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Is travel an essential part of your retirement experience? If so, then you’ll need to do some planning. That includes making sure you have the right Medicare coverage. Luckily, there are many different Medicare Advantage plans to consider that may offer you coverage for travelers.
So whether you’re preparing for a month in France, a winter in Florida or a weekend away from home, you can get the peace of mind that comes from packing the right health coverage for your journey.
Traveling with Medicare while exploring the United States
Medicare can provide excellent health coverage during your travels in the United States. Original Medicare, which is what many people call the combination of Medicare Parts A and B, is widely accepted by health care providers across the country. You just need to confirm that the provider you see accepts Medicare before you receive your care.
“Medicare Advantage plans can be an excellent option for travelers who want coverage while on the road. But members should check with their plans regarding the level of coverage they have while away from home.”
Medicare Advantage (MA) plans can also be a good way to get health coverage while on a trip. MA differs from Original Medicare in a few important ways. Medicare Advantage plans are sold by private companies. Many offer benefits not included in Original Medicare, like dental, vision and hearing coverage. MA plans also include a network of providers. In health maintenance organization (HMO) plans you generally need to use one of the health care providers in network to get coverage for a service. Members of preferred provider organization (PPO) plans have coverage when they see providers who are out of their plan’s network, although they usually pay more.
Fortunately, there are MA plans that have networks that include doctors in many different parts of the country. That means if you pick the right MA plan, you’ll be able to find a care provider in your plan’s network in many of the places you travel in the U.S. In fact, Aetna® Medicare offers a number of MA plans designed to provide you with coverage while traveling.
Comparing domestic and international Medicare travel 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. |
No |
Yes |
Yes |
Yes |
|
Network providers are available throughout the U.S. |
Yes — if the provider accepts Original Medicare |
No |
Yes — if the provider is in network |
Yes — if the provider is in network |
|
PCP referral required |
No |
Varies based on plan |
Yes |
No |
|
Patient’s medical history provided to network doctors while traveling |
No |
No |
No |
Yes — when medical records are requested by the plan member |
|
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. |
No |
|
Network providers are available throughout the U.S. |
Yes — if the provider accepts Original Medicare |
|
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 — if the provider is in network |
|
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 — if the provider is in network |
|
PCP referral required |
No |
|
Patient’s medical history provided to network doctors while traveling |
Yes — when medical records are requested by the plan member |
However, to be completely certain of the level of coverage you will get while on the road, it’s important to check with your plan about the coverage you have before beginning your travels.
Using Travel Advantage while you’re away from home
Does travel means spending an extended amount of time in your second home or with family or in a long-term vacation rental? During these longer stays, you may need to take an even closer look at your MA coverage.
Medicare Advantage is a national program, but MA plans are offered to individuals based on their ZIP codes. That means you are only eligible to remain in a particular MA plan if you are in a ZIP code where that plan is offered. In fact, the Centers for Medicare & Medicaid Services (CMS) require that members be disenrolled from their MA plan if they live outside their plan’s service area for more than six months.
However, there are MA plans designed to allow you to stay on your plan even if you spend significant time outside the plan’s service area. Aetna® offers MA plans with a visitor travel program. This program allows you to remain in your plan for an extra six months on top of what CMS rules allow when you live outside your plan’s service area.
How to make sure your Medicare Advantage HMO plan travels with you
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 is planning to spend three months in New York to visit her grandchildren. Here are some steps she should take to enjoy her coverage away from home.
Before she leaves Florida she should:
Confirm there is a primary care provider (PCP) in New York who is in her plan’s network and is taking new patients
Find a hospital near where she will be staying in New York that is in her plan’s network
Locate a preferred pharmacy in New York near where she will be staying
Pack a digital or paper copy of important medical records
When she arrives in New York she should:
Change her PCP to a local doctor in her plan’s network
Take her medical records with her if she sees her local PCP
Make sure other providers are in her network if referred by her local PCP
No matter which MA plan you choose, it’s important to remember that you still need to follow your plan’s rules while enjoying an extended stay away from home. For example, if your plan requires you to have your PCP refer you to a specialist for care, you need to make sure you select a new PCP near your second residence. Otherwise, you could have difficulty getting referred to a specialist when you need one.
Does Medicare cover international travel?
Are you planning travel outside the United States? You should be aware that Medicare coverage can be very different when traveling internationally. For instance, Original Medicare generally doesn’t cover any type of health care while you’re traveling outside the United States, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands. There are some exceptions, like a few specialized cases where Medicare may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S. But for the most part, you have no coverage for any health care you receive abroad with Original Medicare, including emergency care.
International Medicare coverage comparison
Original Medicare
What you need to know
- Provides coverage for any physician who accepts Original Medicare across the U.S.
- Generally does NOT provide Medicare coverage overseas
Medicare Advantage
What you need to know
- Provides coverage for any doctor in the Medicare Advantage plan’s network
- Provides emergency and urgent care outside of the U.S.
- Generally does NOT cover any follow-up procedures after urgent/emergent care while abroad
Before you travel outside the U.S., talk with your plan provider or insurance agent to get more information about your Medicare coverage while traveling.
There are Medicare Advantage plans that offer forms of coverage for emergency care and urgent care services during international travel. However, coverage and rules vary, so it is important to check with the plan administrator or insurance agent to determine the details of your foreign coverage before you travel.
Get your prescriptions easily while traveling across the U.S.
Getting your prescriptions while on the road is a key part of maintaining your health. That’s why certain MA plans come with a national pharmacy network that allows you to pick up your prescription medications across the United States.
Having a preferred pharmacy network with nationwide reach can save you both time and money when it comes to getting your prescriptions while away from home.
Health coverage for retirement travels
Are you dreaming of traveling once you retire? A big part of turning that dream into a reality is choosing the plan that best meets your health needs while you are on the road. An MA plan can be the right choice for coverage, giving you extra benefits and access to travel-related perks. However, you need to do your homework to pick the plan that best fits your needs. After all, the right plan is one of the most important items you can take with you on your adventures.
Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Out-of-network/non-contracted providers are under no obligation to treat Aetna members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. The formulary, provider and/or pharmacy network may change at any time. You will receive notice when necessary. Plan features and availability may vary by service area.
About the author
Mark Pabst has worked as a writer and researcher in the health care field for almost two decades. When not writing about health he tries to stay healthy through activities like hiking, climbing and paddling in the far-flung corners of his native state of California. However, despite his best efforts he still has a few unhealthy habits he can’t shake, most notably a weakness for jelly donuts.