What's covered anywhere in the U.S.
- Emergency care: for a condition a reasonable person would think puts their health in serious danger. You don't need prior approval.
- Urgently needed care: care you need right away for an unforeseen illness or injury when you're temporarily outside your plan's service area.
- Dialysis: out-of-area kidney dialysis while you're temporarily away.
Routine care while traveling
| Plan type | Routine care outside Oregon |
|---|---|
| HMO | Generally not covered unless the provider is in the plan's network |
| PPO | Often covered out of network at higher cost, if the provider agrees to bill the plan |
| Plan with a visitor or travel program | Covered in the areas and with the providers the program names |
| Original Medicare (for comparison) | Any provider in the U.S. that accepts Medicare |
Some plans owned by national companies also have networks in other states, but you can't assume it. Check your plan's Evidence of Coverage, or call the number on your card before a trip.
Long stays away: the 6-month rule
Medicare Advantage plans cover people who live in their service area. Under 42 CFR 422.74, if you're away from the service area for more than 6 months in a row, your plan must disenroll you, unless it offers a visitor or traveler program, which can let you stay enrolled for up to 12 months. If you move permanently, you get a Special Enrollment Period to choose a plan where you live.
Tips for Oregonians who travel
- Read the out-of-area section of your Evidence of Coverage. It says how the plan handles routine visits, prescriptions and travel programs.
- Carry your plan card. Hospitals bill your plan for emergencies.
- Plan for part-year living. If you spend months each year in another state, compare a PPO, a plan with a travel program, or Original Medicare with Medigap during Open Enrollment (through December 7).
- Know your county's options. Plans differ widely across Oregon; see plans by county.
To compare plans from the companies they work with for how they handle travel, you can request a call from a licensed insurance agent. See also Original Medicare vs. Medicare Advantage in Oregon.
Related questions
What happens if I move out of Oregon?
When travel becomes a move.
Can I keep my doctor with Medicare Advantage?
Networks explained.
Is Medicare Advantage in every Oregon county?
Where plans aren't offered.
Sources
- Medicare.gov — Medicare Advantage plans
- 42 CFR 422.113 — Emergency and urgently needed services
- 42 CFR 422.74 — Disenrollment by the MA organization
- Medicare.gov — Special Enrollment Periods
More questions in this guide
- Can I keep my doctor with Medicare Advantage in Oregon?
- How many Medicare Advantage plans are available in Oregon for 2027?
- Is Medicare Advantage available in every Oregon county?
Part of the guide: Medicare Part C in Oregon — Medicare Advantage · All questions
Frequently asked questions
Does my Medicare Advantage plan cover me outside the U.S.?
Medicare generally doesn't cover care outside the U.S., and plans aren't required to. Some plans add limited foreign emergency coverage as an extra benefit; check your Evidence of Coverage before you travel.
I spend winters in Arizona. What are my options?
Ask whether your plan has a visitor or travel program, which can let you stay enrolled up to 12 months away. Otherwise, Original Medicare works with any provider in the U.S. that accepts Medicare, which many part-year residents prefer.
Can I fill prescriptions out of state?
Usually yes, at a pharmacy in your plan's national network or by mail order. Check your plan's pharmacy directory before you leave.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
