Medicare and Travel: Coverage Outside the United States

Traveling in retirement is a dream for many people. Before you pack your bags for an international trip, it is important to understand how your health coverage works abroad. Many travelers are surprised to learn that Original Medicare generally does not cover health care or supplies you get outside the United States.

For Medicare purposes, the U.S. includes the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa.

Limited exceptions

Medicare may pay for inpatient hospital, doctor and ambulance services you get in a foreign country in rare situations, such as:

• You are in the U.S. when a medical emergency occurs, and a foreign hospital is closer than the nearest U.S. hospital that can treat you.
• You are traveling through Canada without unreasonable delay by the most direct route between Alaska and another state, and a Canadian hospital is closer than the nearest U.S. hospital.
• 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 also cover medically necessary care on a cruise ship in certain circumstances, such as when the ship is in U.S. waters or within a certain time of arriving at or leaving a U.S. port.

Medigap foreign travel emergency coverage

Several standardized Medigap plans, including Plans C, D, F, G, M and N, include coverage for foreign travel emergency care. In general, this benefit:

• Covers 80 percent of the cost of emergency care during the first 60 days of a trip
• Applies after you pay a deductible
• Has a lifetime maximum

Check your policy for exact amounts and terms.

Medicare Advantage plans

Some Medicare Advantage plans cover emergency and urgently needed care abroad. Coverage varies widely, so call your plan before you travel and ask:

• Does the plan cover emergency care outside the U.S.?
• Is there a limit or separate deductible?
• How do I file a claim if I pay out of pocket?

Part D and prescriptions

Part D plans generally do not cover prescriptions purchased outside the U.S. Before a long trip, ask your plan whether you can get an extra supply in advance, sometimes called a vacation override.

Travel medical insurance

To fill gaps, many travelers buy travel medical insurance or medical evacuation coverage. Before buying:

• Check whether the policy covers pre-existing conditions.
• Look at coverage limits for medical care and evacuation.
• Note whether you must pay upfront and file for reimbursement.
• Check age limits, as some policies restrict coverage for older travelers.
• Read exclusions carefully.

The U.S. Department of State provides general information on insurance and health care abroad.

Practical tips before you go

• Bring a medication list with generic drug names, since brand names differ abroad.
• Pack medications in original containers in your carry-on bag.
• Carry copies of insurance cards, your health summary and emergency contacts.
• Know where to get care at your destination. U.S. embassies and consulates can provide lists of local doctors and hospitals.
• Enroll in the State Department's Smart Traveler Enrollment Program (STEP) to receive safety updates and help in emergencies.
• Keep receipts and records of any care you receive.

Traveling within the U.S.

Original Medicare covers care anywhere in the U.S. from providers who accept Medicare. Medicare Advantage plans may have limited coverage outside your service area, except for emergencies and urgent care. If you spend part of the year in another state, ask your plan how coverage works there.

Terrameritavi is an independent publication and is not affiliated with Medicare or any government agency.