Summer is fast approaching and you are making your travel plans. We all have our own checklist of items we need to prepare before leaving for a trip. Are medical emergencies on your list? We often get questions if Medicare covers emergency medical needs while traveling abroad. The short answer is yes and no.
Original Medicare (Parts A, B, and D) generally does not pay for medical services or supplies outside the U.S., except for the certain situations. Original Medicare coverage includes all 50 states, D.C., Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis in a foreign country for the following cases:
- If a medical emergency occurs while in you’re in the U.S., but a foreign hospital is closer than the nearest U.S. hospital.
- You’re traveling through Canada by the most direct route between Alaska and another state, and a Canadian hospital is closer than the nearest U.S. hospital.
- You live in the U.S. and a foreign hopsital is closer to your home than the nearest U.S. hospital regardless of whether an emergency exists.
- If you are on a cruise ship, you may be covered if the doctor is legally allowed to provide medical services and the ship is within 6 hours of a U.S. port.
Any prescriptions drugs you buy outside the U.S. will not be covered by your Medicare drug plan.
Another item to note is that foreign hospitals are not required to file Medicare claims on our behalf, so you will need to submit an itemized bill to Medicare for the medical services you received. We recommend that you work with a Medicare specialist to assist you with this process.
If you have a Medicare supplement plan (Medigap) policy (generally recommend that you have one, it may cover you when you travel abroad. If you have Medigap Plan C, D, E, F, G, H, I, J, M, or N, your plan covers the following:
- Foreign travel emergency care if it begins during the first 60 days of your trip, and it must not be covered by Original Medicare.
- After you pay the $250 deductible for the year, your policy pays 80% of the billed charges for certain foreign emergency care.
- Medigap policies have a $50,000 lifetime limit for foreign travel emergencies.
If you have a Medicare Advantage Plan (Part C), the plans must provide at least the same level of coverage as Original Medicare and the same limitations apply. However, some Medicare Advantage plans may provide additional coverage for foreign travel emergency coverage. Please review the details of your plan.
The only other way to receive additional coverage is buying travel insurance. You will need to make sure it includes health coverage as not all do. Please let us know if you need to look into obtaining coverage through a travel policy and we will refer you to our resources.
Here are some items you may want to add to your travel checklist:
- Locate nearest hospital or urgent care
- Review and document your Medigap or Medicare Advantage coverage
- Print out or save your Advanced Health Care Directive document on your phone
- Keep a note of your doctor’s contact information, list of prescription drugs, and allergies
- If you’re traveling alone or in a group, print or save your emergency contact information on your phone
Please let us know if you have any questions and safe travels!