Traveling abroad is an exciting and enriching experience, but if you rely on Medicare for your health insurance, it’s important to know what your coverage looks like and how it works when you’re outside the United States.
When traveling, health issues can pop up unexpectedly. You might catch unfamiliar bugs, deal with food-borne illnesses, or need treatment for a sprained ankle or dehydration while sightseeing. Changes in climate, altitude, and time zones can also affect your well-being. Plus, managing chronic conditions can be tricky without access to your regular medications or medical care.
Here’s what you need to know about traveling with Medicare and making sure you have the right health coverage for your adventures.
Understanding Medicare coverage outside the USA
Medicare is a federal health insurance program mainly for people aged 65 and older, but it also covers younger folks with certain disabilities. However, its coverage is generally limited to the United States and its territories. This means that when you’re traveling outside the USA, your Medicare coverage might not be as extensive as it is at home.
Here’s a breakdown of the key points you should know:
What is considered “outside of the USA?”
For Medicare purposes, the United States includes the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. Any location outside these areas is considered outside the USA.
Original Medicare (Part A and Part B)
Original Medicare consists of two main parts: Part A and Part B. Together, they provide basic coverage for hospital and medical services to eligible beneficiaries.
Medicare Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health care services. Medicare Part B covers medical services such as doctor visits, outpatient care, preventive services, and durable medical equipment, like wheelchairs, hospital beds, oxygen equipment, walkers, and certain types of prosthetic devices.
- Medicare Part A (Hospital Insurance): Medicare typically does not cover hospital or medical expenses outside the U.S. However, there are a few exceptions, including:
- If a medical emergency happens while you’re in the U.S. and a foreign hospital is closer than the nearest U.S. hospital that can treat your condition, Medicare may cover your care.
- Let’s say you’re traveling through Canada on the most direct route between Alaska and another U.S. state, and you’re not making leisurely stops along the way. If during your drive you experience a medical emergency in which a Canadian hospital is closer than the nearest U.S. facility that can provide treatment, Medicare may cover your emergency care.
- 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 condition, Medicare may cover your care, even if it’s not an emergency.
- Medicare Part B (Medical Insurance): Like Medicare Part A’s hospital care coverage, Medicare Part B usually doesn’t cover non-emergency healthcare services when you’re traveling outside the U.S. However, in some instances, it may cover services you receive on a ship within U.S. territorial waters — up to 12 miles from a U.S. shore. Medicare may also cover emergency and non-emergency ambulance and doctor services you receive right before and during a covered foreign inpatient hospital stay.
Medicare Advantage Plans (Part C)
Medicare Advantage Plans are offered by private companies approved by Medicare and often provide additional benefits not covered by Original Medicare, including emergency and urgent care services while traveling outside the U.S.
However, coverage varies significantly from plan to plan. Before making any plans or reservations, it’s recommended that you review your specific plan’s benefits and limitations regarding international travel.
Medicare Part D (Prescription Drug Coverage)
Medicare Part D covers all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). This includes certain vaccines you might need before traveling outside the U.S., such as yellow fever, typhoid, Japanese encephalitis, mosquito-borne chikungunya, and other diseases.
Your Part D plan won’t charge a copayment or apply a deductible for ACIP-recommended vaccines. However, Medicare drug plans do not cover prescription drugs you buy outside the U.S.
Medigap (Medicare Supplement Insurance)
Medigap policies (also known as Medicare Supplement Insurance) do not cover healthcare costs outside the U.S., except in very limited situations detailed above. They are primarily designed to cover gaps in Medicare coverage within the United States.
However, certain plans that call under Medigap (Parts C, F, G, M, N) may provide emergency healthcare coverage when you travel outside the U.S. These plans typically cover 80% of the billed charges for medically necessary emergency care after a deductible (usually around $250 a year) has been met. There is often a lifetime limit for this foreign travel emergency coverage, which is commonly $50,000.
Note that the deductible and lifetime limit may vary depending on your plan’s specifics. So, be sure to check with your insurance provider for the most accurate and up-to-date information regarding international healthcare coverage under your Medicare plans.
Planning ahead: Tips before you travel
Before you head out on your trip, follow these tips to make sure you’re ready for any medical needs:
- Review your Medicare coverage. Get to know your plan’s specifics, like deductible amounts and coverage limits, and understand what your current Medicare plan covers regarding international travel. If you take part in Medigap or Medicare Advantage, check with your plan provider about the specifics of your coverage abroad.
- Understand the quality of healthcare at your destination. Research the healthcare system in the countries, villages, and resorts you’ll be visiting. Familiarize yourself with how to access medical care and whether English-speaking healthcare providers are available.
- Consider travel insurance. Since Medicare’s coverage outside the U.S. is limited, purchasing travel insurance can provide a little peace of mind. Travel insurance plans often include health coverage, medical evacuation, and repatriation services — all invaluable if you face a medical emergency in a foreign country. Be aware that not all travel insurance offerings include health insurance, so read the conditions or restrictions carefully.
- Keep important information with you. Make a list of emergency contacts that includes your healthcare providers, family members, and your insurance company. Make sure to carry your Medicare card and any supplementary insurance cards on your person. And, if you’ve opted for travel insurance, keep your policy details handy.
What to do in a medical emergency abroad
In the unfortunate event that you need medical attention while you’re traveling, you’ll want to follow the following 4 steps. in order:
STEP 1 – Seek immediate care: Go to the nearest medical facility for treatment. In an emergency, your health and safety come first.
STEP 2 – Contact your insurance provider: Notify your travel insurance and Medigap or Medicare Advantage plan providers as soon as possible. They can provide guidance on which services are covered and help coordinate your care.
STEP 3 – Keep thorough records of what’s happening: Save all medical receipts, bills, and documentation of the care you received. If you can get the names of the facilities and doctors attending to you. If you’re unable to do so, ask a companion to gather this information. These will be important for filing claims with your insurance providers once you return home.
STEP 4 – Repatriation: If your condition requires you to return to the U.S. for treatment, your travel insurance might cover the cost of medical evacuation. Make sure you understand the terms and conditions of this coverage beforehand.
So, pack your bags, and have a great trip — but be prepared!
Traveling with Medicare requires a bit of extra planning, but it shouldn’t deter you from exploring the world. By understanding the limitations of your Medicare coverage, considering additional insurance options, and knowing what steps to take in a medical emergency, you can enjoy your travels with confidence and peace of mind.
If you want to learn more, about any of this — or about Medicare plans in general — contact our team of Medicare experts or use our online form to get started!
You can also see if there is a Medicare office near you so we can chat face-to-face!
Oh, and “Bon Voyage!”
