The State of Medicare: How Portable Is Your Coverage?

For Medicare beneficiaries who are in the process of traveling or moving, it’s crucial to understand what Medicare does and does not cover. Medicare is a federal program, meaning it is administered by the national government. This ensures that those with Original Medicare (Part A and B) can use their insurance in all 50 US states. That means you can receive hospital and medical insurance nationwide as long as a specific provider accepts Medicare.

Medicare Advantage Plans
However, while there is Medicare Part A and Part B portability, Medicare Advantage plans may limit you to emergency and urgent care visits only when you’re traveling out of your service area.. Many Medicare Advantage plans allow you to access coverage throughout the country by using their national PPO network, others may limit you to an HMO network.. It’s important to talk to a licensed broker who can help you navigate which Medicare Advantage plans allow you to use benefits nationwide.

Plans through the National Pharmacy Network allow you to access Part D across the US. Some plans also allow access to services for specific amounts of time (e.g., six months out of the year). This helps to support seniors who are “snowbirds,” those who spend half the year in different places.

Supplemental Insurance (Medigap)
Supplemental Insurance, or Medigap, is an additional plan designed to support those with Original Medicare only. It fills in the gaps, paying specifically for deductibles, copayments, coinsurance, and more. As long as you have Medicare Part A and B, you can use Medigap no matter where you are in the United States.

Medicare coverage can differ from state to state. While Original Medicare ensures that you can receive benefits no matter where you are, Medicare Advantage is a bit more complicated. Medicare Advantage Plans have a wide range of networks, health professionals, and facilities. It is important to understand the exact limitations of your particular plan.

By exploring your Medicare Advantage Plan’s website, you can explore a provider directory and make sure to find benefits that meet your needs. In some plans, you are expected to choose a primary care doctor who keeps you connected with a particular hospital or facility as well. This may limit your ability to use your coverage in other states, except for emergency and urgent care needs.

In addition, your provider can also leave your plan’s network at any time, which may cause you to change facilities or providers as well.

Medigap Policy and Network Restrictions
Medigap Supplemental plans may also have their own policies and network restrictions, however, this is uncommon. Those with Medicare Advantage cannot use a supplemental plan. However, many supplemental plans can also support Americans who require emergency services in other countries, making them a helpful tool for those who travel often.

Medicare Enrollment and Residency Requirements
Most American citizens 65 and older are eligible to apply for Original Medicare. However, immigrants must comply with the 5-year residency rule. The Medicare 5-Year Residency Rule means that green card holders must live in the United States for 5 straight years to enroll in Medicare.

When traveling or relocating, it’s important to understand how to best utilize Medicare benefits. Original Medicare supports beneficiaries who need medical or hospital insurance in all 50 states. However, individuals with Medicare Part C and D have certain restrictions regarding prescriptions and routine care, depending on the plan.

No matter what plan you have, it’s important to properly prepare and research. Here are some ways to plan ahead when moving or traveling out of state to ensure you are properly cared for.

— Bring extra prescription drug medication. Even with Medicare Part D, it may not always be easy to find pharmacies that will support your plan.
— Always keep your Medicare card and doctor’s information handy. You want to be prepared in case of an accident.
— If traveling abroad, consider any vaccines you may need. In other countries, you can become exposed to new germs and bacteria. Use your Medicare at home to get the vaccine support that you need.
— Take time to research the details of your Medicare plan. Fully understand where you can get the medical support you need if something occurs in another state or country.

For more information and support, seek personalized guidance from Medicare counselors and healthcare providers. Medicare benefits can be confusing. Talk to an expert today. 

Find Healthcare Providers: Compare Care Near You | Medicare

Medicare eligibility, enrollment, and coverage options | medicareresources.org

Medicare is an excellent health insurance resource for adults 65 and older, individuals with disabilities, and those with End-Stage Renal Disease. Depending on your plan, it can provide a combination of hospital insurance, medical insurance, prescription drug coverage, and more.

Medicare Part A and B (original Medicare) provide medical and hospital insurance at an affordable rate. It also supports supplemental insurance like Medigap. Medicare Advantage Plans often have the benefits of original Medicare with additional benefits, while Part D helps with prescription drugs.

In most cases, Original Medicare can be used in every state nationwide, while Medicare Advantage has certain restrictions. It’s important to understand your particular plan before receiving health care in a new state or country. If you are confused or need any support, Medicare experts are available to help every step of the way.