Medicare Coverage Outside of the United States

Many people think about traveling the world when they retire. That sounds like a great idea until there is a medical emergency. What would happen if you got sick outside of the United States? Depending on the type of Medicare plan you have, your healthcare options may be limited. Don't give up the dream! This is what you need to know to make sure you have the coverage you need when you leave the country.

Emergency Care Medicare
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Original Medicare and Foreign Travel

It's not that Original Medicare (Part A and Part B) doesn't pay for health care in a foreign country, it's that it does so only in rare circumstances. It all depends on where in the world you are traveling:

  • Travel To and From Alaska: When you're traveling directly between Alaska and the continental United States "without unreasonable delay" (i.e., you are not stopping to vacation in Canada), Medicare will cover care in the nearest Canadian hospital if it is closer than an American hospital.
  • Travel on a Cruise Ship: If your cruise ship is in territorial waters, i.e., within six hours from a U.S. port, Medicare will cover any medically necessary services you receive onboard the ship.
  • Travel Near the U.S. Border: Medicare will pay for care at the nearest hospital when you are traveling near the border, even if that hospital is outside the United States. This applies to emergency situations only.
  • Residence Near the U.S. Border: When someone lives near the U.S. border and the closest hospital is outside the United States, Medicare will cover the cost of hospital care at that facility whether or not it is an emergency situation.

Other than that, Original Medicare says you are out of luck.

Medicare Advantage Plans

Medicare Advantage plans are run by private insurance companies, although the minimal standards for what they must cover are set by the federal government. They have the choice of whether or not to offer foreign coverage as a supplemental benefit.

Thankfully, many plans do offer worldwide emergency coverage. You will want to choose a plan that covers the areas you hope to travel to and you will want to shop around for the best rates. Be sure to keep all copies of your receipts in case the foreign hospital or healthcare provider does not bill your Medicare Advantage plan directly. You can provide the necessary paperwork for reimbursement once you return home.

Keep in mind that this insurance coverage is for emergency purposes only. A Medicare Advantage plan would not cover routine health care in a foreign country. Anyone who lives in another country for part of the year may need to find another source of health coverage for their extended stay.

Medigap Plans and Foreign Travel

Not everyone will want to choose a Medicare Advantage plan. These plans can have a narrow network of healthcare providers, and if your favorite doctor doesn't make the cut, you may not be able to use their services. You also will not be able to take advantage of Medicare Savings Plans that could help keep costs down.

For those who prefer to stick with Original Medicare, a Medicare Supplement plan, also known as a Medigap plan, maybe the best option for travel. Similar to Medicare Advantage plans, the federal government sets the guidelines for what each Medigap plan must cover. There are ten plans available and five of them include coverage for emergency care in a foreign country.

After you pay a $250 deductible, Medigap Plans C, D, F, G, and N will pay up to 80% of your emergency costs. However, they will only do so for the first 60 days you are out of the country. The clock resets after you return to the United States.

These plans also have lifetime limits. After your Medigap plan pays for $50,000 of emergency care, it will no longer offer foreign travel coverage. It doesn't matter if those dollars were spent in one year or over several years.

Other Insurance Options

Unfortunately, you are not allowed to have both a Medicare Advantage plan and a Medigap plan.

People who spend an extended period of time outside of the United States may need to consider purchasing non-Medicare related insurance coverage. A short-term medical plan may be available through your local travel agency or other insurance company.

The U.S. Bureau of Consular Affairs provides a list of insurers, although they do formally endorse them. They also include a disclaimer that "assumes no responsibility or liability for the professional ability or reputation of, or the quality of services provided."

A Word From Verywell

Don't let Medicare stop you from seeing the world! A Medicare Advantage plan or a Medigap plan may be able to get you the emergency travel coverage you need. When these options are not enough, you may be able to purchase a short-term medical plan for your trip.

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Article Sources
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  1. Medicare coverage outside of the United States.

  2. How to compare Medigap policies.

  3. U.S. Department of State - Bureau of Consular Affairs. Insurance Providers for Overseas Coverage.