Original Medicare provides coverage in all 50 states, the District of Columbia, Puerto Rico, U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands. If you have a Medicare Advantage Plan, the rules for out-of-state coverage will depend on the Medicare Advantage Plan you are enrolled in.
In general, HMO Medicare Advantage Plans have provider networks that must be used to be covered for routine care although you will be covered for emergency care, out of area urgent care and kidney dialysis. PPO Medicare Advantage Plans are generally more flexible about seeing providers outside your plan’s preferred network although you may have to pay higher co-pays or coinsurance to receive non-emergency care from an out-of-network provider. If you will be travelling out of state, you can contact your Medicare Advantage Plan for more information on coverage while out of our plan’s service area.