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Retirees ready to go out should check Medicare coverage

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Are you ready to retire, get vaccinated and get out on the road? Don’t forget to check if your Medicare plan travels with you.

Coverage when you’re away from home depends in part on where you’re heading, but it also depends on your coverage details. Whether the care you receive is routine or urgent can also play a role.

According to the Centers for Disease Control and Prevention, about 70 percent of individuals over the age of 65 have received their first Covid shot and 43 percent have been fully vaccinated. As more people get vaccinated against the virus, travel is again in the hearts of those who crouched for last year.

Here’s what you need to know about the differences in Medicare coverage when you’re away from home:

Rough at the core

Basic or original Medicare consists of Part A (hospital coverage) and Part B (outpatient care). Individuals who choose to maintain their coverage instead of taking advantage plans are typically combined with a stand-alone prescription drug plan (Part D).

If this is your situation, the coverage when traveling to the United States and its territory is fairly straightforward. Whether it’s regular care or an emergency, you can go to a doctor or hospital that accepts Medicare. Things get harder when you’re adventuring across US borders.

“When traveling outside the United States, Medicare does not cover you except in very limited or rare situations,” said Daniel Roberts, co-founder of insurance company Boomer Benefits.

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These exceptions are if you’re on a ship in the territorial waters adjacent to the country (within 6 hours from a US port), or if you’re traveling from state to state, but the closest hospital to treat you is If you are in a foreign country (that is, you are in Canada while heading to Alaska from 48 neighboring states).

Note that in the ongoing pandemic, the Department of State has a number of valid recommendations for overseas travel. In addition, the US Centers for Disease Control and Prevention will show evidence that all air passengers, including citizens, are leaving (or returning to the United States) for a negative Covid test, or have recently recovered from the virus. I’m asking for that.

Still, if you’re heading to another country for your vacation, combining basic Medicare with a supplementary policy (also known as Medigap) may give you some compensation abroad.

When traveling outside the United States, Medicare does not cover you, except in very limited or rare situations.

Daniel Roberts

Co-founder of Boomer Benefits

These insurances are generally state-wide standardized, but at different costs, they cover some of the cost sharing associated with basic Medicare such as out-of-pocket and joint insurance. Elizabeth Gabino, founder of Lewin & Gavino and an independent broker and sole agent for the Medicare program, said some of them have limited coverage for international travel.

“Members pay a $ 250 deduction, 20% of the treatment they receive, and up to $ 50,000 in their lifetime,” said Gavino.

Please note that according to the Centers for Medicare & Medicaid Services, this coverage applies to medically required emergency medical care and may have other restrictions.

Advantage plan

For beneficiaries who receive Medicare benefits (Parts A, B, usually D) through an advantage plan, it is worth checking to see if emergency compensation is available abroad. And even if you don’t leave the US soil, you should see what your plan covers.

Advantage plans are needed to cover emergency medical care anywhere in the United States, but you may be crazy about routine medical care outside their service area.

“With traditional HMO plans, when traveling outside the network, there is only an emergency response,” Roberts said. “PPO provides both emergency and non-emergency out-of-network coverage. [but] You will pay more from these network services. “

According to Roberts, there are also hybrid plans that can limit treatment outside the network under certain circumstances.

If you are out of the service area for a period of time (usually 6 months), you may be unregistered from your advantage plan. In such situations, you can switch to basic Medicare.

Gabino said some beneficiaries purchase travel health insurance for overseas travel, regardless of the specific coverage.

Retirees ready to go out should check Medicare coverage

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