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If I travel between two states throughout the year (Maine and Florida), is there a Medicare Advantage plan that can provide coverage in both states without additional cost?


Yes, on a limited basis.  Usually a Medicare Advantage HMO or PPO plan has an established healthcare network and, if you seek a healthcare provider as you travel outside of the plan's network, you will pay more for coverage (except in emergencies).

However, some Medicare Advantage plans do provide extended coverage for people who split their time between two different states.

Example:  The UnitedHealthcare "Passport® travel program"

As a first example, some Medicare Advantage plans provided by UnitedHealthcare offer the UnitedHealth "Passport®" travel program that provided in-network cost-sharing benefits in two different states (or specific counties within different states) to meet the needs of the "Snowbird" or "Sunbird" population.

These Medicare Advantage plans have established networks in different states and plan members can receive in-network coverage or use healthcare providers in either network for the same in-network cost and the plan's same maximum out-of-pocket (MOOP) limits continue to apply.

In this example, the Medicare plan member is required to notify the Medicare plan carrier that the member is traveling outside of the service area and the "Passport" feature is then activated.   The member can continue to use the Passport feature for up to 9-months and must notify the plan carrier when the member returns to the original service area.  (Please note, if a member stays outside of their original service area over 9 months when the Passport feature is activated, the member can be disenrolled from the Medicare Advantage plan.)

To learn more about a Medicare Advantage plan's travel feature, you can call the plan or review the Medicare Advantage plan's Evidence of Coverage document for information under a section heading such as "Getting care using our plan’s optional visitor/traveler benefit".

Please see more information from UnitedHealthcare (the URLs below have spaces inserted to wrap the text, please remove any spaces after copying the URLs):

https://www.uhcprovider.com/ content/dam/provider/docs/public/ health-plans/Passport-FAQs.pdf
https://www.uhcmedicaresolutions.com/ alphadog/UHFL21HM4773734_000
https://www.uhcprovider.com/content/dam/provider/docs/public/health-plans /medicare/2021/2021-uhc-passport-faqs-ma-individual.pdf

Example:  The UPMC for Life HMO "Travel Concierge Program"

For residents of some counties in Ohio and Pennsylvania, the University of Pittsburgh Medical Center (UPMC), through their UPMC Health Plan, offers UPMC for Life Medicare Advantage HMOs, that include the plan's "Travel Concierge Program" allowing HMO plan members to pay in-network cost-sharing when traveling to some states in the sunny-south.

The UPMC website notes that the HMO plan member will: "[p]ay the same cost-sharing as you would at home when seeing a [healthcare] provider in Arizona, Florida, Georgia, North Carolina, South Carolina, and Tennessee."

Like the UnitedHealthcare travel feature, the UPMC for Life plan documentation instructs the plan member who wishes to use the Travel Concierge Program to "[c]all the Health Care Concierge team before you see your provider so that we can help to coordinate your care."

Please see: (https://www.upmchealthplan.com /medicare/learn/plans/ learn-about-emergency-travel-assistance.aspx)

No multi-state travel program available in your area?
Traveling outside of your "home" network and changes in coverage or cost.

If you do not have any Medicare Advantage plans in your area that provide a "Passport" or "Concierge" -like feature, you still are able to travel with your Medicare Advantage plan.

As noted, all Medicare Advantage plan will provide you with emergency coverage outside of your plan’s service area or as you travel across the country.  In addition, Medicare Advantage plans will provide other forms of coverage outside of your local service area. 

However, depending on your chosen Medicare Advantage plan, you may pay much more for out-of-network coverage and, perhaps more importantly, out-of-network coverage may not count toward meeting your annual Maximum Out-of-Pocket limit (or MOOP) - meaning that your out-of-network medical costs are not "capped" and could be very high.

As background, Medicare Advantage plans come in several forms and the availability of plans will depend on the ZIP code or county where you have your permanent address (the address used on federal income tax filing).



Here is a brief overview of the type of Medicare Advantage plans that might be in your area:

(1) Health Maintenance Organization (HMO) – This is usually the Medicare Advantage plan with the lowest premiums as they have the most restrictive network of healthcare providers. In other words, if you travel, you may pay the highest costs when seeking healthcare services outside of the plan's established provider network.  As mentioned above, the "passport" option may be included in an HMO.

(2) Health Maintenance Organization with a Point of Service option (HMO-POS) - An HMO-POS is a Medicare Advantage Plan that is a Health Maintenance Organization with a more flexible network allowing plan Members to seek care outside of the traditional HMO network under certain situations or for certain treatment - all for an additional cost or co-payment rate. Again, your out-of-network spending may not count toward your annual MOOP limit.

(3) Preferred Provider Organization (PPO) - This type of Medicare Advantage plan has a more flexible provider network as compared to a HMO Medicare Advantage plan. With a Medicare Advantage PPO you can generally use doctors, hospitals, and providers outside of the network without a referral - but for an additional cost.  As mentioned above, the "passport" option may be included in a regional PPO (RPPO).

(4)  Medicare Advantage Private Fee for Service (PFFS) plan - This type of Medicare Advantage plan has the most flexible options as it is designed to be accepted by any healthcare provider that accepts both Medicare and the terms and conditions of the specific Medicare Advantage PFFS plan. So in theory, there is no established network of healthcare providers and instead, you will need to ensure that your chosen providers accept the plan – no matter where you are located (and if there is an established network that accepts the PFFS plan, you can still travel outside the network).

But, the challenge with a PFFS plan can be that your doctors or healthcare provider may or may not accept the plan's terms and conditions - and each subsequent visit to a healthcare provider required that you re-affirm that the PFFS plan is still accepted.  PFFS plans are not currently as popular as they were in past years due to changes in Medicare Advantage plan design requirements and many older PFFS plans were consolidated into more conventional Medicare Advantage plans with established networks.  Today, only a limited number of Medicare Advantage PFFS plans still exist. You can click here to read about the decline of the Medicare Advantage PFFS plan.

(5)  Medicare Savings Account (MSA) - Unlike other Medicare Advantage plans, Medical Savings Account plans are made up of a high-deductible health plan for your Medicare Part A and Medicare Part B coverage and a medical savings account funded by an annual tax-free deposit. So, you can use the money in your savings account to pay for Medicare Part A and Medicare Part B expenses, and when your MSA deductible is met, the plan pays for any further Medicare-covered services.  You might find that the MSA (like a PFFS plan) does not have an established network of healthcare providers and you can visit any provider (doctor or hospital) that accepts the terms of the MSA (but, emergency care cannot be denied).  You may also find that some MSAs have a healthcare network and you will pay more for coverage is you seek healthcare out-of-network.

To see Medicare Advantage plans that are available in your Service Area, you can use our Medicare Advantage plan finder (MA-Finder.com). If you click on the Medicare plan name, you can see an overview of the plan's coverage.

Q1Medicare Medicare Advantage Plan Finder showing MOOP
For more information, please contact the Medicare Advantage plan (we provide the telephone number for most Medicare Advantage plans within the plan's Coverage Details) or telephone a Medicare representative at 1-800-633-4227.





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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.