Yes, even though Medicare Advantage plans (
MA or MAPD) usually have a service area for a specific county or ZIP code - and may not be as "portable" as a
Medicare Supplement - you can travel with your Medicare Advantage plan.
However, depending on your chosen Medicare Advantage plan, you may
pay more for out-of-network healthcare - and your out-of-network healthcare costs may not impact your out-of-pocket spending limit (
MOOP) or you may have a higher out-of-network MOOP limit.
In fact, the type of Medicare Advantage plan that you join may determine how much you will pay for healthcare cost as you travel acoss the United States.
- If you join a Health Maintenance Organization
(HMO)
Medicare Advantage plan, you probably will pay the lowest monthly premiums, but may
find that HMOs have the most restrictive healthcare network - meaning that, if you travel, you may pay the highest costs when seeking healthcare
services outside of the plan's established provider network.
Please read your plan's coverage details as your out-of-network costs may not count toward your Medicare Advantage plan's annual Maximum Out-of-Pocket Limit (MOOP). Look for language in your plan's Summary of Benefits or Evidence of Coverage documents that may state:
“Like all Medicare health plans, our [Medicare Advantage] plan protects you by having yearly limits on your out-of-pocket costs for medical [Medicare Part B] and hospital care. Your yearly limit(s) in this plan: $6,700 for services you receive from in-network providers.” [emphasis added]
- If
you join a Medicare Advantage HMO-POS (HMO point of service) plan, you may
find that the plan provides the affordability of an HMO and the flexibility of
a Medicare Advantage PPO or Medicare Advantage PFFS plan (explained
below).
With an HMO-POS, you may be allowed to go outside of the plan's healthcare
network, but you may pay more for out-of-network (or POS) coverage and your
out-of-pocket costs may not count toward your Medicare Advantage plan's annual
Maximum Out-of-Pocket Limit (or MOOP) or out-of-network costs may count toward a higher MOOP.
Again when you review your plan's documentation, you may read something such as this example with an in-network MOOP that is less than the combined in-network and out-of-network MOOP:
"Because you are enrolled in a Medicare Advantage Plan, there is a limit to how much you have to pay out-of-pocket each year for in-network medical services that are covered by our plan (see the Medical Benefits Chart in Section xx, below). This limit is called the maximum out-of-pocket amount for medical services.
As a member of our plan, the most you will have to pay out-of-pocket for in-network covered services in 20xx is $6,700. The amounts you pay for copayments, and coinsurance for in-network covered services count toward this maximum out-of-pocket amount. . . . If you reach the maximum out-of-pocket amount of $6,700 for in-network services, you will not have to pay any out-of-pocket costs for the rest of the year for in-network covered services. . . .
Your plan also has a combined maximum out-of-pocket amount of $10,000. This is the most you pay during the calendar year for covered plan services received from both in-network and out-of-network providers. . . . If you have paid $10,000 for covered services, you will have 100% coverage and will not have any out-of-pocket costs for the rest of the year for covered services. . . .." [emphasis added]
Emergency Care is covered out of state
Please remember, all Medicare Advantage plans provide coverage for
emergency care - even if you are outside of your plan's Service Area.
For more information
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. For more information, please contact the Medicare
Advantage plan or telephone a Medicare representative at 1-800-633-4227.