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. If you’re planning a trip or like to travel, you’ll have peace of mind knowing you are covered anywhere in the world for emergency or urgent care.
What is Covered When Traveling?
What is Covered When Traveling?
Important Travel Coverage Information
You can be away for up to 6 months
You can be outside our service area1 for up to six consecutive months and still be covered for emergency or urgent care. (For example, if you go to Florida for the winter, you could stay there for up to six consecutive months and be covered for urgent or emergency care.)
No referral needed
You do not need a referral from your primary care physician (PCP) before getting emergency or urgent care. Routine care, such as a physical, is not covered outside our service area, so remember to schedule routine care before or after your travel plans.
What is a medical emergency?
- A medical emergency is when you believe your health is in serious danger.
- Examples of a medical emergency include severe pain, a bad injury, sudden illness, or a medical condition that is quickly getting much worse.
- You are covered for medical emergencies anywhere in the world.
If you have a medical emergency:
- Get medical help as quickly as possible.
- Call 911 for an ambulance or go to the nearest emergency room, hospital, or urgent care center.
- You do not need to get approval or a referral first from your PCP.
- 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?
- 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.
- Because of the situation, it isn’t reasonable for you to obtain medical care from a network provider.
- You are covered for urgent care anywhere in the world.
If you require urgently needed care:
- 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.
How to get reimbursed
If you receive emergency or urgently needed care outside our service area, you may need to pay out-of-pocket. Simply save the paperwork for any services you have, and call Customer Relations for reimbursement details2. Or you can fill out a member reimbursement form available on the plan documents page of our website and submit it to us.
Remember your medication
If you take any medications, make sure you have enough before leaving for a trip. In certain situations, you can request a “vacation override” for a larger supply if you need it. Just call Customer Relations at least 5 business days before leaving for your trip (at least 14 business days if filling through Mail Order). Be sure to have your prescription and pharmacy information handy.
What if you lose your medication?
If you lose or run out of your medication when traveling, we will cover prescriptions filled at an out-of-network pharmacy if a network pharmacy is unavailable3. (This applies to Tufts Medicare Preferred HMO members whose plan includes prescription drug coverage).
Save your receipts
If you need to fill a prescription at an out-of-network pharmacy, you will have to pay the full cost of the prescription. But you can be reimbursed for our share of the cost by submitting a paper claim form. Just save your receipts and call Customer Relations for details.
- The Transportation Security Administration4 website has helpful tips to get you through airport checkpoints quickly and securely, including which medications and supplies you can transport by plane.
Medication travel tips
- 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.
- Bring copies of your prescriptions so you can fill them in the event you lose your medications.
- 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.
- 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.
Protecting your medications
- 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).
- 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.
- 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.
- When traveling by plane, pack medications in your carry-on, not in checked luggage.
- When traveling by car, remember not to leave your medications in the car, especially in warm weather, and never leave them in the trunk.
The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copays, and restrictions may apply. Benefits may change on January 1 of each year.
1Our service area is the state of Massachusetts except for Berkshire, Franklin, Dukes, and Nantucket counties.
2Reimbursement applies to emergency and urgent care situations only. You may be responsible for any copayments that apply.
3This applies to Tufts Medicare Preferred HMO members whose plan includes prescription drug coverage.
4Please note, by clicking on this link, you will be leaving www.tuftsmedicarepreferred.org.