Understanding Medicare Coverage Overseas

Jul 27, 2020

Chances are if you ask a retiree what they plan on doing during retirement, travel is at the top of their list. Of course, who wouldn’t want to trade the 9-5 grind in for jet setting adventures around the globe? It sounds like a great idea, but how does Medicare coverages overseas work? What would happen if you needed to seek medical care while traveling abroad?

Depending on the type of Medicare plan you have, your options may be limited and, in some cases, extremely costly.  Before you embark on your travel adventures, it is important to understand how your Medicare coverage overseas or outside the United States will apply to your healthcare needs while traveling.

Will Medicare Cover Me if I Travel Overseas?

Generally speaking, no. Basic Medicare (Part A and Part B) only applies to healthcare within the United States and its territories (Guam, Puerto Rico, U.S. Virgin Islands, American Samoa, and the Northern Mariana Islands). However, there are a few rare circumstances in which Medicare would cover the cost of medical treatment in a foreign country. According to Medicare.gov, these circumstances include:

  • You’re in the U.S. when a medical emergency occurs that requires immediate medical attention to prevent a disability or death, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
  • You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
  • You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.

An additional circumstance also applies to travel on a cruise ship.  Medicare may cover the cost of medical treatment if your cruise ship is in territorial water, at a U.S. port, or within 6 hours of a U.S. port. Other than these few rare circumstances, Medicare does not reimburse for care outside of the United States.

Cost of Medicare Coverage Overseas

Unless your care falls into the rare instances mentioned above, you will be responsible for 100% of the cost of receiving medical treatment in a foreign country. On the contrary, if your medical treatment DOES fit the parameters above, you will only be responsible for 20% of the cost. In this situation, Medicare Part A will cover inpatient hospital visits, while Medicare Part B covers emergency and non-emergency ambulance, hospital, and doctor services. It is important to note; Medicare drug plans do not cover prescription drugs purchased outside the United States.

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Options for Medicare Coverage Overseas

If traveling overseas is a part of your retirement plan, you may want to consider supplemental coverage that will protect you in case of an emergency while traveling outside of the United States.  Here are a few options to consider: 

1. Medigap Supplement Plan

Medigap is a Medicare supplement insurance plan that works alongside original Medicare to help cover certain costs that Medicare doesn’t pay for.  Currently, Plans C, D, F, G, M, and N offer emergency health coverage for foreign travel.

Some key attributes of a Medigap supplement plan for international travel include:

  • Coverage for the first 60 days of travel
  • 80% of costs covered for emergency care outside the U.S., after a $250 deductible is met for the year.
  • Lifetime limit of $50,000

It’s important to note that some Medigap plans are only eligible for enrollment during specific time frames. Contact us to speak with a licensed insurance agent regarding a Medigap supplement plan.

2. Medicare Advantage Plan

A Medicare Advantage plan (also known as Part C) is a type of Medicare health plan that is offered by a private insurance company.  Medicare Advantage plans provide all the benefits of a basic Medicare plan plus much more.  Some Medicare Advantage plans cover medical emergencies that occur during foreign travel.  It is important to note that Medigap plans cannot be used in conjunction with Medicare Advantage plans.

3. Private Travel Insurance

If you aren’t planning on traveling often, or if you’re looking for a more temporary pay as you travel plan, you may want to consider private travel insurance.  There are several options for private travel insurance that offer a variety of foreign healthcare benefits to supplement your Medicare coverage.

Overall, basic Medicare on its own won’t cover international medical emergencies. However, there are a variety of supplemental plans that can help fill in the gap.  Taking the time to consider which option is best for you prior to enrolling in a Medicare plan or before travel can help ease the stress of an unforeseeable overseas medical emergency.

Planning on Traveling Overseas?

Find out Which Medicare Supplement Plan is Right For You!

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