A Guide To Your Health Care Coverage When Traveling

Knowing that your health plan will be there for you when you’re away from home is an important part of enjoying your next trip. Tufts Medicare Preferred HMO members have the peace of mind that comes with worldwide coverage for emergency and urgent care. This helpful guide outlines the details of what is covered when you travel. Take it with you and enjoy your trip!

What is covered when I travel?

1. Tufts Medicare Preferred HMO covers members for emergency and urgently needed care anywhere in the world.
2. You can be outside of our service area for up to 6 consecutive months and still be covered for emergency and urgently needed care.

What is a medical emergency?

1. A medical emergency is when you believe your health is in serious danger.
2. A medical emergency includes severe pain, a bad injury, sudden illness, or a medical condition that is quickly getting much worse.

If you have a medical emergency:

1. Get medical help as quickly as possible.
2. Call 911 for an ambulance or go to the nearest emergency room, hospital, or urgent care center.
3. You do not need to get approval or a referral first from your Primary Care Physician (PCP).
4. As soon as possible, you or someone else should call to tell us about your emergency (usually within 48 hours), because we need to follow up on your emergency care. The Customer Relations number is conveniently located on the back of your membership card.

What is urgently needed care?

1. Urgently needed care is when you need medical care right away because of an illness, injury, or condition that you did not anticipate, but your health is not in serious danger.
2. Because of the situation, it isn’t reasonable for you to obtain medical care from a network provider.

If you require urgently needed care:

1. If you are outside of our service area and cannot get care from a network provider, our plan will cover urgently needed care that you get from any provider.

Medication Travel Tips

Requesting a vacation override

1. A vacation override allows you to bring a larger supply of your prescription medication with you when traveling out of the country or to a remote location.
2. To request a vacation override, contact Customer Relations 5 business days before leaving for your trip with your prescription and pharmacy information.

Filling prescriptions when you travel

1. If you lose or run out of prescriptions when traveling, we will cover prescriptions that are filled at an out-of-network pharmacy if a network pharmacy is not available. (This applies to Tufts Medicare Preferred HMO members whose plan includes prescription drug coverage).
2. At a non-network pharmacy, you will have to pay the full cost (rather than paying just your copayment) when you fill the prescription. You can then ask us to reimburse you for our share of the cost by submitting a paper claim form. Just save your receipt and call Customer Relations to ask for a Prescription Claim Form. Mail the completed form with your receipt to the address on the form.

Be prepared

1. Check your supply of prescription drugs you take on a regular basis before leaving for a trip and if possible, take all the medication you need with you.
2. Bring copies of your prescriptions so you can fill them in the event you lose your medications.
3. Have a list of the generic names of your medications, especially when traveling overseas. If you need an emergency refill, physicians or pharmacists will be more likely to recognize generic names.
4. Bring the name and telephone number of your doctor and pharmacy. The contact information for Tufts Health Plan Medicare Preferred* is listed on the back of your member ID card.

Protect your medications

1. Read the storage instructions on the prescription label or talk with your doctor if you’re not sure how to store your medications when traveling.
2. When traveling by plane, pack medications in your carry-on, not in checked luggage.
3. When traveling by car, remember not to leave your medications in the car, especially in warm weather, and never leave them in the trunk.

Airport security

1. The Transportation Security Administration Web site tsa.gov/travelers has helpful tips to get you through airport checkpoints quickly and securely, including which medications and supplies you can transport by plane.

* Tufts Health Plan Medicare Preferred is a Medicare Advantage organization with a Medicare contract.

Contact information

If you have any questions, just call Customer Relations at 1-800-701-9000 (TTY 1-800-208-9562). Representatives are available Monday – Friday, 8:00 a.m. – 8:00 p.m. (From October 15 – February 14, representatives are available 7 days a week, 8:00 a.m. – 8:00 p.m.) After hours and on holidays, please leave a message and a representative will return your call the next business day.