If you’re planning a long-term vacation, traveling south for the winter, or have recently purchased a second home, you may be wondering if your Medical Supplement plan works in another state. The short answer is: yes. Medicare Supplement plans, also called Medigap, offer the same coverage at home and away.
Like Original Medicare (Medicare Parts A and B), Medigap plans are accepted across the U.S. Read on to learn more about using Medicare Supplement out of state, the steps you can take to ensure coverage, and if it covers international travel.
How your Medicare Supplement out-of-state coverage works
A Medigap plan is designed to travel with you, and understanding how it works away from your home state is crucial for uninterrupted access to care and predictable costs with no surprises. Below, you’ll find answers to common questions about using your Medigap plans on your travels.
Does Medigap work anywhere in the U.S.?
Yes, Medigap and Medicare work across all 50 states and Washington, D.C. It also offers full coverage across U.S. territories, including Puerto Rico, the U.S. Virgin Islands, American Samoa, the Northern Mariana Islands, and Guam. A Medigap plan covers up to 20% of costs not covered by Original Medicare, including copays, co-insurance, and deductibles.
If a doctor accepts Medicare, do they accept Medigap?
Yes, Medigap is accepted by any doctor or hospital that accepts Medicare — there are no network restrictions in your home state or while traveling throughout the country. To ensure coverage and avoid surprise bills, it’s critical to contact the doctor or facility before your visit and specifically ask if they accept Medicare. If you only ask about carrier coverage, they may confuse it with an group insurance plan or a Medicare Advantage plan, which may not offer the same coverage or have limitations that don’t apply to Medigap plans.
Using Medigap in another state
Once you’ve confirmed that the out-of-state healthcare provider or hospital accepts Medicare, you’re ready to use your Medigap coverage. There are no special steps you need to take; just schedule and receive care as usual.
What isn’t covered by Medigap
Be mindful of the healthcare costs Medigap doesn’t cover, whether at home or away. Standard Medigap plans do not cover costs associated with:
- Prescription drug coverage (Medicare Part D, which covers medications, is a separate plan)
- Dental care
- Vision care or glasses
- Hearing aids
- Long-term care, such as in a skilled nursing facility
- Private-duty nursing services
Does a Medigap plan include international coverage?
In general, you’re not covered under Medicare or Medigap outside the U.S., though there are a few exceptions. Medigap Plans C, D, F, G, M, and N cover up to 80% of foreign emergency care costs, though the exact amount covered depends on your plan’s limits.
Original Medicare offers foreign healthcare coverage for these specific scenarios:
- Emergency health services in Canada, if you’re traveling from the U.S. mainland to Alaska, and the nearest hospital is in Canada.
- Medical care aboard a cruise ship when it’s in a U.S. port or within territorial waters.
- Emergency and non-emergency inpatient care in a foreign hospital if it’s closer than the nearest U.S. hospital.
Internationally, Medicare and Medical Supplement plans do not cover:
- Prescription drugs purchased internationally, even if you have a drug plan (Part D)
- Routine doctor’s appointments and care
It’s important to note that foreign healthcare providers aren’t required to file medical claims to Medicare on your behalf, so be prepared to submit an itemized bill if you receive international care.
Since Medicare and Medigap offer very limited coverage outside the U.S., you may want to consider travel medical insurance for international trips, especially if you have any chronic health or autoimmune conditions. Consult with your insurance provider before traveling to learn about specific international benefits your plan may offer and whether you need additional coverage to meet your health needs.
Medigap vs. Medicare Advantage: Choosing coverage that fits your travel plans
A Medigap plan protects you from large out-of-pocket health costs, at home and across the country. Depending on your plan, it may even cover some costs incurred abroad — all without network restrictions or time limitations. That’s something Medicare Advantage plans can’t offer.
Some Medicare Advantage plans limit routine health coverage to a home service area, while others may require prior authorizations or finding an out-of-state primary care provider (PCP) for referrals within a particular network. Many Medicare Advantage plans also limit out-of-state coverage to six continuous months, meaning you could lose your medical coverage if your stay exceeds that.
The difference is clear: a Medical Supplement plan offers more travel freedoms without potential limitations. Have peace of mind on your next trip by getting in touch with our licensed insurance agents to learn more about your healthcare options.
Disclaimer:
The information provided in this blog post is intended for general informational purposes only and does not constitute medical advice. It is not a substitute for professional medical consultation or treatment. Always consult with a qualified healthcare provider for any questions you may have regarding a medical condition.
United Medicare Advisors does not endorse or recommend any specific products, treatments, or procedures mentioned in this article. Reliance on any information provided in this blog post is solely at your own risk. We encourage you to discuss any health concerns or questions with your doctor before making any decisions about your health, wellness, or treatment.
