Will Medicare Cover Me Outside the U.S.?
Many people dream of traveling in retirement. When planning travel, it is normal to consider the basics like where you will stay, where you will eat, and what kind of sightseeing you will take in but what about your health coverage abroad? This is a large factor to add into your travel planning.
Original Medicare will go anywhere with you in the United States, including the District of Columbia, Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam, and the Northern Marina Islands. Though, it isn’t quite the same abroad.
Original Medicare is hospital in outpatient coverage that is provided by the federal government. Since Medicare is a national health system, it is situational for Medicare to cover any health services received outside of the country. For example, if you are traveling within the United States and the nearest hospital is a foreign hospital when a medical emergency occurs, you can choose that international hospital over an American one – this also applies if you are traveling through Canada.
Another example would be if you are on a cruise ship. Medicare may cover your emergency health care services if you are on territorial waters. Now, remember, Medicare Parts A and B will only pay their share of the services you receive, so you will still have out-of-pocket spending.
Since Medicare is an American healthcare system, other countries do not have to accept it as a form of payment. You may be able to file an appeal when you come across this scenario when you make it back to the states.
If you have a Medigap plans C, D, F, G, M, or N, you will receive an emergency foreign coverage benefit. Medigap foreign coverage still has a deductible of $250 that you must meet, and the policy should pay 80% of your costs.
When traveling, you will only receive emergency coverage outside the country if you obtain the service within the first 60 days of your travel. Your plan will not pay its share if you are outside this window and receive a health care service or supplies.
Something to take note of is that any Medigap plan with foreign coverage has a limited $50,000-lifetime benefit. Once your Medigap plan has paid out $50,000, your plan will no longer cover medical services outside the United States for the lifetime of your policy.
Before you travel overseas, check your plan’s Summary of Benefits to ensure you have foreign coverage.
Whether you have an HMO or PPO Medicare Advantage plan, your plan will not cover you outside the United States regardless of your network. Now, some Medicare Advantage plans will offer you worldwide emergency coverage. There are some cases where a foreign hospital will bill your plan, so you will want to travel with your Medicare Advantage card.
With that said, like Original Medicare, foreign hospitals do not have to accept your insurance. If this happens, you will want to keep all receipts and bills from your service and bring them back with you to the states. Once you make it back home safely, you can submit the bills to your Medicare Advantage plan and file for reimbursement.
Now, remember, you should only receive health care services for unexpected, emergency circumstances. Do not expect to receive a planned surgery in a foreign country and be disappointed when your carrier will not reimburse you.
As you can see, Medicare has limited coverage when traveling outside America. Most seniors purchase additional travel insurance to ensure they will receive extra coverage in case of an emergency. Before your travel plans go into full effect, read over your Medicare plans Summary of Benefits to see if you have foreign emergency coverage and if you should look into purchasing additional coverage.