If you spend any time out of state, the safest option is to enroll in a Medicare Supplement plan. These plans have no network restrictions.
Fortunately, I can help you with either a Supplement or an Advantage plan.
Unfortunately Supplement plans cost much more.
So, I’d like to help you avoid or delay paying this extra money if I can. (Sometimes we can’t. In some cases, a supplement is the only logical option. Or you may tell me the additional safety is more important to you than the additional premium. That’s OK too.)
Some of the best Medicare advantage plans in CT have $0 monthly premiums. Most Connecticut Medicare Advantage include drug coverage. The monthly premiums for the popular Connecticut Medicare Supplement and prescription drug plan combinations start at $200 per month.
If You Are Unlikely to Need Medical Care When in Another State
Any Medicare Advantage Plan or Medicare Supplement plan is likely to cover you well. If you are visiting another state for a few weeks, my assumption is you would only seek medical care if you have a medical emergency or have an urgent need.
Either type of plan will cover you well in these scenarios. They will cover you for any medical emergency (or urgent need) with the same out of pocket costs, whether you’re in network or out.
This is true for all Medicare Advantage policies. This is true for all types. HMOs, PPOs and POS plans all have similar language in their contracts regarding emergent and urgent care.
This is true for all Medicare Supplement policies also. These plans have no network restrictions.
But sometimes you can still have a problem with a Medicare Advantage plan. Any plan will cover your medical emergency and when you have an urgent medical need.
Once you’re stable, you will have to deal with out-of-network costs for any follow up treatment.
So, you may have to cut your vacation short and come back to Connecticut to get follow up treatment. It could be worse, you could be too sick to travel, but still considered medically stable.
If You Are Likely to Need Routine Medical Care When in Another State
Do you expect to see a doctor or other provider when out of state for something that is neither an emergency nor an urgent need? If so, most Medicare Advantage plans will be a poor fit for you.
(There is one exception.)
You won’t get coverage for routine visits when out of network with any HMO.
A PPO or POS plan will cover you when out of network. Sort of. Your copays and other out-of-pocket expenses will be much higher when you seek care out of network. In most cases, the deductible that applies out-of-network will be so high that you will get no coverage for routine visits.
Most agents would say that a Medicare Supplement is the only good option in this situation. And most of the time they would be right.
Here Is the Exception
One of the insurance companies has multiple networks for their Medicare Advantage Plans. These are HMO. HMOs are generally the most restrictive plans. But these plans allow you to change from one of their networks to another.
You only have to give them a day’s notice. (Which is so cool!)
One of their networks is in Connecticut. They have networks in most other states as well. So, although technically you can’t get coverage when out of network for routine visits, you can change to the network the serves your second home. (If they have one in that county and state.)
If the place you are traveling to has doctors in their network, you can have the best of both worlds. You can have the low premium of a network-based plan. You can also have and coverage for routine care in the other state.
You just have to do two things to make this work. The day before you get on the plane or behind the wheel, call your company and tell them you want to switch to the network in the other state. You do this before you leave Connecticut and when you’re on your way back.
If You are Traveling Outside the US
Neither Medicare Part A nor Part B will cover you while out of the country with rare exceptions.
(One exception is if you get hurt in Canada while traveling between the lower 48 and Alaska, but this coverage is temporary. You can’t be in Canada very long. You have to be in transit to or from Alaska.)
Medicare Supplement Plans that include “Foreign Travel Emergency” are
- Medigap Plan C
- Medigap Plan D
- Medigap Plan F
- Medigap Plan G
- Medigap Plan M
- Medigap Plan N
Many Medicare Advantage plans cover emergency care outside the US also.
Travel insurance policies are also available. Let me know if you want info about these plans
Still wondering “which Medicare Supplement plan is best for me?” Complete our questionnaire and I will email your recommendations in the next 24 hours (or so).