MEDICARE MEMBERS: PROTECT YOURSELF AGAINST MEDICARE FRAUD AND IDENTIFY THEFT! THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF INSPECTOR GENERAL IS ALERTING THE PUBLIC ABOUT A FRAUD SCHEME INVOLVING GENETIC TESTING. LEARN HOW TO PROTECT YOURSELF.
Medicare Advantage Coverage When Traveling
Traveling to new places, meeting new people and experiencing new adventures can be exciting for every age. While travel comes with great rewards, it could also become less enjoyable when faced with health challenges.
Before your next trip out of town, get to know what your plan covers when you are away from home.
Traveling Outside of the United States
In most situations, Medicare won’t pay for healthcare or supplies you get outside the United States or its territories. However, your Medicare Advantage plan includes coverage for worldwide emergency or urgent care when traveling outside of the United States.
- Services classified as emergency, urgently needed, or post stabilization care had they been provided in the United States.
- Ambulance transportation to the emergency room when other types of transportation could endanger your health.
What’s Not Covered
- Part D prescription drugs obtained at a retail pharmacy outside of the United States.
- Foreign taxes and fees such as currency conversion or transaction fee.
Traveling Within the United States
You may be able to get care from out-of-network providers for emergency or urgently needed services. In addition, your plan will cover dialysis services for End-Stage Renal Disease (ESRD) received at a Medicare-certified dialysis facility.
Review your Evidence of Coverage (EOC) or contact Member Services for more details.
Tips for Your Trip
In addition to packing your luggage, passport and other important items make sure you know what to do for healthcare services in the event of an emergency.
Before Your Trip
- Contact Member Services or review your EOC to understand what services would be covered or not covered in the case of needing emergent care.
- You will be required to pay a copay for worldwide emergency, urgent care, and transportation services. Copays may be waived in certain situations. Review your EOC for plan details.
- Purchasing travel insurance may also provide more coverage for emergency medical services.
During Your Trip
- Medical services received outside of the United States and its territories have an annual limit.
- You will have to pay out-of-pocket for healthcare services when traveling, however you can request reimbursement from your plan.
- Obtain copies of your medical records and proof of payment for the medical services you received. You’ll need to submit this information with your reimbursement request.
Acceptable Documents for Proof of Payment:
- Provider receipts indicating zero balance on claims
- Cruise ship cabin statements
- Canceled checks
- Bank account statements
- Copy of wire transfer
- Credit card statements
- Proof of down payment for medical services
- Avoid paying for medical services in cash (if possible) as it can make obtaining a valid proof of payment difficult
After Your Trip
- You have 365 days from the date of service to submit a reimbursement request for medical services.
- Complete a Member Reimbursement Claim form and send your request along with copies of your medical records and proof of payment for medical services to the address near the top of the form.
- It will take about 30 days to process your request once we’ve received all documentation.
If you have questions before and after your trip, please call Member Services. We’re here to help.
Material ID: Y0020_14316WEB_M_2020_ Accepted_08172020_C