If you are enrolled in Medicare Part A and Medicare Part B, also known as Original Medicare, then you are covered anywhere in the U.S. The only stipulation is that you are required to use a doctor and/or hospital that accepts Medicare.
Medicare defines the U.S. as:
- All 50 states
- American Samoa
- Guam
- Puerto Rico
- U.S. Virgin Islands
- Northern Mariana Islands
Original Medicare Coverage In Another State
Original Medicare consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). As long as the physician or hospital accepts Medicare insurance, you can seek treatment, regardless of your location within the United States. If you travel to another state, your Original Medicare plan follows you. This also applies if you move to another state.
If you enroll in a Medigap plan alongside your Original Medicare coverage, you’ll also receive coverage throughout the U.S. Some Medigap plans will even provide coverage outside of the U.S., but only up to the plan’s limits.
Medicare Advantage Coverage In Another State
Medicare Advantage, or Medicare Part C, is offered by private insurance companies approved through Medicare. These plans consist of Medicare Part A and Part B and extra options, such as vision, dental, and/or prescription coverage. Out-of-state coverage with Medicare Advantage is based on the plan you are enrolled in. If you decide to travel within the United States, you can seek emergency treatment from out-of-network providers. If you need non-emergency treatment, it is likely that treatment will not be covered, and you will be responsible for payment.
Medicare Advantage plans are required to cover emergency and urgent care costs, regardless of where you travel within the United States. If you travel outside of your Medicare Advantage plan’s coverage area for six months or more, some plans will drop your coverage. You will be eligible for a Special Enrollment Period to re-enroll. If you do not enroll at this time, you will automatically be enrolled in Original Medicare.
Medicare Part D Coverage In Another State
Some Medicare Part D plans offer out-of-state or national coverage, meaning you can fill your prescriptions at any in-network retail pharmacy within the United States. There is a chance that the cost of your drug will change from state to state. These costs can fluctuate due to coinsurance or fixed copays and whether your copays change between standard and preferred network pharmacies.
Give Us A Call Today
The team with Game Changing Benefits is here to help you learn all about your Medicare coverage options. If you travel frequently and want to learn more about the coverage you may receive, reach out to us today.