Travel Medical Coverage

Medicare usually doesn’t cover health care while you’re traveling outside the U.S. Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands are considered part of the U.S. There are some exceptions, including some cases where

Medicare Part B (Medical Insurance)

 may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S.

Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis you get in a foreign country in these rare cases:

  • You’re in the U.S. when a medical emergency occurs that requires immediate medical attention to prevent a disability or death, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
  • You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
  • You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.

In some cases, Medicare may cover 

medically necessary

 health care services you get on board a ship within the territorial waters adjoining the land areas of the U.S. Medicare won’t pay for health care services you get when a ship is more than 6 hours away from a U.S. port.

Medicare drug plans don’t cover prescription drugs you buy outside the U.S.

Medicare supplement insurance (Medigap) policies may cover you when you travel outside the U.S.

Your costs in Original Medicare

You pay 100% of the costs, in most cases. In the situations described above, you pay 20% of the 

Medicare-Approved Amount

, and the Part B 

deductible [glossary]

 applies.

In the situations above, Medicare pays only for services covered under 

Original Medicare

:

  • Medicare Part A (Hospital Insurance) covers hospital care (care you get when you’ve been formally admitted with a doctor’s order to the foreign hospital as an inpatient).
  • Part B covers emergency and non-emergency ambulance and doctor services you get immediately before and during your covered foreign inpatient hospital stay. Medicare generally won’t pay for services (like return ambulance trips home) in either of these cases:
    • Medicare didn’t cover your hospital stay.
    • You got ambulance and doctor services outside the hospital after your covered hospital stay ended.
  • You pay the part of the charge you would normally pay for covered services. This includes any medically necessary doctor and ambulance services you get in a foreign country as part of a covered inpatient hospital stay. You also pay the coinsurance , copayments, and deductibles you’d normally pay if you got these same services or supplies inside the U.S.
Note

Foreign hospitals aren’t required to file Medicare claims for your travel medical costs. You need to submit an itemized bill to Medicare for your doctor, inpatient, and ambulance services if both of these apply:

  • You’re admitted to a foreign hospital under one of the situations above
  • The foreign hospital doesn’t submit Medicare claims for you

note:

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

Things to know

The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S.

Medicare drug plans don’t cover prescription drugs you buy outside the U.S.

Medicare supplement insurance (Medigap) policies may cover you when you travel outside the U.S.

Note

Because Medicare has limited travel medical coverage outside the U.S., you may choose to buy a travel insurance policy to get more coverage. An insurance agent or travel agent can give you more information about the cost of travel medical insurance. Travel insurance doesn’t necessarily include health insurance, so it’s important to read the conditions or restrictions carefully.

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