Does Medicare Coverage Work Overseas?

Medicare generally does not cover healthcare services received outside the United States. This federal health insurance program primarily provides coverage within the 50 states, the District of Columbia, and U.S. territories. Understanding these limitations is important for individuals planning international travel. This article clarifies Medicare’s coverage rules when abroad and explores alternative options for medical protection during overseas trips.

Understanding Medicare’s Coverage Scope Outside the United States

Medicare, encompassing Part A (hospital insurance) and Part B (medical insurance), typically does not pay for healthcare services or supplies received when traveling outside the U.S. This includes services obtained on cruise ships once they enter international waters.

There are limited exceptions where Medicare might offer coverage. Medicare applies if an individual is in a U.S. territory, including Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. In these locations, Original Medicare covers services from providers who accept Medicare.

Limited Medicare coverage may apply in foreign hospitals during specific emergency situations. If a medical emergency occurs in the U.S., and the closest hospital is in a foreign country like Canada or Mexico, Medicare may cover those services. Similarly, if traveling a direct route through Canada between Alaska and another U.S. state, Medicare might cover care at a Canadian hospital if it is the closest facility for an emergency.

For cruise ship travel, Medicare may cover medically necessary services only if the ship is within U.S. territorial waters when services are provided. This means the ship must be in a U.S. port or within six hours of arrival at or departure from a U.S. port.

Options for Medical Coverage While Traveling Internationally

Since Medicare’s overseas coverage is restricted, individuals traveling internationally often seek additional medical protection. Travel health insurance, purchased from private insurers, is a common option designed to cover unexpected medical expenses abroad. These policies cover emergency medical care, including hospital stays, doctor visits, prescription medications, and emergency medical evacuation.

When considering travel health insurance, review policy limits, deductibles, and whether pre-existing conditions are covered. Some policies also offer benefits like trip cancellation or interruption coverage, distinct from medical benefits.

Certain Medigap (Medicare Supplement Insurance) plans offer a limited foreign travel emergency benefit. Medigap Plans C, D, F, G, M, and N include this benefit. These plans cover 80% of approved costs for foreign travel emergency healthcare after a $250 annual deductible is met.

This Medigap foreign travel benefit has limitations; it applies only to emergencies that begin within the first 60 days of a trip. There is a lifetime maximum benefit, typically $50,000, after which coverage is exhausted. Once this limit is reached, individuals become responsible for any further medical expenses incurred abroad.