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Medicare Coverage Outside the US
Nov 30, 2021

Medicare Coverage Outside the US

With very few exceptions, your Medicare coverage does not travel with you when you leave the United States.

With Original Medicare, while you’re generally covered within the U.S. (with some exceptions), you typically do not get any medical coverage when traveling outside of the country. That means if you have a medical emergency and need to see a doctor, go to a hospital, or fill any prescriptions, you’ll have to pay for it 100 percent out-of-pocket.

Don’t let your trip be ruined by unexpected costs associated with a medical emergency. If you’re traveling, be sure you understand what your coverage is (or isn’t) in the country you’re visiting. If you won’t be covered, consider alternatives such as purchasing travel insurance, or if you travel regularly, enrolling in a Medicare Advantage (Part C) plan for extra coverage during your trips.

Medicare coverage abroad

In most cases, Original Medicare doesn’t cover health care services while you’re traveling outside of the U.S. or its territories. (Medicare considers the U.S. to include the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.)

You would have to pay 100 percent of health care costs incurred while abroad out-of-pocket.

Additionally, prescription drugs are never covered if you purchase them outside of the U.S., even if you have Part D prescription drug coverage.

Does Medicare cover you outside the United States?

There are a few exceptions where Medicare would pay for inpatient hospital, doctor, ambulance services or dialysis you receive while in a foreign country:

  • You’re in the U.S. when you have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital.
  • You’re traveling a direct route through Canada without reasonable delay between Alaska and another state when a medical emergency happens, and the Canadian hospital is closer than the nearest U.S. hospital.
  • You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital, regardless of whether the emergency exists or not.

Additionally, Medicare may cover medically necessary services if you are aboard a ship within the territorial waters adjoining the land areas of the U.S., typically within six hours of a U.S. port.

Dialysis may also be covered in emergency situations, but not routine dialysis.

If one of the above situations applies to you, you’d have to submit an itemized bill to Medicare for the services received. You’ll also have to complete a “Patient Request for Medical Payment” form and submit a letter explaining your reason for submitting the claim yourself. Foreign hospitals aren’t required to file Medicare claims, so if you do not file yourself, your services will not be covered.

You’d be responsible for 20 percent of the Medicare-approved amount (though your Medicare Part B deductible applies). Medicare Part A (hospital insurance) would cover hospital care, and Part B (medical insurance) would cover emergency ambulance and doctor services you’d get immediately before and during your covered inpatient hospital stay.

Essentially, you’d pay the charge you normally would pay for covered services. This includes deductibles, coinsurance and copayments for doctor and ambulance services, as well as inpatient and/or outpatient services and supplies.

Do Medigap plans provide travel coverage?

Your Medigap (Medicare Supplement) policy may offer coverage for health care services or supplies you get outside of the U.S. Specifically, Medigap plans provide foreign travel emergency health care coverage while traveling. This includes foreign emergency care if it’s

  1. Medically necessary
  2. Begins during the first 60 days of your trip, and
  3. Isn’t otherwise covered by Medicare

In most cases, you’d pay 20 percent of the costs after meeting a $250 annual deductible. Your Medigap plan would pay the remaining 80 percent of the costs. Medigap foreign travel emergency coverage has a lifetime limit of $50,000.

Before traveling overseas, talk to your plan to ensure you understand when you would and wouldn’t be covered.

Do Medicare Advantage plans provide travel coverage?

Medicare Advantage (Part C) plans offer everything Original Medicare does and more, including hearing, vision, dental, Part D and other coverage. Many Medicare Advantage (MA) plans also offer some travel coverage.

In many cases, whether you’re in the U.S. or another country, emergency services will be covered by your MA plan. Typically, this would include ambulance transportation and medically necessary inpatient or outpatient services.

Before traveling overseas, talk to your plan to ensure you understand when you would and wouldn’t be covered.

Other travel insurance options

Travel health insurance, or foreign travel insurance, is temporary coverage designed to pay for emergency medical expenses from illness or injury while traveling. In many cases, whether you have Original Medicare with Medigap or a Medicare Advantage plan, you may want to consider purchasing an additional travel insurance policy.

Travel insurance doesn’t cover pre-existing conditions, prescriptions for preventive care. But it does typically cover ambulance/emergency transportation and medically necessary inpatient and outpatient services.

These policies are sold by private insurance companies. Talk to a travel agent or request a quote before traveling. This coverage is not related to Medicare, so you cannot purchase coverage through Medicare or your Medigap or MA plan.

Medicare coverage while living abroad

If you live abroad on a temporary basis, or frequently travel back and forth to the U.S., you may want to consider enrolling in Medicare Parts A and B.

If you are a U.S. citizen, you can apply for and receive Social Security retirement benefits while living abroad as long as you or your spouse worked and paid Social Security taxes in the U.S. for at least 10 years.

If you’re collecting Social Security benefits when you become Medicare eligible, you may be automatically enrolled in Part A. You may also consider enrolling in Part B to ensure you have medical coverage during your stays in the U.S., as well as to avoid gaps in coverage or late enrollment penalties if you move back into the U.S.

To enroll in Medicare while abroad, you can sign up by requesting enrollment forms from the U.S. Embassy or Consulate in the country where you live. The Social Security Administration should also send you a letter explaining your Initial Enrollment Period, and offering you the ability to request an enrollment packet.

If you enroll, you must pay your Part B premium, even while abroad.

Medicare costs

In 2022, you will pay the following costs for Medicare:

  • Part A
    • Premium: You typically won’t pay a monthly premium for Part A. (If you do have to purchase Part A, you will pay either $274 or $499 per month).
    • Deductible: $1,566
    • Coinsurance based on number of inpatient hospital days
  • Part B
    • Premium: $170.10
    • Deductible: $233
    • 20 percent coinsurance after you meet your deductible
  • Part C
    • Premium: Varies by plan
    • Deductible: Varies by plan
    • Out-of-pocket costs vary by plan
  • Part D
    • Premium: Varies by plan
    • Deductible: Varies by plan
    • Out-of-pocket costs vary by plan

How to apply for Medicare

If you qualify for Medicare, there are a number of ways you can apply:

  • Apply online at www.ssa.gov.
  • Visit your local Social Security office.
  • Call Social Security.
  • Call the RRB (if you worked for a railroad).
  • If you already have Part A and want Part B, you must complete an Application for Enrollment in Part B.

Additional resources

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