Medicare very rarely covers medical care received outside the United States, but you do have a couple of options.
Medicare health insurance is only intended to cover healthcare in the United States. Just like most other major health insurance plans, Medicare will not cover your healthcare if you are outside of the country. Original Medicare, which is comprised of Parts A and B, does cover you in all 50 states as well as several U.S. territories.
International coverage is provided by Medicare Supplement plans, also known as Medigap, as well as some Medicare Advantage plans. This article will go through how to find out which plans cover international care, as well as some unique situations in which Original Medicare will cover healthcare in another country.
When does Medicare cover healthcare received in another country?
Medicare covers your healthcare costs in all 50 states as well as American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.
Original Medicare will also cover medical care in other countries during some unique emergencies. There are three main situations in which this coverage is allowed:
- If you are traveling from one of the lower 48 states to Alaska through Canada, and you are undergoing a medical emergency, Medicare will cover it if the closest hospital is in Canada. This coverage is only available if there isn’t an unreasonable delay in Canada and you are traveling on a direct route between Alaska and another state.
- If you are on a cruise ship that is still in U.S. territorial waters, then your care will be covered by Medicare. Territorial waters encompass an area about 6 hours away from any U.S. port.
- If you are near the border of Canada or Mexico and you need inpatient care, then Medicare will cover it if the foreign hospital is closer to you than any U.S. hospital. This will be more relevant to people living near the border than those who are traveling, although it may apply in rare cases to people traveling within the U.S. in one of these areas.
Does Medigap cover international healthcare services?
Medigap insurance, also known as Medicare Supplement insurance, is a type of private insurance that covers your out-of-pocket costs under Original Medicare. There are several plans out there, and each one covers a different set of costs. Most of these are things like your Part A deductible and Part B coinsurance, but many plans also cover foreign travel emergencies.
The plans that cover this are Plans C, D, F, G, M, and N. All of these plans cover 80% of the total foreign travel healthcare cost, so you will need to cover the remaining 20% out-of-pocket. The total lifetime limit for foreign coverage under Medigap is $50,000. You will have to pay any foreign healthcare costs after that out-of-pocket unless you have another healthcare plan that covers them.
Are Medigap Plans C and F still available?
Medigap Plan C and Plan F are both being phased out by Medicare. These plans are not available to anyone who became eligible for Medicare after January 1, 2020. If you became eligible before that date, you will still be able to buy these plans even if you weren’t enrolled in Medicare at that time. The only thing that matters is your eligibility date. However, we do not recommend signing up for either plan. Historically, premiums rise rapidly after a Medigap plan is discontinued. Instead, we typically recommend either Medigap Plan D or Medigap Plan G as alternatives.
Medicare Supplement Plan G and Plan D are very similar to Plans F and C, with the only differences being that neither covers the Medicare Part B deductible and Plan D doesn’t cover Part B excess charges. If you want foreign emergency coverage and are drawn to the extensive coverage option of Plan F, Plan G is the best alternative.
Does Medicare Advantage cover international care?
Medicare Advantage, also known as Part C, is a way of getting your Medicare benefits through a private insurance company. These plans are required by law to cover at least the same things that Original Medicare covers, but they have some differences.
First, Medicare Advantage plans have provider networks like most private insurance plans you are used to. This means that you won’t have the same coverage everywhere in the country. However, Medicare Advantage is required to cover emergency care anywhere in the U.S., even when non-emergency care isn’t covered.
Second, Medicare Advantage plans usually offer additional coverage of some sort. This will often be things like dental, vision, or prescription drug benefits, but could also include foreign emergency care. This coverage will vary between plans, so you will have to check each plan you are looking at to make sure it has this coverage.
How does Medicare work with interstate travel?
If you have Original Medicare, you will be covered in the same way in each state. The important thing is to find doctors that are Medicare-approved so that your coverage will be accepted. There is no provider network for Original Medicare.
If you have Medicare Advantage, then your coverage will be limited to some degree. With most Advantage plans, you can only receive non-emergency care in a certain area. In this case, you would have to pay more for healthcare outside of that area and may not have coverage in some cases. Make sure to check the details of your plan's provider network to see what your interstate travel options are, because this will vary.
Under Medicare Advantage, emergency care will be covered in each state, even if it is outside of your network.
Planning international travel in the time of COVID
If you are planning to travel internationally during the COVID-19 pandemic, there are several guidelines for you to keep in mind. If you have been fully vaccinated with an FDA-approved vaccine, then you don’t have to get a COVID test before traveling unless it is required by the country you are traveling to.
The requirements and needs of each country will vary depending on their current risk level. The CDC provides this map that gives an assessment of the current risk level in almost every country in the world.
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