When planning a trip, it is essential to understand the extent of your Medicare coverage, whether domestic or international. Medicare Parts A and B cover medical expenses in the United States, including Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, and other U.S. territories.
If you’re traveling abroad, you might wonder if your Medicare insurance will cover your medical expenses. Well, it’s worth noting that Medicare doesn’t cover medical expenses outside of the United States except for emergencies.
Medicare Coverage Exceptions When Traveling Abroad
Typically, Medicare doesn’t offer healthcare services coverage when traveling outside the United States. However, there are several circumstances where Medicare Part B may cover the medical expenses received on a ship in the territorial waters bordering the U.S. land areas.
Nonetheless, it is notable that Medicare will not cater to healthcare services if the ship is more than six hours away from a United States port. But there are exceptional cases where Medicare can cover your inpatient hospital, doctor, and ambulance services while in a foreign country, and they include the following:
- When you experience a medical emergency while in the U.S. and a foreign hospital is nearer than the nearest U.S. hospital that can provide treatment for your condition.
- If you’re traveling between Alaska and another U.S. state via Canada and a medical emergency arises, and a Canadian hospital is nearer than the nearest U.S. hospital that can provide medical assistance.
- If you’re residing in the U.S. and a foreign hospital is closer to your residence than the nearest United States hospital that can manage your medical condition. In this case, it doesn’t matter if it’s an emergency.
- Medicare will cover ambulance transportation to a foreign hospital only if it’s medically essential and a doctor has admitted you for medically decisive inpatient hospital services.
What Costs Will You Incur?
Usually, Medicare requires you to pay the full cost. However, in the exceptional circumstances mentioned earlier, you will only have to pay the same portion you usually pay for similar services covered by Medicare. Thus, you must pay for the necessary doctor and ambulance services for a covered inpatient hospital stay in a foreign country.
You will also cater for coinsurance, copayments, and deductibles as you would for the same services in the United States. However, it’s essential to note that Medicare will only cover services comprised in Original Medicare.
- Medicare Part A, or Hospital Insurance, provides coverage for inpatient hospital stays in a foreign hospital following a doctor’s order.
- Medicare Part B covers emergency and non-emergency ambulance and doctor services you receive before and during your covered inpatient hospital stay in a foreign country.
Can Medicare Supplement Plans Cover International Travel?
Medicare Supplement plans are insurance policies designed to cover the out-of-pocket costs that Original Medicare Parts A and B do not cover. These plans provide additional benefits to individuals with Original Medicare. You will, thus, continue to receive the same benefits as Original Medicare if you have a Medicare Supplement plan.
Medicare Supplement Plans C, D, F, G, M, and N include emergency coverage for travel outside the U.S. Medigap High Deductible Plans F, and G also provide coverage for emergencies abroad. However, it is notable that Medicare Supplement Plans A, B, K, and L do not include this emergency coverage for travel abroad.
Can Medicare Advantage Plans Provide Coverage for Travel Outside the United States?
Private insurance companies offer Medicare Advantage plans (Medicare Part C) as an alternative to Original Medicare. These plans incorporate various features to offer a comprehensive healthcare package. To be covered, you must visit medical facilities within the network of your Medicare Advantage plan.
Some Medicare Advantage plans cover international travel, but there might be limitations to specific medical treatments. Before traveling overseas, notify your carrier to learn about the emergency travel benefits covered by your plan and how to file claims for reimbursement.
If you’re outside the areas covered by your Medicare Advantage plan for more than six months, your carrier may eliminate you from the policy. Therefore, check your plan’s exclusions before traveling to avoid any problems.
Is Travel Insurance Necessary if I am Enrolled in Medicare
Since Original Medicare has limited coverage outside of the United States, it may be necessary to purchase travel insurance. The beauty of travel insurance is that it can help cover emergency and non-emergency expenses when using Medicare. And remember, the travel insurance coverage and benefits vary depending on the provider and plan.
Travel insurance might cover international expenses that your Medicare fails to cover. With travel insurance, you don’t have to worry about paying out of pocket for medical care if you cannot return to the United States. For instance, if you have Original Medicare and plan to travel abroad, it’s essential to get travel insurance to cover unexpected medical expenses.
