Does Medicare Cover You Out of the Country?

Medicare, the U.S. federal health insurance program, primarily serves individuals aged 65 or older, some younger people with disabilities, and those with End-Stage Renal Disease. A common question for beneficiaries planning international travel is whether this coverage extends beyond U.S. borders. Generally, Medicare does not cover medical services received outside the United States. Understanding Medicare’s limited international provisions and alternative coverage options is important for anyone considering travel abroad.

Medicare’s General Stance on International Coverage

Medicare, specifically Parts A (Hospital Insurance) and B (Medical Insurance), generally does not provide coverage for healthcare services obtained outside the United States. This means that if you receive medical treatment in a foreign country, you will likely be responsible for the full cost. “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, where Medicare coverage generally applies.

Despite this general exclusion, there are a few specific and limited circumstances under which Medicare might offer some coverage. One exception involves medical emergencies occurring while you are in the U.S., but the nearest hospital equipped to treat your condition is in a foreign country, such as Canada or Mexico. Similarly, if you are traveling directly between Alaska and another U.S. state through Canada and an emergency arises, Medicare might cover services at a Canadian hospital if it is closer than the nearest U.S. facility. These situations are determined on a case-by-case basis.

Medicare coverage on cruise ships also depends on the ship’s location. Medical services received on a cruise ship may be covered by Medicare if the vessel is in a U.S. port or within six hours of arrival at or departure from a U.S. port, placing it within U.S. territorial waters. However, once the ship enters international waters, Medicare generally will not cover medical expenses.

Medicare Part D, which covers prescription drugs, typically does not extend coverage for prescriptions filled outside the U.S. While Part D may cover certain vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) that you might need before international travel, the cost of ongoing medications obtained abroad is generally not covered. Given these specific and rare exceptions, relying on Medicare for international healthcare needs is not advisable, and beneficiaries should plan for alternative coverage.

Medigap and International Travel

Medigap, also known as Medicare Supplement Insurance, consists of private insurance plans designed to help cover some of the out-of-pocket costs not paid by Original Medicare, such as deductibles, copayments, and coinsurance. Certain Medigap plans offer a specific benefit for foreign travel emergencies, which can provide a layer of protection when traveling outside the U.S.

Specifically, Medigap Plans C, D, F, G, M, and N typically include foreign travel emergency healthcare coverage. For beneficiaries who became eligible for Medicare before January 1, 2020, Plans C and F may still be available and offer this benefit. This coverage usually pays 80% of the billed charges for medically necessary emergency care received outside the U.S. after an annual deductible of $250 is met.

A key limitation of Medigap’s foreign travel emergency benefit is that it generally applies only to emergencies that begin during the first 60 days of a trip. There is also a lifetime limit on this coverage, typically $50,000, which can be reached quickly in the event of a significant medical emergency abroad. This benefit is exclusively for emergencies and does not cover routine care, non-emergency treatments, or elective procedures while abroad. Additionally, Medigap policies do not cover prescription drugs obtained outside the U.S.

Travel Insurance for International Healthcare

For Medicare beneficiaries, standalone travel insurance policies often provide the most comprehensive and reliable health coverage for international trips, going beyond the limited scope of Medicare and Medigap. These policies are distinct from Medicare or Medigap and are specifically designed to address various risks associated with international travel, including medical emergencies.

Travel insurance policies typically offer broad emergency medical expense coverage, often with higher limits than those found in Medigap plans. A particularly important component of many travel insurance plans is emergency medical evacuation coverage, which can cover the significant cost of transporting you to the nearest adequate medical facility or even back to your home country if medically necessary. This critical benefit is generally not covered by Original Medicare or Medigap.

Many travel insurance policies also offer the option to waive exclusions for pre-existing medical conditions, provided specific criteria are met, such as purchasing the policy within a certain timeframe after your initial trip deposit. This waiver can be crucial for travelers with ongoing health concerns. When considering travel insurance, it is important to carefully review policy limits, deductibles, and any exclusions, such as those for adventure sports or specific pre-existing conditions. Understanding the claims process and any provider networks is also advisable to ensure the policy aligns with your specific travel and health needs.