Why might Original Medicare with a Part D plan be better than a Medicare Advantage plan for frequent travelers?
Answered by 25 licensed agents
Original Medicare combined with a Part D prescription drug plan offers flexibility, nationwide access, and consistent coverage, making it an excellent choice for frequent travelers. Unlike Medicare Advantage plans, which are often geographically limited and depend on specific provider networks, Original Medicare with Part D ensures you can access care and prescriptions anywhere in the United States without restrictions.
Medicare covers up to $50,000 lifetime. You pay for medical care abroad, and when you return, submit the claim to Medicare reimbursement for approved Medical services. For Medicare Advantage plans, coverage for emergency care is still up to a $50,000 Lifetime limit.
It really isn't since original Medicare only pays 80%, the member is responsible for 20% of everything which can become costly. and you have to PAY for Part D every month & pay for your medication. A Medicare Advantage Plan includes drug coverage with Tiers 1 & 2 usually $0 costs , depending g on the plan
Because you never have to worry about ANY network restrictions. You can use Medicare in all 50 states and US territories. So if you're a frequest traveler or have residences in multiple states, having straight Medicare and a supplement(Medi-Gap)makes getting care much easier.
Most drug plans have very large national retailers in their network. So getting prescriptions in other states is easy with a stand alone Part D drug plan or through a Medicare Advantage plan.
Original Medicare with a Part D is better than a Medicare Advantage plan for frequent travelers as doctors, specialists, and medical facilities that accept Medicare will accept Original Medicare. It is important to consider a Medicare Supplement Plan or Medigap Plan to address some of the other 20% of costs that original Medicare does not cover. If you travel outside your geographic area, chances are you are going to travel outside of your network which means that costs could be more expensive or may not be covered. If you travel outside of the network, you are mostly covered in the event of an emergency situation.
Part D Prescription Drug Plans offer a nationwide network. In many cases, there are more than one preferred pharmacy within the network for fulfilling prescription drugs, but many also will allow you to fulfill it at other pharmacies at the standard pharmacy rates which could mean higher copays or coinsurance.
The bottom line is if you travel frequently and may become ill on the trip, you have more flexibility and can see a doctor or specialist immediately without having to wait until you get back home to get back to your network. There are no network restrictions with original Medicare and Medicare Supplement or Medigap plans. You also do not need referrals.
This is not necessarily true. It depends on your unique situation. If you spend partial time at two different residences, it depends where those places are located. In this case, a Medicare supplement might be better. In some cases with advantage, you can have doctors in both places. When it comes to international travel there is limited coverage for emergencies worldwide with a Medicare supplement. With Medicare advantage you have worldwide emergency care.
Medicare Supplements contain the perk that you will have $50,000.00 lifetime covering out of country trips as long as the health issue has occurred within the first 60 days of your travel. You will need possible travel insurance for a helicopter evacuation as this is not a part of any Medigap plan. An Advantage plan does not include this same benefit, sorry.
Original Medicare with a Part D (Prescription Drug Plan) may be preferable because it offers nationwide access to any Medicare-participating provider, whereas Medicare Advantage plans are typically limited to a specific geographic service area.
Some Medicare Advantage plans may offer state-to-state coverage, while others limit their coverage to a specific defined area.
Well when you say original Medicare with a part D plan you are leaving out the most important factor which is also having a Medicare Supplement or Mefigap plan. If you have original Medicare paired with a Medicare Supplement, then you do not have to worry about Network and finding doctors that will accept the plan.
When you have an advantage plan, you have to stay in the insurance company's network. PPOs are a little better in that they allow you to go in and out of network (with a higher coinsurance/copay for out of network). Where Original Medicare doesn't have any networks. You have the freedom to see any provider in the United States, as long as they accept Medicare.
Medicare Advantage plans utilize networks to help keep costs down, while Original Medicare is taken by any provider that accepts Medicare. However, emergency room and urgent care visits are generally covered anywhere in the US on Medicare Advantage plans. Also, many large Medicare Advantage plans now have nationwide PPO networks, so that even for routine, non-emergent or non-urgent care, a member only needs to call his/her customer service number to find a local in-network provider when out of town.
Original Medicare with a Part D plan might be a better choice than a Medicare Advantage (MA) plan for frequent travelers for several key reasons: Nationwide coverage and Provider flexibility. If you travel often Original Medicare with Part D gives you the broadest, most flexible access to care across the US without having to worry about networks, service areas, or referral hoops.
With Original Medicare, you can see any doctor or visit any hospital in the U.S. that accepts Medicare, while Medicare Advantage plans typically restrict you to their specific provider networks, which can be regionally limited. This makes it easier to maintain your healthcare coverage while traveling, especially if you frequently change locations.
You might want to have a Medicare Supplement Plan along with a Stand Alone Part D plan so you don't have any limitations. Meaning you can go anywhere see any doctors as long as they accept Medicare. You will have to pay a monthly premium for your Medicare Supplement Plan along with your Stand Alone Part D Drug Plan. Which I can go over that with you based on your age, gender, county, and state.
Original Medicare can be used in all 50 states, as well as in the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the Virgin Islands. The same isn’t true for Medicare Advantage plans. These plans have defined service areas and may not cover out-of-state care, with the exception of emergency and urgent care situations.
When you have Original Medicare you are exposing your risk to no out of pocket maximum with your responsibility for expenses that occur. My suggestion would be to ensure that you are reviewing Medicare Advantage plans that have a large network range if you are a frequent traveler. A Medicare Supplement may be the best option as the benefits of your Medicare Supplement are accepted by any doctor who accepts Medicare giving you the most flexibility.
One thing many older adults wonder is whether their Medicare benefits are portable. If you travel often within the U.S., you should know original Medicare covers hospital care and doctor visits in all 50 U.S. states as well as Washington, D.C., Puerto Rico; the U.S. Virgin Islands; Guam; American Samoa; and the Northern Mariana Islands. There are no network restrictions; you can see any provider that accepts Medicare.
What about Medicare Advantage? The issue of coverage area isn't as straightforward. Certain Medicare Advantage plans do provide state-to-state coverage, including a national pharmacy network that allows you to pick up your prescription medications at locations across the country. However, other Medicare Advantage plans may not cover care outside of their defined service area—or they may impose higher cost-sharing or prior-authorization rules for out-of-network care.
Note: Both original Medicare and Medicare Advantage plans are required to cover emergency and urgent care anywhere in the U.S. without additional restrictions or out-of-pocket costs.
Will you be spending a large amount of time at a second home, with family, or at a long-term vacation rental? If you have an Medicare Advantage plan, be sure you understand its rules before heading out on an extended stay. This is because:
With many Medicare Advantage plans, you’re limited in the amount of time you can spend outside your service area and still be covered (e.g., six months). For example, if you’re a snowbird who spends winters in Florida, you can remain there for six consecutive months and maintain your Medicare Advantage coverage. If you stay longer than that, you may be disenrolled from the plan and automatically enrolled in original Medicare. While six months is common, some MA plans allow you to travel continuously within the U.S. for up to one year and still keep your benefits.
If you are a frequent traveler, original medicare will travel with you to any state and can see any doctor that accepts original medicare. A medicare advantage plan is usually confined to a network of doctors in the area/zip code you reside in.
In general, one might say that . It’s because you don’t have to worry about networks . However that also applies on ppo advantage vs hmos . Talking with a good broker who offers multiple choices allows you to make the decision of which you may prefer.
With Original Medicare, you may go to any facility that accepts Medicare. With a Medicare Advantage Plan, you may be limited to facilities outside of your service area.
Original Medicare with a medigap plan and Part D wont have networks to navigate if you need to utilize your insurance. Where ever medicare is accepted is where you can use it. If you are in an advantage plan you could be out of network if you travel and have an emergency. Thats the best answer I can give you without knowing your specifics.
Many Medicare Advantage plans come at an additional cost to the consumer and many do not "travel" outside of a specified coverage area. No need for a frequent traveler to buy something that they can not use. The other side of this coin is that there are many MA plans that DO travel...worldwide and have $ZERO$ cost!