In most cases, Original Medicare doesn’t provide medical care coverage when traveling outside the U.S. However, there are several situations when Medicare covers international care. Here’s when Medicare works overseas and how to get healthcare coverage if you’re going abroad.
Key Takeaways
- In four situations, Original Medicare and Medicare Advantage plans will pay for Medicare-covered services internationally.
- Most Medicare Supplement Insurance plans provide coverage for emergency medical care while you’re traveling abroad.
- Comprehensive travel insurance policies typically cover emergency medical care and evacuation if you’re overseas.
When Does Medicare Cover Healthcare Services Abroad?
There are only four situations when Original Medicare and Medicare Advantage plans pay for Medicare-covered health services outside the U.S:
- You have a medical emergency in the U.S.; the nearest hospital to treat your condition is in another country.
- You have a medical emergency in Canada while traveling directly between Alaska and another U.S. state without “unreasonable delay,” and a Canadian hospital is closer than the nearest U.S. hospital that can treat your condition.
- You live in the U.S., and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat your emergency or non-emergency medical condition.
- You have Medicare Part B and you get medical attention while on a cruise while the ship is in U.S. territorial waters, docked at a U.S. port, or within six hours of arrival or departure from a U.S. port.
What Areas Does Medicare Consider the U.S.?
Medicare was designed to provide health coverage only within the U.S., according to Ari Parker, a Medicare expert and the author of “It’s Not That Complicated,” a book about navigating the Medicare system. The U.S. includes all 50 states and Washington, D.C. But it also includes Puerto Rico and the U.S. Virgin Islands in the Caribbean, as well as Guam, the Northern Mariana Islands, and American Samoa in the South Pacific.
“Anywhere else is considered outside the U.S.,” Parker said.
What Does Medicare Pay for in the Four Situations?
“In these situations, Medicare will only cover Medicare-approved services received in the foreign hospital,” Parker said. “For example, Medicare won’t cover prescription drugs obtained outside the U.S.”
Medicare Part A or Medicare Part B covers doctors, inpatient hospital treatment, and medically necessary ambulance transportation, as long as you’re admitted for medically necessary covered inpatient hospital services.
When using Medicare benefits abroad, you usually must pay the provider out of pocket and submit the itemized medical bill to your doctor in the U.S. to file the claim. Foreign hospitals aren’t required to submit Medicare claims to your U.S. healthcare provider.
If the foreign hospital does submit Medicare insurance claims, your plan pays for its share of Medicare-covered services. You pay the remaining costs out of pocket through coinsurance, copays, and deductibles.
Medicare Advantage Coverage for International Travel
Most Medicare Advantage plans don’t cover travel outside your service area, including to other U.S. states. So these plans often don’t cover international travel either. The plans only pay for medical care in one of the four qualifying situations.
However, some Medicare Advantage plans may provide additional coverage abroad. For example, some plans:
- Have in-network international doctors and hospitals
- Allow you to stay enrolled in the plan if you’re traveling abroad for more than six months
- Cover prescription services abroad
Determine your international coverage by reviewing your plan’s summary of benefits.
Medicare Supplement Insurance and International Travel
Most Medicare Supplement Insurance plans (Medigap plans) can include emergency medical coverage in a foreign country. Medigap Plans C, D, G, M, and N, currently being sold, will cover medically necessary care in a foreign country.
But here’s the fine print for these plans:
- The emergency treatment must happen within the first 60 days of travel.
- You must first meet a $250 annual deductible (on top of any other deductibles you’ve paid).
- The plans only cover 80% of your care.
- There’s a lifetime maximum of $50,000.
Discontinued plans (E, F, H, I, and J) also still offer coverage to those enrolled. However, Medigap plans A, B, K, and L do not provide foreign emergency coverage.
How to Get Coverage for Medical Care If You Travel Abroad
If you’re planning a trip abroad and want coverage for medical emergencies, there are a few alternatives to Medicare that you can consider.
Buy Travel Insurance
Comprehensive travel insurance provides financial coverage for unexpected issues that can happen while traveling, such as emergency or short-term medical expenses and evacuation for medical reasons. Air evacuation is not covered by Medicare.
However, be aware that costs may be higher if you’re 65 or older and may exclude preexisting conditions. Some plans restrict application or coverage to those under a certain age. Those over age 75 may have a more challenging time finding coverage.
Consider an annual medical travel insurance plan that isn’t based on age or lower minimum coverage to lower costs. Also, choose a plan that doesn’t exclude preexisting conditions if you have chronic health issues.
Get a Medicare Advantage Plan With Travel Benefits
Some Medicare Advantage plans are available with a travel benefit, which allows you to receive additional medical care. Typically, you’ll pay out of pocket for services and then get reimbursed by your insurance company. However, these Medicare Advantage plans may be challenging to find, as most restrict coverage to specific geographic service areas.
Get Medicare Supplement Plan Coverage
If you have Original Medicare, buying a Medicare Supplement plan (also known as Medigap) outside the initial enrollment period may be possible, depending on your situation or your state.
However, you may pay more for coverage than if you’d bought it when first eligible. Or you could be denied coverage, particularly if you have a preexisting condition. Successfully buying a Medigap coverage plan could require significant research on Medigap companies.
Frequently Asked Questions (FAQs)
Does Medicare Pay for Prescription Drugs Outside the U.S.?
No, Medicare plans don’t pay for prescription drugs when you’re outside the U.S. If you’re planning a trip abroad, bring your medications. You should contact your insurance company if you need help getting prescriptions in a foreign country.
Does Medicare Cover Healthcare Services on a Cruise Ship?
Depending on the ship’s location, Medicare plans will cover healthcare services on a cruise. Your plan will only pay for Medicare-covered expenses if the ship is traveling through U.S. territorial waters, is docked at a port in the U.S., or is within six hours of a U.S. port. Plan for any potential medical coverage in advance to avoid medical debt. If the cruise ship offers a medical coverage plan, compare cost, coverage, and limits to what you can buy from a travel insurance company.
Does Medicare Supplement Plan G Cover International Travel?
Medigap Plan G will cover your emergency medical expenses when traveling internationally during the first 60 days. The plan will pay for 80% of Medicare-covered services after you pay the $250 annual deductible. You’re responsible for the other 20% of the cost.
Am I Eligible to Receive Medicare If I Move Outside the U.S.?
If you’re a U.S. citizen and move outside the U.S. to live as an expatriate, you are still eligible for Medicare. But benefits will be minimal. Your plan only covers emergency medical care in the four qualifying situations and only for a limited period. However, you can use your full Medicare benefits if you travel back to the U.S. or visit a U.S. territory.
The Bottom Line
Original Medicare and Medicare Advantage plans provide limited medical coverage when traveling internationally in a few specific situations. To get medical coverage while traveling outside the U.S., your best bet may be to purchase travel insurance. But you can also investigate a Medigap plan (if you have Original Medicare and can still enroll), or a Medicare Advantage plan that includes extra travel benefits.
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