Travel Out Of State?

[grant espelund]

me and the wife are planning to sign up for a low-cost ($0) premium medicare advantage plan (Familycare of Oregon). But our ins. advisor told us there is one drawback: You won't be covered for out-of-state travel, except for emergency services. We had planned a trip to California next year and are concerned about being covered. Does anyone know of a plan you can buy, to supplement the supplement, for limited short-term OOS travel?

 

[MBSC]

This is one of the drawbacks of a MA HMO. As your advisor stated, emergencies (heart attack, stroke, car accident, etc.) are covered out-of-network.

Most who travel frequently either choose a MA PPO or stay on Original Medicare with a Medigap. The number of providers who accept Original Medicare is larger.

The rules are somewhat different for Medicare Advantage plans, which typically have more limited provider networks compared to traditional Medicare and which may not provide any coverage out-of-network. For emergency services, Medicare Advantage plans must apply in-network cost sharing rates even for out-of-network providers. Balance billing limits similar to those under traditional Medicare also apply. For non-emergency services, enrollees in PPO plans in surprise medical bill situations would be liable for out-of-network cost sharing, but Medicare balance billing rules would still apply, while enrollees in HMO plans might not have any coverage for non-emergency out-of-network services.

http://kff.org/private-insurance/issue-brief/surprise-medical-bills/

 

[JC]

If your $0 premium plan is an HMO you are only typically covered out of network for Emergency or Urgently needed services at an urgent care facility. However there are a few Insurance companies that offer Travel benefits to cover you in network when you travel. You should contact your insurance company to see if this is an option on your policy