As we get close to spring and the travel bug begins to bite, you may wonder if you have Medicare coverage if you travel abroad. The quick answer is if you’re 65 and traveling overseas, it would be good to consider a supplement to your Medicare coverage. Notably, Medicare won’t travel abroad with you. Medicare will only cover you in all 50 states of the U.S., including all its territories, such as Puerto Rico, American Samoa, Guam, the Northern Mariana Islands, and the U.S. Virgin Islands.
You’ll need supplemental insurance outside the U.S. and its territories because Medicare will only cover emergencies in limited circumstances. These emergency services are included in Canada if you travel from Alaska to another state.
What does Medicare Cover while Traveling Overseas?
Some things that Medicare covers while traveling abroad:
- If you’re going to a foreign hospital and that hospital is closer to your home than an American hospital, Medicare may pay for services. This situation could apply to Americans living on the Mexican or Canadian borders.
- If you’re going through an emergency while traveling in the U.S. and a foreign hospital is closer to you.
- If you are on a cruise ship currently in U.S. territorial waters, the ship must be within 6 hours of an American port.
Beyond the above, if you want to ensure emergency medical coverage, you’ll need to plan for coverage while traveling abroad. A policy that falls into one of these categories can help; Medicare Advantage, Medicare Supplement, or trip-specific travel health insurance.
Will Medigap cover you while you’re overseas?
Most Medigap plans include a foreign travel benefit, so check if yours does. The Medicare supplement plans C, D, E, F, G, H, I, J, M, and N that cover travel will pay for 80% of the amount of money charged to you for medically necessary emergency care outside the U.S. and within its territories. Some things to consider:
- You’ll have to pay a $250 deductible.
- The medical emergency has to occur within 60 days of the beginning of your trip. If you have left the country indefinitely, it will not work.
- There’s a $50,000 lifetime limit to the amount that this benefit will pay.
You should also be aware that Medigap policies don’t replace Medicare but act as an additional benefit on top of the coverage you already have under original Medicare. Another thing to note is that Medicare Part D prescription benefits do not extend outside the U.S. and its territories.
Will Medicare Advantage cover you while overseas?
Medicare Advantage plans are an alternative to Medicare offered by private health insurance companies. All of these plans are different because of the benefits they provide. Don’t hesitate to ask your Medicare Advantage provider to check if your plan includes health insurance for foreign travel (usually, they don’t).
If your Medicare Advantage plan has travel insurance:
- Make sure that it covers health issues such as medically necessary emergencies or preexisting conditions.
- Be aware that not all Part C plans cover travel in every country and could also be limited in covering domestic travel emergencies. These Part C plans work in limited geographical areas.
- Your benefits will be better or equal to Medicare, but they don’t apply everywhere.
- If your Medicare Advantage plan agency learns you’ve been living away from your plan’s service area for six months or more, you will be automatically unenrolled from your plan.
Is travel health insurance an option for me?
Trip-specific travel health insurance could be an option if you don’t want the ongoing premiums of Medigap or a Part C plan but want coverage while traveling overseas.
- The price and scope of your coverage will vary depending on several factors. These factors include the traveler’s age and trip length.
- Be sure to get a plan that will cover medical emergencies. The plan should include medical team “medevac” evacuations.
- Your plan should not only include “trip protection” cancellations caused by illness. Learn about policy exclusions for preexisting conditions and penalties for cancellations in case your trip is postponed or put off entirely.
Some experts have recommended acquiring insurance for at least $50,000 in medical expenses and $100,000 in evacuation costs. Some currently existing plans have features over that, such as $250,000 in medical coverage and $1 million in evacuation costs.
How can I submit foreign claims to Medicare?
Medicare will only cover international healthcare costs under a few circumstances, but if you are a recipient of Medicare-covered services under these exceptions, then there’s some paperwork that you need to fill out.
- Because foreign hospitals are not asked or required to file Medicare claims, you may have to submit an itemized bill to Medicare for any foreign healthcare services you receive.
- If you are a recipient of Medicare-covered services on a cruise ship, a doctor will file a claim on your behalf.
If you want to get more information on how or where to send a foreign claim, you can visit the Centers for Medicare and Medicaid services, and you should also print the Patients’ Request for Medical Payment form (CMS 1490S).
Need help navigating your Medicare coverage with your travel plans? Give Karen or Matt a call at 865-203-2040 or email at contact@bigorangemedicare.com!
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*Medicare Insurance Specialty Group is Not Approved By, Endorsed By, or Affiliated With A Government Agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.