So, you’re on Medicare and traveling abroad. You have an emergency, what do you do and do you have coverage?
Medicare usually doesn’t cover health care while you’re traveling outside 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. However, Medicare won't pay for health care services you get when a ship is more than 6 hours away from a U.S. port.
- You're in the U.S. when a medical emergency occurs, 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 U.S 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.
What Are Your Costs
You pay 100% of the costs, in most cases.
In the situations described above, 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 a part of a covered inpatient hospital stay. You also pay the coinsurance, copayments, and deductibles you'd normally pay if got these same services or supplies inside the U.S. 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.
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.
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.