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How Medicare Advantage can deliver health care when you’re on the road

Color portrait of Mark Pabst By Mark Pabst

Is travel an essential part of your retirement experience? If so, then you’ll need to do some planning. That includes making sure you have the right Medicare coverage. Luckily, there are many different Medicare plans to consider that may offer you coverage during your travels.

So, whether you’re preparing for a month in France, a winter in Florida or a weekend away from home, you can get the peace of mind that comes from packing the right health coverage for your journey.    

Exploring the United States

Medicare can provide excellent health coverage during your travels in the United States. Original Medicare, which is what many people call the combination of Medicare Parts A and B, is widely accepted by health care providers across the country. You just need to confirm that the provider you see accepts Medicare before you receive your care. 

“Medicare Advantage plans can be an excellent option for travelers who want coverage while on the road. But members should check with their plans regarding the level of coverage they have while away from home.”

Medicare Advantage (MA) plans can also be a good way to get health coverage while on a trip. MA differs from Original Medicare in a few important ways. MA plans are sold by private companies, and many offer benefits not included in Original Medicare, like dental, vision and hearing coverage. MA plans also include a network of providers. In Health Maintenance Organization (HMO) plans you generally need to use one of the health care providers in network to get coverage for a service. Members of Preferred Provider Organization (PPO) plans have coverage when they see providers who are out of their plan’s network, although they usually pay more.

Fortunately, there are MA plans that have networks that include doctors in many different parts of the country. That means if you pick the right MA plan, you’ll be able to find a care provider in your plan’s network in many of the places you travel in the U.S. In fact, we offer a number of MA plans designed to provide you with coverage while traveling. 

However, to be completely certain of the level of coverage you will receive while on the road, it’s important to check with your plan regarding the coverage you have before beginning your travels. 

A home away from home

Does travel means spending an extended amount of time in your second home or with family or in a long-term vacation rental? During these longer stays, you may need to take an even closer look at your MA coverage. 

Medicare Advantage is a national program, but MA plans are offered to individuals based on their ZIP codes. That means you are only eligible to remain in a particular MA plan if you are in a ZIP code where that plan is offered. In fact, the Centers for Medicare & Medicaid Services (CMS) require that members be disenrolled from their MA plan if they live outside their plan’s service area for more than six months. 

However, there are MA plans designed to allow you to stay on your plan even if you spend significant time outside the plan’s service area. Aetna offers MA plans with a visitor travel program. This program allows you to remain in your plan for an extra six months on top of what CMS rules allow when you live outside your plan’s service area. 

Regardless of which MA plan you choose, it’s important to remember that you still need to follow your plan’s rules while enjoying an extended stay away from home. For example, if your plan requires you to have your PCP refer you to a specialist for care, you need to make sure you select a new PCP near your second residence. Otherwise, you could have difficulty getting referred to a specialist when you need one.  

Foreign travel

Are you planning travel outside the United States? You should be aware that Medicare coverage can be very different when abroad. For instance, Original Medicare generally doesn’t cover any type of health care while you’re traveling outside the United States, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands. There are some exceptions, like a few specialized cases where Medicare may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S. But for the most part, you have no coverage for any health care you receive abroad with Original Medicare, including emergency care. 

There are Medicare Advantage plans that offer forms of coverage for emergency care and urgent care services during foreign travel. However, coverage and rules vary, so it is important to check with the plan administrator or insurance agent to determine the details of your foreign coverage before you travel. 

Pack your prescriptions

Getting your prescriptions while on the road is a key part of maintaining your health. That’s why certain MA plans come with a national pharmacy network that allows you to pick up your prescription medications across the United States. 

Having a preferred pharmacy network with nationwide reach can save you both time and money when it comes to getting your prescriptions while away from home. 

Hit the road

Are you dreaming of traveling once you retire? A big part of turning that dream into a reality is choosing the plan that best meets your health needs while you are on the road. An MA plan can be the right choice for coverage, giving you extra benefits and access to travel-related perks. However, you need to do your homework to pick the plan that best fits your needs. After all, the right plan is one of the most important items you can take with you on your adventures. 

 Aetna Medicare is a HMO, PPO plan with a Medicare contract.  Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Out-of-network/non-contracted providers are under no obligation to treat Aetna members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. The formulary, provider and/or pharmacy network may change at any time. You will receive notice when necessary. Plan features and availability may vary by service area.

About the author

Mark Pabst has worked as a writer and researcher in the health care field for almost two decades. When not writing about health he tries to stay healthy through activities like hiking, climbing and paddling in the far flung corners of his native state of California. However, despite his best efforts he still has a few unhealthy habits he can’t shake, most notably a weakness for jelly donuts.