Retirement brings a lot of exciting, new changes. One thing many people look forward to in retirement is being able to travel when they want, where they want. Whether you’re taking a quick trip, going for an extended stay, or even relocating for a little while, it’s important to know how—and if—Medicare will cover you.
Medicare coverage outside of the 50 states (plus American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands) depend on things like the type of coverage, how long you’ve been outside of the country, and whether it’s an emergency or not.
This article explains when and how Original Medicare, Medicare Advantage, and Medigap covers you while traveling outside the USA.
Original Medicare Travel Coverage
Generally, Original Medicare (Part A and Part B) only covers emergency situations out of the country. Also, Original Medicare only offers emergency coverage in certain situations. For instance, if you are vacationing in Europe and an emergency occurs, Original Medicare will not cover it.
Situations where Original Medicare will cover your emergency medical expenses include:
- If a medical emergency occurs while you’re in the United States, and a foreign hospital that can properly treat you is closer than a U.S. one, Original Medicare will cover you.
- If you are traveling to/from Alaska from/to another state directly through Canada and an emergency occurs, Original Medicare will cover your medical expenses at a Canadian hospital if it’s closer than a U.S. one.
- If you live in the United States and a foreign hospital is closer than any U.S. hospital. Your medical expenses will be covered by Original Medicare even if it’s not an emergency.
Covered Services Outside the USA
If one of the above situations occurs, Original Medicare pays the same as it would inside the United States. However, not all services are covered outside the country.
For example, Medicare Part B will only cover doctor services you receive outside the hospital after you’ve been released if Medicare covers your inpatient hospital stay. If Medicare doesn’t cover your hospital stay, then your doctor services won’t be covered either.
Medicare Part B may also cover any non-emergency medical services that you receive before and while you’re admitted to the foreign hospital. However, these services are only covered if Medicare covers your inpatient hospital stay.
Note that foreign hospitals are not required to submit claims to Medicare. Therefore, you may end up having to pay for your services yourself at the time you receive them. Once you return to the U.S., you can submit your claim to Medicare and file for reimbursement.
Traveling with a Medicare Plan
There are two types of Medicare plans that you can have in addition to or instead of Original Medicare: Medicare Supplement Plans (Medigap) and Medicare Advantage.
Medicare Advantage, also known as Medicare Part C, has thousands of plan options. These are private plans approved by Medicare; each plan is designed by the carrier and may have different benefits than others. However, most Medicare Advantage plans include emergency travel coverage.
Medicare Advantage plans must offer the same benefits as Original Medicare—you don’t lose any coverage—but many offer additional benefits for their members. To see how a Medicare Advantage plan covers health care outside of the U.S., review its Summary of Benefits.
Medigap Travel Coverage
A great thing about Medigap plans is that they cover you anywhere within the U.S. as long as you see a doctor who accepts Medicare. However, they work a bit differently outside the country.
If you have one of the Medigap plans that offer foreign travel emergency coverage such as Plan F or Plan G, then your Medigap plan will cover up to 80% of your emergency medical expenses. Medigap plans with this coverage have a $50,000-lifetime benefit limit as well as an annual $250 deductible.
Another restriction on this benefit is that it only is in effect during your first two months outside of the country. So, if you’re traveling for longer than two months, you will want to look into purchasing travel insurance in addition to your Medigap plan.
Short-term travel insurance is a great alternative to Medicare’s travel coverage. If you’re worried about health coverage overseas with Original Medicare, you may want to purchase a travel insurance plan to cover you on your trip.