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Here to make Medicare and Medigap a little bit easier one step at a time. And, if you travel for leisure, travel to visit family, or live in another state part time, you might be wondering how Medicare Supplemental coverage works while you travel outside your zip code, city, state, or even the United States. And,if you’ve done any research about Medicare, then you might already know that Medicare’s network is huge.
In fact, there are 515,000 providers actively receiving Medicare payments, according to CMS (the Centers for Medicare and Medicaid Services) as of January 2017. So, this is a huge benefit to you while you are traveling. But, do you wonder if a Medicare provider will accept your Medicare Supplemental coverage plan outside of your zip code? Well, I’m going to provide you all the details about how Medicare Supplement plans work while you’re traveling. How it compares to Medicare Advantage Plans, and make sure you stay to the end for my tips on how to use your Part D drug coverage while traveling, as well. So, let’s get started. You know, the great news about Medicare Supplement insurance is that you can use it across all 50 states, including U. S. territories (District of Columbia,Puerto Rico, U. S. Virgin Islands, Guam, American Samoa, or Northern Mariana Islands). So, all you have to do is remember that a provider who accepts Medicare will also accept your Medicare supplement plan regardless of who the insurance company is.
For example, let’s say that you live in Texas and you purchased a Medicare Supplement plan from Manhattan Life Insurance Company, and you’re going to travel to Florida either for pleasure or maybe you live there part time. But, you realize that, in Florida, Manhattan Life does not sell Medicare Supplement insurance, so you’re wondering if your plan will work in Florida. Well, not to worry, you can absolutely use your plan. Again, while traveling, it’s not about the name of your insurance carrier. It’s about seeing providers who accept Medicare. And, that’s the key. As long as you go to the provider who accepts Medicare, where ever you are in the U. S. , or the territories, then your Medigap plan will pay its portion of costs according to your Outline of Benefits for your plan. And, it works seamlessly, because the provider sends your claim to Medicare, who then processes it, and then electronically sends it to your Medigap insurance company who will then pay its portion of costs. So,the bottom line is, as long as you’re seeing a Medicare approved provider who is in Medicare’s vast network, then you will be covered and your Medigap insurance plan will also work regardless of where where you are in the United States.
So, now you know how Medicare Supplement coverage works in the United States and it’s U. S. territories. But, what about foreign travel? Well, Medicare, itself, is very limited on what it will cover outside of the United States. In fact, there are only three situations in which Medicare will provide some healthcare coverage and they are very limited and have very strict rules that apply with hospital stays within Mexico and Canada. So, I advise you to read the publication in which CMS putout regarding those rules, and I’ll put the link in this post below so you can look at the details of those situations. But, now let’s focus on Medicare Supplement insurance plans and how they work outside of the United States. So, Medigap Plans C, D, E F, G H,I, J, M, and N pay 80% of the billed charges for certain medically necessary emergency care needs outside the U. S. after you have met a $250 deductible for the year. Now, keep in mind, these Medigap policies cover foreign travel emergency care if it begins within the first 60 days of your trip and has a lifetime limit of $50,000.
Now, I want to be clear, Medicare Supplement insurance is the same thing as Medigap insurance. The terms are used interchangeably, but they’re the exact same types of health coverage. But, what’s not the same are Medicare Supplement plans and Medicare Advantage plans. And, they definitely don’t work the same while traveling. And, one of the reasons why is because Medicare Advantage Plans do not use Medicare’s huge network of Medicare providers. Instead, Medicare Advantage Plans, being HMOs and PPOs, have providers in their service area networks, dedicated to your zip code or your county. So, this limits your availability when needing a provider out of your area. So, depending on the type of coverage you have with a Medicare Advantage Plan, it’s quite possible they will not cover you as you’re traveling throughout the United States and U. S. territories. It really all depends on where you’re traveling,how long you’re traveling for, the type of care that you’ll need. Those are really important details if you’re planning on getting a Medicare Advantage Plan or you have one; that you really take a look at the rules that apply to traveling within the United States with that Medicare Advantage Plan. And, the same holds true if you plan on traveling with a Medicare Advantage Plan outside of the United States. There are different rules that apply with each Medicare Advantage Plan, so you want to make sure that you look at those rules for your particular plan. Which is definitely not the case with a Medicare Supplement plan, also known as a Medigap plan, you do not have to continue worrying about what rules apply. You never have to check that.
If you have Medicare and your Medigap plan, then you know that you can visit any doctor within the United States who accepts Medicare, and you will be covered. And, let me share an example of how Medicare’s network really came in handy for my father-in-law who was getting ready to travel out of the country. Prior to leaving, he was staying with us and, they day he was actually leaving, noticed a spot on his skin that was rather uncomfortable. So, he wasn’t near his home. So, he wasn’t able to see his dermatologist, so he had to find one near our home. Which he was able to do using Medicare’s network. Their provider network. Now, had he had a Medicare Advantage Plan, it would have been a different story. He would have had to go outside of the network, which would have incurred either the full cost of the provider visit or he would have had to pay a higher out of network cost. But, because he had Medicare and a Medigap plan, he had no problem finding a Medicare provider. Having that spot taken care of before he left for his vacation. Which he was going out of the country, so Medicare wouldn’t of deemed that as medically necessary, or an emergency while he was traveling out of the U. S. , so he would not have been able to have that treated until he returned. So, it was good he was able to take care of it before leaving.
And, as promised, let’s talk about Part D drug plans and how they work while traveling. Now, if you already have a Medicare Part D plan or you’re going to be choosing one, definitely want to check on this – when you’re in Medicare’s Plan Finder Tool or you can even call Medicare directly, but what you want to know is that this particular plan has national coverage. And, with Medicare’s Plan Finder Tool you can do this by looking at the plan and finding the little “N”. That “N” indicates national coverage and you can use this plan across the United States. The other thing you want to do is make sure that you choose a plan that has more than one retail location. So, right now, in 2017 (at the time of this video), there’s a plan called AARP Walgreens. This particular plan you can only use at Walgreens. So, if that’s the plan that you’re going to choose, where you can only use one retail location, you might want to make sure that this particular retail location is available where you’re traveling. Especially, if you live somewhere part time.
Of course,there’s so much more to learn about Medicare and Medicare Supplement insurance and if you’re just starting your research feel free to access my free Medicare eCourse, by simply clicking on the little “i” in the right hand corner of the screen. Or, by clicking on the links in the post below. I cover all the different parts of Medicare, enrollment opportunities,deadlines, penalties, and so much more. And, if you want to stay on top of Medicare topics, feel free to join me at REMEDIGAP’s Facebook page. And, of course, you can subscribe here so you can always see my videos when they come out. And, if you like this video, please”like” it. And, last but not least, share it with your friends so that they can stay informed, as well.