Q: Am I covered by Medicare when I travel outside of the United States?

The short answer is no. Medicare coverage is limited to the U.S. and its territories, including Puerto Rico, Guam, the Northern Mariana Islands, the U.S. Virgin Islands, and American Samoa.

There are only three ways you may receive care outside of the United States if you have Medicare and need to see a doctor:

1) You are in the U.S. when you have a medical emergency, but a foreign hospital is closer than the nearest U.S. hospital.

2) You are traveling the most direct route between Alaska and another state, through Canada without unreasonable delay when a medical emergency arises. If a Canadian hospital is closer than a U.S. hospital, Medicare will provide coverage.

3) A foreign hospital is closer to your home in the U.S. than the nearest U.S. hospital and can treat your medical condition, even if it is not an emergency.

One thing to remember is that if you do encounter one of these situations, Medicare only pays for Medicare-covered services. Six of the Medicare Supplement Plans – C, D, F, G, M or N – cover emergency care outside of the U.S. if the medical care starts within 60 days of leaving the U.S. Coverage is for 80% of the billed charges for Medicare-eligible expenses for medically-necessary emergency treatment. The patient pays a $250 deductible and there’s a maximum lifetime benefit of $50,000.

If you have a Medicare Advantage Plan (like an HMO or PPO) or another Medicare health plan, your plan may offer additional coverage for health care services you receive outside the U.S. Make sure to check with your plan before traveling to see what’s covered.

Since, in many cases, you simply can’t take your Medicare coverage with you outside of the U.S., you might want to check into travel health insurance.

 

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Jennifer Lavelli, a financial services consultant and Medicare advisor, helps people choose the right coverage for their needs, at no cost to her clients. Insurance licensed in NY, NJ and CT, Jennifer is a Certified Senior Advisor, a Certified Long Term Care specialist, and AHIP certified. Contact Jennifer at 914-295-4502 or JenniferLavelli@live.com