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If you have Orginal Medicare, you have coverage anywhere in the U.S. and its territories. This includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Most doctors and hospitals take Original Medicare.
If you have a Medicare Advantage Plan, your plan may or may not cover care outside of its service area. Some plans may cover providers that are out-of-network or out of your service area, but with higher cost-sharing (copayments, coinsurances). Your plan may also impose other rules or restrictions (like prior authorization). Contact your plan to see what rules and costs apply when you travel within the U.S.
Note: Medicare Advantage Plans are required to cover emergency and urgent care anywhere in the U.S. without imposing additional costs or coverage rules.
If you travel outside your Medicare Advantage Plan’s service area continuously for more than six months, you will automatically be disenrolled from most plans. You will have a Special Enrollment Period to join a different Medicare Advantage Plan. If you do not choose a new plan, you will automatically be enrolled in Original Medicare.
Some Medicare Advantage Plans provide special benefits that allow you to stay in the plan if you travel continuously in the U.S. or its territories for up to 12 months. Check the rules closely if your plan offers a visitor or travel benefit. Only certain areas may be included, certain care may not be covered, and/or you may pay more if you see providers that are outside the plan’s network.
Source: Medicare Interactive, powered by the Medicare Rights Center