Planes, Trains and Automobiles: Am I Still Legally Covered by Medicare?

November 1, 2016
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How to Travel in the U.S. After Retirement with Medicare Coverage

Aging Long Island residents have endured the stresses of a long career, possibly having had a family and raised children, and have carefully planned for their retirement; at long last, there comes a time to reap the benefits of their lifelong successes and take well-earned vacations. It’s not often that Long Islanders get the chance to see the Grand Canyon, after all. Many New Yorkers choose to travel across or around the United States, as it is simpler to plan a domestic trip than a foreign one.

Yet, there is a residual fear that, in the event of an emergency, Medicare beneficiaries won’t receive the same medical care as they do at home. So, does Medicare cover its insured during domestic travel?

The short answer is yes: a senior citizen with Medicare is able to travel anywhere in the United States (including its territories: Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands and the Northern Mariana Islands) and still enjoy the comfort and convenience of the federal program, if his or her selected health care provider accepts Medicare – and not all local doctors will.

Some providers will not accept Medicare as a full payment, and require an additional out-of-pocket expense, which could be up to 15 percent higher than Medicare’s approved amount. Other providers will not accept it at all, and you may be putting yourself at risk of paying the entire health care cost upfront.

Medicare and Medicare Advantage generally cover emergency and urgent care and will only require a small surcharge of $65 or less for short-term care from an out-of-network provider. Elderly travelers are encouraged to look over their health care plans; personal Medicare plans will detail the applicable service area and rules pertaining to care and care payment when one travels out of that geographic area.

Depending on the plan, a trip exceeding six months may result in automatic disenrollment, which re-enrolls the beneficiary in Original Medicare if another plan is not chosen within the special enrollment period. Although some plans include travel benefits that would negate this risk, it is best to read over your paperwork to be sure before you leave.

Long Island-based elder care coordinators can offer advice and recommendations to our clients for obtaining adequate health care. If you have questions or if you are unsure of the terms of your insurance, contact the elder law attorneys at Tully Law, P.C.

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