Does Medicare Cover You Out of the Country?

Many individuals wonder if Medicare covers healthcare services outside the United States. Generally, it does not, though limited exceptions exist. Alternative insurance options can provide coverage for international medical needs. Understanding these options is important for international travelers.

Medicare Coverage Outside the United States

Medicare Parts A (Hospital Insurance) and B (Medical Insurance) generally do not cover healthcare services or supplies obtained outside the United States. This includes 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. Therefore, Medicare typically will not pay for medical care needed in most foreign countries.

A few specific situations allow for Medicare coverage in a foreign hospital. This includes emergencies in the U.S. where the nearest hospital capable of treatment is in a foreign country. Another scenario applies to those traveling through Canada between Alaska and another U.S. state, if an emergency occurs and a Canadian hospital is closer than the nearest U.S. hospital. Additionally, Medicare may cover non-emergency inpatient services in a foreign hospital if it is closer to your U.S. home than the nearest U.S. hospital that can treat your condition.

In these rare instances, Medicare’s standard payment structure applies. Medicare typically pays 80% of the approved amount for covered services, with individuals responsible for deductibles and coinsurance. Foreign hospitals are not obligated to file claims with Medicare, so you may need to pay upfront and seek reimbursement. Furthermore, Medicare Part D, which provides prescription drug coverage, generally does not cover prescriptions filled outside the U.S.

For medical care on a cruise ship, Medicare may offer coverage only if the ship is in a U.S. port or within six hours of arriving at or departing from one. If the ship ventures into international waters beyond this radius, Medicare typically does not cover medical care. These limited exceptions should not be relied upon as comprehensive insurance for general international travel.

Supplemental Insurance and Travel Medical Plans

Because Medicare’s coverage abroad is restricted, individuals often seek other insurance options for international travel. Medigap (Medicare Supplement Insurance) provides one such option, with some plans offering limited foreign travel emergency healthcare coverage. Specifically, Medigap Plans C, D, F, G, M, and N typically include this benefit. Plans E, H, I, and J, though no longer sold to new enrollees, also provide this coverage if purchased before June 1, 2010.

These Medigap plans generally cover 80% of billed charges for medically necessary emergency care outside the U.S., after a $250 annual deductible. This coverage is limited to emergencies that begin during the first 60 days of a trip. It also has a lifetime maximum benefit, often set at $50,000. This benefit is for emergency care only, not routine or non-emergency treatments, and applies only if Original Medicare does not otherwise cover the care.

Travel medical insurance offers a more comprehensive solution for healthcare needs while traveling internationally. These dedicated policies are designed for medical emergencies abroad. They often include coverage for emergency medical treatment, hospital stays, and critical services like medical evacuation and repatriation of remains. Some plans may also cover non-emergency care.

When considering travel medical insurance, review policy details such as coverage limits, deductibles, and provisions for pre-existing conditions. Many policies offer emergency assistance services to help locate reputable medical providers and coordinate care. Confirm whether the policy allows for direct payment to providers or if you will need to pay upfront and seek reimbursement. While some private health insurance plans might offer limited international coverage, this is less common for those relying on Medicare.

Preparing for Medical Needs Abroad

Preparation for medical needs while traveling abroad extends beyond securing insurance. Carry copies of your insurance cards, including any Medigap or travel medical insurance policies, along with your passport and a list of emergency contacts. Keep these documents in a secure, accessible location, separate from originals.

Carry a detailed list of current medications, including their generic names and dosages, along with any known allergies and relevant medical conditions. For controlled substances or certain prescription medications, a letter from a treating physician explaining the necessity can prevent issues at customs. This medical information can be invaluable in an emergency where communication is challenging.

Understand how to locate medical care in a foreign country. Travel insurance providers often offer 24/7 assistance to help identify reputable doctors and hospitals. U.S. embassies or consulates can also provide lists of local medical facilities. Plan for payment logistics, as many foreign healthcare providers may require upfront payment for services, even with insurance; retain detailed records and receipts for later reimbursement.

Have a general emergency plan for peace of mind. This includes knowing the local emergency services number in the destination country, which can differ from 911 in the United States. Familiarity with contacting local authorities or emergency medical services can improve response times during an unexpected medical event.