Does Medicare Provide Coverage Overseas?
Understand Medicare's limited international scope and explore vital health insurance options and preparations for safe travel abroad.
Medicare is a federal health insurance program in the United States, primarily for individuals aged 65 or older, and some younger people with disabilities or medical conditions. While it helps with healthcare costs, it does not cover all medical expenses. Understanding its scope is important, especially when considering travel beyond U.S. borders.
Understanding Medicare’s Scope
Medicare generally does not cover healthcare services received outside the United States. For Medicare purposes, “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. This means that for most international travel, you would be responsible for the full cost of any healthcare or medical supplies needed.
While Medicare Part D (prescription drug coverage) may cover vaccines recommended for international travel, it typically does not cover prescription drugs purchased outside the U.S.
Specific Situations for Coverage
Despite the general rule, there are limited exceptions where Medicare Part A (Hospital Insurance) and/or Part B (Medical Insurance) might cover services in a foreign hospital.
One situation is if you are in the U.S. and experience a medical emergency, and the closest hospital capable of treating your condition is in a foreign country. This applies if the foreign hospital is nearer than the nearest U.S. hospital that can provide the necessary treatment.
Another scenario involves traveling through Canada on a direct route between Alaska and another U.S. state. If a medical emergency occurs, Medicare may cover services if a Canadian hospital is closer than the nearest U.S. hospital that can provide care.
Medicare also provides coverage if you live in the U.S. and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, even if it is not an emergency. This applies to residents near the borders of Canada or Mexico. In these cases, Medicare typically pays for medically necessary inpatient hospital services and emergency ambulance or doctor services received immediately before or during a covered inpatient stay.
Travel Health Insurance Options
Given Medicare’s limited overseas coverage, exploring additional health insurance options for international travel is a prudent step. Travel health insurance is designed for international trips and can cover medical emergencies, medical evacuation, and repatriation of remains. These policies often have higher benefit limits for medical expenses and emergency evacuations compared to standard health plans.
Medicare Supplement Insurance, also known as Medigap, can also provide foreign travel emergency healthcare coverage. Medigap Plans C, D, F, G, M, and N offer this benefit. These plans typically pay 80% of billed charges for certain medically necessary emergency care outside the U.S. after an annual deductible of $250 is met. This coverage usually applies if emergency care begins during the first 60 days of your trip and has a lifetime limit of $50,000.
Medicare Advantage (Part C) plans are required to cover at least the same benefits as Original Medicare, including the limited overseas exceptions. Some Medicare Advantage plans may offer additional foreign travel emergency benefits, but this varies by plan and provider. Check with your specific plan to understand any international coverage it may offer. Some employer-sponsored or private health insurance plans may also offer international coverage; review your policy details.
Essential Preparations for Travel
Beyond insurance, several practical health preparations are important for international travel. Consult a doctor before your trip, ideally four to six weeks in advance, to discuss vaccinations and manage chronic conditions. Your doctor can also ensure you have an adequate supply of any prescription medications.
Carry copies of your prescriptions, a doctor’s note for medications, and a list of all current medications, including their generic names. Keep copies of important documents such as your passport, insurance cards, and emergency contact information separate from the originals. Familiarize yourself with local emergency numbers and how to access care in your destination country, including U.S. embassy or consulate information.