Every U.S. citizen aged 65 or older is entitled to Medicare, including for emergency medical treatment. But what happens when you cross into Canada?
Unfortunately, many people don’t consider how Medicare coverage works while traveling. What happens if you need emergency care and you are outside the country? Do those same rules apply when you are traveling in our close northern neighbor – Canada? Here’s what you need to know about Medicare coverage in Canada.
Does Medicare cover everywhere?
Before we zero in on Canada and Medicare coverage, we’d like to remind you that you can receive Medicare coverage in all fifty states, Washington, D.C., Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam, and the Northern Mariana Islands.
Medicare usually doesn’t cover healthcare costs when participants travel outside the country. However, there are some exceptions to the rule.
Medicare Part B (Medical Insurance) may cover healthcare services that you get on board a cruise ship within U.S. territorial waters. However, Medicare won’t pay for services when the ship is more than six hours away from a U.S. port.
In addition, Medicare Part A (Hospital Insurance) may pay for inpatient hospital stays and doctor and ambulance services you get in another country if you are in the United States when a medical emergency occurs – and a foreign healthcare facility is closer than the nearest American hospital.
Can I use my Medicare card in Canada?
No, you can’t use Medicare during international travel. However, here are two scenarios of when Medicare might cover your medical services in Canada.
- Scenario #1: You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and one of the contiguous states. A medical emergency occurs, and a Canadian hospital is closer than the nearest U.S. hospital. In this case, Medicare will cover these healthcare services.
- Scenario #2: You live in the U.S., and a foreign hospital is closer than a U.S. hospital. In this case, Medicare will cover your emergency and non-emergency services in a Canadian hospital.
In addition, it’s worth noting that Medicare covers emergency and non-emergency ambulance services you get immediately before and during your inpatient hospital stay in a foreign hospital. But, if your hospital stay ends up not being covered, your ambulance ride to the hospital won’t be either.
Medicare Part D (Prescription Drug) plans don’t cover medications you buy outside the U.S.
How does Medicare work in Canada?
To be clear, you can only use Medicare if you meet one of the previous scenarios. You can’t use Medicare if traveling in Toronto or Montreal and have a foreign travel emergency. If you need medical care in a foreign country, you will typically pay 100% of the costs.
However, if you experience one of the two scenarios described in the previous section, Original Medicare will cover your medically necessary healthcare services the same way the program would cover the costs if the healthcare crisis occurred in the U.S. You would pay the premiums, coinsurance, copayments, and deductibles you’d typically pay.
Please note that foreign hospitals may not file your Medicare claims. You may be required to submit an itemized bill to Medicare for reimbursement.
How to receive healthcare coverage when traveling internationally
There are two options for receiving healthcare coverage when traveling if you are a Medicare participant.
- Option #1: You may buy a travel health insurance plan. An insurance agent (or travel agent) can help you set up a policy. Make sure you are purchasing travel health insurance – and not just travel insurance.
- Option #2: Some Medigap policies (or Medicare supplement plans) may cover emergency care when you travel outside the U.S. You may also ask your insurance provider if a Medicare Advantage Plan would cover medical emergencies in foreign countries.
Is it Medicare enrollment time? Are you considering traveling abroad? Research how Medigap plans (Medicare supplement insurance) can reduce your out-of-pocket costs of receiving medical care when you’re not at home.
Comparing Medicare plans is easy with our Find a Plan tool. Just enter your zip code to start reviewing costs and benefits of Medicare plans in your area.