Will Medicare Cover Skiing Accidents on Vacation?

Many snowbirds plan skiing vacations during the winter. Skiing is a great winter activity that keeps you physically active and gets you outside in the fresh air. Although learning how to ski may be easier at a younger age, anyone can pick up skis and learn the ropes at any age.

Many places inside and outside the U.S. can make for a great skiing vacation. However, you will want to verify how your insurance will cover you before you arrive at your destination because skiing accidents can happen. If you have Medicare or a Medicare Advantage plan, your coverage will be different if you are inside or outside the U.S.

Skiing vacation within the U.S.

If you plan a skiing vacation somewhere within the U.S., you will want to review your health insurance plan’s documents to know how each plan will cover you. It is also essential to understand how you are covered if you are admitted as an inpatient versus outpatient, but Medicare will provide coverage across the nation.

Medicare Part A hospital coverage

Medicare Part A will kick in when you are admitted as an inpatient in a hospital due to a skiing accident. You do have a deductible that you must meet first before Medicare kicks in, but Part A will cover your room and board along with your daily meals. Some medications and lab services can also be covered by Part A. However, Medicare Part B will cover any outpatient service in the hospital, such as surgery.

Medicare Part B outpatient coverage

Medicare Part B provides outpatient coverage. If you have a skiing accident but need to go to the emergency room, urgent care, or doctor’s office, Medicare Part B will cover you. There is a separate Part B deductible that you must meet, but once that is met, you will be responsible for 20% of the cost of Medicare-approved services.

Additional plans

Since Medicare has deductibles and out-of-pocket costs that you are responsible for paying, you may choose to enroll in a Medicare Supplement or Medicare Advantage plan for cost-sharing help. If you have a Medicare Supplement plan, you can use this secondary insurance across the nation. It will travel with you and provide you with the same coverage whether you are out of state or not. For example, if you have a Medicare Supplement Plan G, your only out-of-pocket cost for a skiing accident would be the Part B deductible.

If you have a Medicare Advantage plan, your coverage will be different compared to Original Medicare and Medicare Supplement plan. Advantage plans have a network of providers within a specific service area. When you are outside of that service area, you may not have coverage, or you may have to pay more if you need coverage. For example, if you are enrolled in a PPO Advantage plan, you may have hospital or outpatient coverage if you are out-of-network. However, you generally will need to pay a higher copay or coinsurance for that service since you are not in your plan’s service area.

You can find the exact details on your coverage in your plan’s Summary of Benefits, so if you do plan a skiing vacation within the U.S., be sure to view your plan’s details to know how you will be covered in the chance of a skiing accident.

Skiing vacation outside of the U.S.

Original Medicare provides limited coverage outside of the U.S. The exceptions where Medicare may provide coverage are if you were on a cruise ship in U.S. territorial waters and need emergency care or traveling en route to the U.S. and another country’s hospital is closer. So, if you only have Original Medicare Part A and Part B, you may not have coverage if you are traveling outside of the U.S. for a ski vacation.

How additional plans cover you outside the U.S.

You may have foreign travel emergency coverage from your Medicare Supplement plan. Supplement Plans C, D, F, G, M, and N will cover 80% of the costs of an emergency when you are in another country. However, you do have a $250 deductible, and there is a $50,000-lifetime limit. The emergency accident must happen within the first 60 days of your vacation for your Medigap plan to provide coverage.

However, an Advantage plan will provide different coverage for you. Most Advantage plans will offer worldwide emergency coverage with a certain copay amount or coinsurance. The emergency would need to be life or limb, and there is a chance the foreign hospital or office will not bill your plan. If that happens during your skiing accident, you will want to keep all receipts and submit them once you are back in the U.S.

Conclusion

Whether you plan a ski vacation because you are an avid skier or want to cross skiing off your bucket list, you will want to know how your insurance will cover you if there is a skiing accident. Your coverage will all depend on the type of Medicare plan you have.