If you are like many retiring seniors in the United States, travel is high on your list of priorities. However, it’s probable that you are also worried about what your medical insurance covers outside the USA. With a government-run program like Medicare, it is easy to question whether foreign travel will be covered.
The good news is, as a Medicare beneficiary you will be entitled to some foreign benefits in the case of an emergency. But as expected, the foreign coverage is not as comprehensive as you would expect here in the states. Keep reading to find out all you need to know about traveling outside the USA with Medicare.
Original Medicare Foreign Coverage
With Original Medicare coverage alone, the situations in which you will be covered abroad are quite situational.
For a nationalized system like Medicare, the tight foreign regulations are understandable as it could become quite a headache to create a synchronized health coverage system that worked no matter where beneficiaries were in the world.
Here are the situations in which you can count on Medicare to cover you outside of the United States:
- If you have a medical emergency requiring medical attention, on your way to or from Alaska by way of Canada – Medicare will cover your treatment in a Canadian facility.
- In the case you have a medical emergency or non-emergency situation while in the U.S. or its’ territories, and the nearest hospital is in another country. It typically applies to Canada or Mexico, and you would be covered by Medicare at the nearest hospital.
- If you are on a cruise ship and 6 hours away from a U.S. port, Medicare will cover your medical services at the nearest facility.
To summarize, if you are near the United States or in a border area, Medicare may cover in an emergency at the closest hospital in proximity to you.
How Medicare Works Outside of the USA?
Since you will be in a foreign facility, Medicare may not cover services in the same way as they do in the United States. Additionally, foreign facilities may not accept Medicare or be willing to bill Medicare for your treatment.
Foreign providers and hospitals are not required to submit your claim to Medicare, though some will have a process in place to do so. If you find yourself in a situation where a foreign hospital or provider will not coordinate with Medicare, you will need to pay out-of-pocket.
If you end up covering your medical bills on your own, be sure to save every bill and receipt to submit for Medicare reimbursement when you return to the U.S.
In the same way, billing may be different abroad. Also, the way Medicare will cover services is different. For example, Medicare Part B will only cover non-emergency services if your inpatient hospital stay is covered.
Additional Medicare Coverage Options Abroad
We’ve looked at how Original Medicare will cover you abroad. Now let’s look at how Medicare Advantage and Medicare Supplement plans will work while you’re out of the country.
Medicare Advantage outside the USA
Medicare Advantage plans, also known as Medicare Part C, are federally regulated private plans. Since these plans are offered through private insurance companies, there are thousands of options available with varying coverage.
With so many available options, your out-of-network benefits can vary. However, you can count on every Medicare Advantage plan having foreign emergency travel coverage. Review your Summary of Benefits to know exactly what kind of coverage your Medicare Advantage plan has and what your share of any emergency costs may be.
Medicare Supplement outside the USA
Medicare supplement plans are an add-on option to Original Medicare plans that fill in the out-of-pocket gaps. These plans are popular among many beneficiaries for their comprehensive coverage.
The great thing is, there are six Medicare supplement plans available that cover up to 80 percent of expenses in the case of a foreign emergency, with a lifetime limit of $50,000. The emergency must occur within 60 days of you leaving the United States, so it’s not a benefit that was intended for long-term travel.
Just like in the states, a Medicare supplement plan will only cover services that Medicare also approves and will pay after Medicare covers their portion.
Medicare will travel with you as you travel abroad, but not as comprehensively as you would count on it to do at home. It is best to have a supplemental option in addition to Medicare as well as a short-term travel policy.
You can never be overprepared when it comes to your health coverage while traveling outside of the country.
Guest contributor Danielle Kunkle has written the previous article. Danielle specializes in writing content that helps people understand Medicare – what it is, which part covers what, etc. She’s also on the Forbes finance council as their Medicare expert.