for international travel
Are you planning travel outside the U.S.? It’s even more important that you have the right plan. Here’s how Original Medicare compares to Medicare Advantage when you leave the country.
Original Medicare
Original Medicare usually does not cover care overseas or outside of:
- The United States
- Puerto Rico
- The U.S. Virgin Islands
- Guam
- American Samoa
- The Northern Mariana Islands
There may be times when Medicare may pay for services on a ship in U.S. waters. But for the most part, you won’t be covered overseas. Even in an emergency.
Medicare Advantage
Medicare Advantage plans can cover some care overseas:
- They provide emergency and urgent care outside the U.S.
- They don’t usually cover follow-up care after urgent or emergency care while abroad.
Do you plan to travel outside the U.S.? Always check with your Medicare plan to make sure you know what’s covered.
Using Travel Advantage to extend coverage while you’re away
Planning to spend a lot of time at a second home or with family? You might need to look closely at your Medicare Advantage coverage.
Medicare Advantage is a national program, but plans are offered based on your ZIP code. You can only stay in a plan if you live in a ZIP code where it’s offered. The Centers for Medicare & Medicaid Services (CMS) has set a limit on how long you can be away and still stay in your plan. If you live outside your plan’s service area for more than six months, you might need to switch plans.
But some Medicare Advantage plans let you stay on your plan even if you spend a lot of time outside your service area. For example, Aetna offers plans with a visitor travel program called Travel Advantage. This program lets you stay on your plan for an extra six months over the CMS limit when you live outside your service area.
Comparing coverage
|
Original Medicare |
Aetna Prime HMO/PPO |
Aetna HMO with Travel Advantage |
Aetna PPO with Explorer |
|
|---|---|---|---|---|
ER and urgent care covered — in the U.S. |
Yes |
Yes |
Yes |
Yes |
ER and urgent care covered — outside the U.S. |
No |
Yes |
Yes |
Yes |
Network pharmacies are available throughout the U.S. |
Yes |
Yes |
Yes |
Yes |
Network providers are available throughout the U.S. |
Yes |
No |
Yes |
Yes |
PCP referral required |
No |
Varies based on plan |
Yes |
No |
Patient’s medical history provided to network doctors while traveling |
No |
No |
No |
Yes — if a plan member asks for this |
|
Original Medicare |
|
|---|---|
ER and urgent care covered — in the U.S. |
Yes |
ER and urgent care covered — outside the U.S. |
No |
Network pharmacies are available throughout the U.S. |
Yes |
Network providers are available throughout the U.S. |
Yes |
PCP referral required |
No |
Patient’s medical history provided to network doctors while traveling |
No |
|
Aetna Prime HMO/PPO |
|
|---|---|
ER and urgent care covered — in the U.S. |
Yes |
ER and urgent care covered — outside the U.S. |
Yes |
Network pharmacies are available throughout the U.S. |
Yes |
Network providers are available throughout the U.S. |
No |
PCP referral required |
Varies based on plan |
Patient’s medical history provided to network doctors while traveling |
No |
|
Aetna HMO with Travel Advantage |
|
|---|---|
ER and urgent care covered — in the U.S. |
Yes |
ER and urgent care covered — outside the U.S. |
Yes |
Network pharmacies are available throughout the U.S. |
Yes |
Network providers are available throughout the U.S. |
Yes |
PCP referral required |
Yes |
Patient’s medical history provided to network doctors while traveling |
No |
|
Aetna PPO with Explorer |
|
|---|---|
ER and urgent care covered — in the U.S. |
Yes |
ER and urgent care covered — outside the U.S. |
Yes |
Network pharmacies are available throughout the U.S. |
Yes |
Network providers are available throughout the U.S. |
Yes |
PCP referral required |
No |
Patient’s medical history provided to network doctors while traveling |
Yes — if a plan member asks for this |
An example: Monique makes sure her health care is covered for travel
Monique C. has a Medicare Advantage HMO plan from Aetna that includes the Travel Advantage feature. Travel Advantage allows Monique to remain in her plan for an extra six months when out of her plan’s service area. It also offers a multistate provider network.
She lives in Florida, but she plans to spend three months in New York with her grandchildren. She knows she’s covered for a while longer if anything comes up. Here’s what she should do to use her plan away from home:
Before Monique leaves Florida, she should:
Find a primary care provider (PCP) in New York who’s in her plan’s network and is taking new patients
Check for a hospital near where she’ll be staying in New York that’s in her plan’s network
Find a preferred pharmacy in New York near where she will be staying where she can get her prescriptions
Pack a digital or paper copy of important medical records to bring with her
When Monique arrives in New York, she should:
Change her PCP to a local doctor in her plan’s network
Bring her medical records with her if she sees her local PCP
Make sure any other providers she sees are in her network if her local PCP refers her
No matter which Medicare Advantage plan you choose, follow your plan’s rules while you’re away. For example, if your plan needs a referral to see a specialist, make sure you pick a new PCP near you. Or you may have trouble seeing a specialist when you need one.
