Medicare only covers foreign travel under specific circumstances. If you need travel coverage, consider a Medicare Supplement.
Where Are You Covered Under Medicare?
Medicare covers its beneficiaries for health care services they receive in the U.S. and its territories. This includes Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
Cases When Medicare Covers You While Traveling
Medicare will cover some cases if you are on a ship and receive medically necessary health care services while the ship is in territorial waters adjoining the land areas of the U.S. If the ship is more than six hours away from the port, you will not be covered by Part B.
Medicare does not cover prescription drug costs outside of the U.S.
Medicare may cover inpatient care, doctor services, and ambulance services if you end up in one of the following situations:
- A medical emergency that could lead to disability or death occurs while you are in the U.S. and need immediate medical attention. However, a foreign hospital is closer than a U.S. hospital to treat your medical condition.
- A medical emergency occurs while traveling through Canada by the most direct route between Alaska and another state. The Canadian hospital is closer than the nearest U.S. hospital to treat your emergency.
- You live in the U.S., but a foreign hospital is closer to your home than the nearest U.S. hospital to treat your medical condition, regardless of whether it’s an emergency or not.
When Medicare covers your foreign health care costs, you will owe the regular costs associated with Medicare Part A and Part B. That includes the Part A or Part B deductible, along with Part A coinsurance based on the number of days you were an inpatient, and the Part B copayment of 20% of the Medicare-approved amount for covered services.
Foreign hospitals are not obligated to file a claim to Medicare. If they do not, and one of those situations applies, you will need to file an itemized bill for the covered services.
How to Get Foreign Travel Emergency Coverage
People who frequently travel out of the country should consider adding a Medicare Supplement plan. These policies help pay for the costs of Original Medicare and can help with deductibles, copayments, coinsurance, hospice care, and more.
Six of the available Medicare Supplement plans offer 80% coverage for foreign travel emergency care.
To sign up for a Medicare Supplement, you must first be enrolled in Medicare. Each beneficiary has an individual Medicare Supplement Open Enrollment period that begins once they are first enrolled in Medicare Part B and turn 65 years old. This enrollment period lasts for six months. During that time, the insurance providers cannot prevent you from purchasing a plan because of pre-existing conditions: you have guaranteed issue rights during those six months.
You may still be able to purchase a Medicare Supplement plan if you are younger than 65 and have Medicare due to a disability. Insurance companies are not required to sell these policies to people under age 65. Some states make one or two plans available to people under 65. Check with your state to see if there are protections allowing you to purchase a plan. Keep in mind that insurance companies may charge you higher premiums for the same plan they sold a 65-year-old.
Traveling Medicare beneficiaries should be aware of the limited coverage available under Medicare. Pack a first aid kit, and hopefully, foreign health care costs will be lower abroad if you need medical attention.
For more information about Medicare coverage or what a Medicare Supplement plan can do to bolster your coverage, speak with an agent at Magellan Healthcare. Our team works to get Medicare beneficiaries the coverage that works best for them. Give us a call today!
