Does Medicare Work Anywhere?

Does Medicare work anywhere I live or go? If I travel to another state, will my Medicare coverage still pay my bills? Can I see any doctor and Medicare will still pay?

Will Medicare work wherever you are? Will it be there for you when you need it most?married couple hospital bed

  • Never any networks, you can travel anywhere in the US and still have coverage
  • Medicare works with any hospital, doctor or lab in the United States
  • Medicare follows you when you move to a new city or state

Because Medicare supplement plans go hand in hand with original Medicare, you will never have a gap in coverage when you travel or relocate to a different city.

Paying too much for your Medigap plan? Use our online instant Medigap quote engine to find the best rates based on your age, gender and zip.

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There is nothing like original Medicare for peace of mind, especially when you move. Medicare can work anywhere.

What follows is a true story. Events actually happened. Only the names have been changed.

 

Does Medicare work anywhere in the US?

Fred and Ethel had been married for years. Like most couples, they had their spats but they always made up and deep down inside they truly loved each other.

Fred had a heart condition that required him to see a specialist several times a year. Ethyl was a nurse for many years before retiring due to health issues and she took good care of Fred. As they aged they realized they wanted to be closer to their daughter Lucy in Atlanta, so they made plans to sell their house and relocate.

Lucy loved her parents and so did her husband Ricky. Their children were grown and they agreed to invite Fred and Ethyl to move in with them.

And so it began.

 

Fred had a heart attack

Fred and Ethyl sold their home in Louisiana and moved to Georgia to live with Lucy and Ricky. The move went smoothly but not without incident.

Soon after moving Fred had a heart attack and was taken by ambulance to Northside Hospital. After being stabilized in the ER Fred was admitted to the coronary care unit where he could be monitored 24 hours. A few days later he was moved to a private room so his care could be continued until he was well enough to be discharged.

Will Medicare work anywhere?

Medicare covers emergency room, hospital ICU, doctors, scans, and inpatient lab work in full subject to a $1288 deductible (2016). For the next 60 days following admission Medicare will pay 100% of your medical bills.

Fred was ready for discharge but the doctors wanted him to spend a few days in a rehab facility before going home where he would need periodic home health care.

Medicare works anywhere. In the hospital, in rehab, at home.

 

But Fred and Ethyl didn’t have Medicare

Medicare can work anywhere, but Medicare Advantage is a different animal.

In order to save money they enrolled in a $0 premium Medicare Advantage HMO plan. What they saved in premiums they paid out in health care expenses between doctor trips and hospital visits while living in Louisiana. As Fred’s health declined their out of pocket costs grew to several thousand dollars each year.

married couple walking from storeMedicare HMO plans offer coverage for in network care and emergency care out of network. But you have no coverage for out of network treatment when it is not a medical emergency.

Lucy was helping her parents with the move so she called their insurance carrier to find out what needed to be done to continue coverage. She was told their current plan would be good for 60 days. Once they relocate to Georgia they will need to notify Social Security of their new address and secure new coverage.

But things didn’t go as smoothly as expected.

Fred’s emergency admission to the hospital was covered by his HMO even though the hospital was not in his network. But doctor visits by both Fred and Ethyl prior to his admission were not covered and they had to pay out of pocket.

Fred’s rehab and home health care would not be covered by his plan either since Atlanta providers were not included in his plan.

Their out of pocket expenses had already run more than $1,000 and they were going to become even higher unless they could secure new coverage.

Lucy called me three days before the end of the month, asking for my help in securing new Medicare coverage. Specifically, she wanted a Medicare supplement plan for her parents.

 

What she wanted was impossible

When Lucy called, her dad was still in the hospital and they had not yet notified Social Security of the change in address. The best we could hope for would be to have everything in place by the first of the month following.

In the meantime their non-covered medical expenses were mounting.

Even moving to another Medicare Advantage plan with Georgia networks is possible, but not within the time frame they needed.

Original Medicare has no networks. If Fred and Ethyl had original Medicare and a supplement plan their out of pocket exposure would have been minimal.

Their Medigap plan would also follow them from Louisiana to Georgia without a hitch. No need to change plans. The same coverage they had in Louisiana would continue in Georgia.

Does Medicare work anywhere? Absolutely. So will your Medicare Advantage plan. Just be prepared to pay more when you travel out of the Advantage plan service area, and changing coverage once you arrive may be a challenge.

When you want full coverage anywhere you go, nothing beats original Medicare and a Medicare supplement plan

original medicare supplement coverage

 

Popular searches that lead to this page.

Does Medicare cover me when I travel? Am I still covered by Medicare when I travel out of state? Can I go to any provider when I have a Medicare Advantage plan? How does Medicare Advantage HMO work?

 

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Welcome to Medicare – What’s Covered?

Welcome to Medicare. What’s covered, what isn’t?  In the exam room I notice a sign. “Lab work is not covered by Medicare“. You owe $289. Do not pass go. Do not collect $200.

Welcome to Medicare physical exam? Covered. Lab work? Not covered.  Really? You turned 65 and signed up for Medicare. What happens next?

Here is a short introduction to Medicare. What’s covered, what isn’t,  and what to expect

  • Medicare’s definition of preventive care has surprises
  • Lab work may not be covered
  • Medical necessity is the rule
  • Free exams aren’t always free

Whether you have original Medicare and a supplement or you enrolled in an Advantage plan, the underlying rules of what is covered and what isn’t are the same. The difference is in how you pay for it.

You might want to view our Medicare Exam video on YouTube

Turning 65 – Welcome to Medicare 2018 – What’s Covered?

dr kildareBy the time you reach 65 and enroll in Medicare, most people have a doctor (or doctors) they like and trust. They want to continue that relationship and are not interested in picking a doctor from a list provided by an insurance company.

Georgia Medicare Plans specialize in helping you keep your doctor(s) and finding a Medicare supplement plan that fits your needs and budget. We have rates and information on more than 230 different Medigap plans and will provide a FREE REPORT on all plans based on your age, gender and zip.

You can start your research by comparing rates and benefits for roughly 30 plans by getting an INSTANT GA Medigap quote.

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I understand your confusion. Most people want information so they can understand what lies ahead. They want the time to read, make notes and ask questions.

Most of the insurance agents you will talk to are not old enough to enroll in Medicare and have not experienced it first hand. Bob Vineyard turned 65 in September, 2015 and enrolled in Medicare. In spite of 40 years in the health insurance business and over 400 Medicare clients, I am still learning things every day about how Medicare works.

Ask me anything. Others talk, we listen.

 

Welcome to Medicare Surprises

When I turned 65 and signed up for Medicare, one of the first things I did was schedule my Welcome to Medicare physical.

Because I chose original Medicare and a supplement plan, I was able to keep my doctor. My group insurance plan required me to have an annual exam and wellness interview so there should not have been any surprises with my Welcome to Medicare exam.

That was the wrong assumption.

While waiting in the exam room I saw a notice on the bulletin board.

Lab work is not covered by Medicare

Seriously? What’s that all about?

Preventive screenings are covered by Medicare in the following situations

  • Abdominal aortic aneurysm scan – Men only, if you smoked 100 cigarettes in your lifetime
  • Bone density – Mostly women, if you are estrogen deficient or have osteoporosis
  • Lab tests – Only if considered medically necessary by Medicare

What is considered medically necessary?

Medicare defines medically necessary as tests or treatment needed to diagnose or treat an illness, injury, condition, disease or symptoms that meet accepted standards of care.

Preventive lab work may not be covered by Medicare.

 

Congratulations! You are healthy. Your test is not covered!

I take no medications. For the last few years my doctor has run routine lab work to make sure my body is doing what it is supposed to. As much as it galls me to say, my Obamacare plan covered routine tests like CBC, Lipid Panel, CMP, etc. at no charge to me.not covered

These tests were not free. The labs and technicians do not volunteer their time. The costs associated with the lab tests were absorbed by the health insurance carrier and baked into the premiums.

Not so with Medicare.

Those under age 65 pay nothing.

If you are 65 and older, there is no more free lunch.

When I asked about the sign on the wall. The one that said “Lab work is not covered by Medicare” her response took me aback.

Medicare generally doesn’t cover those tests if you are healthy. But if you were sick, they would pay for them.

Sign this ABN form. If Medicare denies the claim you will have to pay the cost of your lab work. You will owe $289.

So much for my “free” Welcome to Medicare exam.

 

Medicare physical exam.

Is it covered? Is it free? How much will I have to pay?

Original Medicare is quite good in most respects. No more doctor networks. Forget about balance billing (when you use Medicare providers that accept assignment).  Huge bills for health care are a thing of the past.

So exactly what is covered, and what isn’t? Check out this free Guide to Medicare Preventive Services. And yes, it really is free. Click to download.

 

More ways to save money.

Most of the retirees we talk to are paying too much for their Medicare supplement plan. Many are facing rate increases. One large Mutual company has increased rates 10 times since 2012!

Medigap plan F will be retired in 2020. Switch now if you can. Plan G is popular with over 90% of our clients. Some have not had a rate increase in two years.

Get a free GA Medigap quote.  FREE report listing rates for all plans based on your age, gender and zip code  sent by email once we confirm your information.

 

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You need to be informed. The more you know and understand the better it will be for your bank account.

 

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