Am I covered under medicare while traveling overseas?

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Travel is one of life’s greatest pleasures. For many, post-retirement travel abroad is a lifelong dream. The available time allows individuals to explore their way across Europe or experience vast parts of Asia. Unfortunately, illness, accidents or a medical emergency can happen anywhere. You need to know what your medical coverage is when booking travel.

Will Medicare Cover Me When I’m Abroad?

No, but there are a few narrow exceptions according this website. Your Medicare Part A and Part B, which cover hospital care and outpatient services, are only effective in the United States. Services received in the 50 states, District of Columbia, Puerto Rico, U.S. Virgin Islands, Northern Mariana Islands, American Samoa and Guam are covered. Medicare is not obligated to accept claims from a foreign hospital, pay for drugs or cover any non-urgent medical visits.

What are the Exceptions?

Medicare will only cover treatment outside the U.S. in three instances. These situations are rare and only apply to a few specific geographic areas. If you receive medical care abroad, discuss your treatments with your doctor. Medicare only covers services received abroad that it would in the U.S.

  • You suffer a medical emergency in the U.S. but the closest hospital is in a foreign country. For example, you are in the northern U.S. and the closest hospital is in Canada.
  • You are traveling directly between Alaska and another U.S. state through Canada on a direct route “without unreasonable delay.” If a medical emergency occurs and a Canadian hospital is closer than the nearest U.S. hospital, the treatment you receive at the foreign hospital may be covered. You must be wary because Medicare conducts a case-by-case review to determine if your trip qualifies as “without unreasonable delay.”
  • You reside in the U.S. and your residence is closer to a foreign hospital than the nearest U.S. hospital. You can receive treatment at that hospital for emergencies and non-emergency medical conditions.

You must make sure the claim is submitted to Medicare if your treatment qualifies under one of the exceptions. Foreign providers are not required to submit their claims to Medicare. You need to obtain and submit itemized bills to Medicare to ensure the services are covered. Otherwise, you will be responsible to the hospital for the full amount.

What if I’m on a Cruise?

Again, it is a matter of geography. Medicare will not cover any service if the ship is more than 6 hours away from a U.S. port when the service is received. There is no exception for an emergency.

Medicare may cover medically necessary treatment you receive on a ship under two conditions. The physician must be legally permitted to provide medical treatment onboard the cruise ship and the ship must be docked in a U.S. port or fewer than 6 hours away from a U.S. port when you underwent treatment. Under this exception, it does not matter if the services are due to an emergency or not.

If your treatment qualifies under the exception for cruises, your on-ship doctor is required to submit the claim to Medicare. You can also request itemized bills and file a claim yourself.

How Can I Get Coverage Abroad

There are several options to ensure you have medical coverage when traveling.

Medigap Policies

You may already be covered if you have basic Medicare and a Medigap policy. The C, D, E, F, G, H, I, J, M and N plans cover emergency health care you receive when traveling abroad. These plans pay 80% of the claim amount for certain medically necessary emergency care once the $250 deductible is met. However, Medigap policies only cover emergency care during foreign travel if it begins during the first 60 days of your travels. Medicare will not cover services that it would not cover in the U.S. If you frequently travel abroad, Medigap policies have a $50,000 lifetime limit.

You should always review your coverage with your Medigap provider to ensure you understand your coverage limits and terms.

Medicare Advantage Plans

If you have an Advantage plan, it must follow Medicare’s coverage rules and abide by the existing exceptions. Additionally, these plans may offer their own coverages for foreign travel. You should verify your coverages with the plan administrator before traveling outside of the U.S.

Purchasing Supplemental Insurance

You can purchase a supplemental policy that covers you while traveling. Be sure to research covered services and limits before committing to a plan. Different products may only cover emergencies.

Also, remember that trip insurance likely does not cover medical expenses. Discuss any offerings with your travel agent before selecting a product.

Know Your Coverage Before Traveling

Medicare will never cover services you receive outside of the U.S. while traveling abroad. The few exceptions are for cases of U.S. residents in remote areas close to international borders. Never assume your supplemental plan will protect you during travel. You must contact your provider to verify eligibility and limits. Otherwise, you will most likely be left covering the full out-of-pocket expense during an emergency.