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September 13, 2023

Medicare is a federal health insurance program for those who meet eligibility requirements. The program comprises four different parts (A, B, C, and D) that cover hospitalization, medical services, prescription drug coverage, and other benefits. For most beneficiaries, Medicare provides essential healthcare coverage, but many may wonder if their benefits extend internationally. If you're considering traveling outside of the United States, here's what you need to know about using Medicare abroad.

Original Medicare Coverage Outside the United States

Medicare does not provide coverage for medical services outside the United States or its territories, except in some specific emergency situations

Original Medicare Coverage Outside the United States

Original Medicare does provide some coverage for beneficiaries traveling outside of the United States. However, this coverage has limitations that may leave travelers exposed to significant healthcare costs.

Part A Coverage Outside the U.S.

Medicare Part A, which covers inpatient hospital stays, doesn't provide coverage outside of the United States except in some specific circumstances. Examples of these circumstances include emergency care in a Canadian hospital that is closer to the nearest US hospital than any American facility or emergency care on a ship that is within six hours of a US port. If a beneficiary is treated on the basis of these conditions, Medicare Part A pays for their services.

Part B Coverage Outside the U.S.

Medicare Part B, which covers most outpatient services, covers medical services received outside the United States, but only in limited circumstances. In scenarios where a healthcare provider deems a medical treatment emergency or urgently required, Original Medicare can cover the medical costs, but only to the extent deemed "reasonable and necessary" by Medicare. Medicare beneficiaries must meet certain conditions for the care received outside of the United States to be considered emergency care.

Supplemental Options for Medicare Coverage Outside the U.S.

Medicare beneficiaries have two additional options to augment their Original Medicare coverage outside the US.

Medicare Advantage (Part C) Plans

Medicare Advantage plans are an alternative to Original Medicare that offers the same services covered in Original Medicare, but through private insurance companies. Some Medicare Advantage plans offer coverage for services provided outside of the United States. If you're planning to travel outside of the United States, make sure to select a Medicare Advantage plan that offers such coverage. Keep in mind that costs may depend on the specific plan.

Medigap Policies

Medigap, better known as Medicare Supplement Insurance, is sold by private insurance companies and is intended to help bridge the gap between Original Medicare coverage and out-of-pocket costs Medicare beneficiaries may face. Some Medigap policies include coverage for healthcare expenses incurred internationally. These plans are usually standardized, meaning whichever insurance company you purchase the plan from, you'll receive the same coverage.

How Much Does Medicare Cover for International Healthcare Expenses?

Medicare only covers international healthcare expenses in limited circumstances, so the amount covered in each case depends on the particular scenario. Some plans or supplemental insurance options, like Medicare Advantage and some Medigap policies, may provide more significant coverage when traveling outside of the United States.

Should I Rely on Medicare When Traveling Outside the U.S.?

It's essential to consider all your healthcare coverage options when traveling outside of the United States. While Medicare does provide some limited coverage internationally, it's typically not enough to prevent significant out-of-pocket expenses. Consider options like travel insurance, which might offer additional coverage like emergency medical evacuation. Also, remember to investigate the details of your Medicare Advantage or Medigap plan if you have one, as some of these plans provide additional coverage when traveling internationally.

travel insurance IMG

Tips for Traveling with Medicare

If you're considering traveling outside the United States while on Medicare, review these tips to make sure you're prepared and can make the most of your trip:

  1. Check your healthcare coverage before leaving the United States. Contact your Medicare provider or a representative from your Medicare Advantage or Medigap plan to determine what your healthcare coverage looks like outside of the United States.
  2. Consider purchasing travel insurance. If your healthcare coverage doesn't cover healthcare costs abroad, consider purchasing travel health insurance to cover unexpected medical costs. Be sure to ask about what's covered and include factors like your age, medical history, and the length of your trip.
  3. Make a list of important medical documents. Before leaving the United States, make a list of essential medical documents that you should bring with you, including your Medicare card, medical summaries, and a list of medications alongside their dosages.
  4. Find out where English-speaking doctors are. Knowing where to get medical help when traveling internationally can be challenging, especially if you don't speak the native language. Research how and where to get help if you need it, and find out whether English-speaking physicians are available in your destination.
  5. Consider getting vaccinations before you go. Check the Centers for Disease Control and Prevention's (CDC) website for an updated list of vaccinations needed for the country or countries you plan to visit. Getting vaccinated protects you from various illnesses that are unique to specific regions.

In conclusion, international travel requires smart planning, especially when it comes to healthcare. While Medicare provides limited coverage for international healthcare expenses, it's essential to consider additional healthcare coverage options when traveling abroad. Be sure to research your healthcare coverage options early and make preparations so that you can reduce the risks and focus on experiencing your trip to the fullest.  

Don't hesitate to reach out to an insurance agent for assistance - they are there to help and guide you through the process.

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