Does Medicare Cover Medical Care While Traveling Abroad?

Medicare generally does not cover health services received outside the United States and its territories, though specific, limited exceptions exist. Understanding these distinctions and exploring alternative coverage options is important for international travelers.

Medicare Coverage for Overseas Travel

Medicare (Parts A and B) generally does not cover health services received outside the United States and its territories. “Outside the U.S.” refers to any location other than the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

However, Original Medicare may cover certain medically necessary services in a foreign hospital in three specific situations. One exception is when you are in the U.S. and experience a medical emergency, but the closest hospital able to treat your condition is in a foreign country.

Another scenario is when you are traveling through Canada without unreasonable delay, via the most direct route between Alaska and another U.S. state, and a medical emergency occurs where a Canadian hospital is closer than the nearest U.S. hospital. Medicare determines “without unreasonable delay” on a case-by-case basis.

The third exception applies if a foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether it is an emergency. In these rare instances, Medicare may cover inpatient hospital, doctor, and ambulance services that are medically necessary as part of a covered foreign inpatient hospital stay.

If Medicare covers these services, you still pay the standard deductibles, coinsurance, and copayments. For example, Medicare covers 80% of the Medicare-approved amount after deductibles are met.

Foreign hospitals are not obligated to file Medicare claims. If your care falls under one of these specific exceptions, you typically need to pay for services upfront. Then, submit an itemized bill to Medicare for potential reimbursement. This process requires meticulous record-keeping of all medical documents and receipts.

Medicare Part C (Medicare Advantage) plans generally do not cover care or prescriptions outside the U.S. While Medicare Advantage plans must provide coverage, their international coverage beyond the limited exceptions is rare and varies by plan. If a Medicare Advantage plan offers emergency travel benefits, understand the specific terms and conditions, including how claims and reimbursement are handled.

Similarly, Medicare Part D plans typically do not cover prescription drugs purchased outside the U.S. If you need medication while abroad, expect to pay 100% of the cost out of pocket. While some Part D plans may cover certain recommended vaccines for international travel, they do not extend to routine prescription fills overseas. Travelers reliant on specific medications should plan to bring an adequate supply for their entire trip.

Supplemental Travel Health Insurance

Because Medicare’s coverage for overseas medical care is highly restricted, individuals traveling internationally often acquire supplemental health insurance. These options fill coverage gaps. Two primary types of supplemental coverage can provide financial protection for medical needs abroad.

One option involves certain Medigap policies. Many Medigap plans, including C, D, F, G, M, and N, offer foreign travel emergency healthcare coverage. These plans typically cover 80% of billed charges for medically necessary emergency care received outside the U.S., after an annual deductible of $250 is met. This coverage is generally limited to the first 60 days of each trip and has a lifetime maximum benefit of $50,000. This Medigap benefit is specifically for emergencies and does not cover routine care or non-emergency treatments.

A separate category is stand-alone travel health insurance policies. These policies offer a broader range of benefits beyond just emergency medical care. Coverage often includes emergency medical expenses for unforeseen illness or injury, hospital stays, doctor visits, and prescription medications. Many policies also include medical evacuation benefits, covering the cost of transporting you to an appropriate medical facility or back to the U.S. if medically necessary.

When selecting a stand-alone travel health insurance policy, examine the coverage limits, deductibles, and any exclusions, including pre-existing conditions. Some policies may offer a waiver for pre-existing conditions if certain criteria are met. Understand whether the policy provides primary coverage (pays before other health insurance) or secondary coverage (requires claims to be filed with your primary insurer first). Determine if the policy offers direct payment to foreign healthcare providers or operates solely on a reimbursement basis, as many foreign providers expect upfront payment.

Accessing Medical Care While Abroad

Before traveling internationally, gather essential documents. These include your Medicare and any supplemental insurance cards, policy numbers, and emergency contact information for your insurance providers. Carry both physical and digital copies of these documents, along with a list of current medications and medical conditions. Understand the specifics of your supplemental policy, such as whether it requires contacting them before seeking care.

If a medical emergency or need for care arises while abroad, seek appropriate medical attention. If you have supplemental travel health insurance, contact your insurance provider’s emergency assistance line as soon as possible. They can help locate local medical facilities, coordinate care, and explain the payment process. Many foreign healthcare providers expect immediate payment, so travelers may need to pay out-of-pocket at the time of service, even with insurance coverage.

After receiving care, keep meticulous records. Obtain detailed itemized bills, medical reports, and receipts for all services, medications, and treatments received. If documents are not in English, translation may be required by the insurer.

For Medicare-covered exceptions, submit itemized bills directly to Medicare. For Medigap or stand-alone travel insurance, complete a claim form and submit it with all supporting documentation, including proof of payment. Documenting currency conversion rates at the time of payment can also help with reimbursement. Submit all required paperwork promptly to facilitate the reimbursement process.