If you are a Medicare beneficiary with Original Medicare, Part A and Part B, you can travel anywhere in the United States and still be covered, as long as you use doctors and hospitals that accept Medicare. If you travel outside of the United States, however, your Medicare coverage is limited.
Please note that when it comes to Medicare coverage, “outside of the United States” includes any location outside of the 50 states, the District of Columbia, Puerto Rico, Guam, American Samoa, Virgin Islands, and the Northern Mariana Islands.
There are a few situations when Medicare may cover you outside of the country if you need medical care in a foreign hospital:
- Medicare will cover health care in a foreign hospital if you live in the United States and have a medical emergency, but the nearest foreign hospital is closer to you than the nearest U.S. hospital.
- Medicare may also provide coverage in Canada if you have a medical emergency while you’re traveling on a direct route, without unreasonable delay, between Alaska and another U.S. state, and the closest hospital that can treat you is in Canada. Medicare will determine on a case-by-case basis what qualifies as “without unreasonable delay.”
- Medicare will also cover certain health-care services you get in a foreign hospital, regardless of whether it’s an emergency, if you live in the United States and the foreign hospital is closer to your home than the nearest U.S. hospital.
- Medicare will also cover you while on a cruise ship if you need to receive medically necessary care while the ship is in U.S. waters or a U.S. port (or within six hours of arrival or departure from a U.S. port). The physician treating you must be legally allowed to provide medical care on a cruise ship.
In the above limited situations, Medicare may pay for inpatient hospital care, doctor services, and/or ambulance services. Please note that if you’re enrolled in Medicare plan that includes prescription drug coverage (such as a stand-alone Medicare Prescription Drug Plan), these plans don’t cover prescription medications that you purchase outside of the United States.
Traveling with Medicare Advantage plans
If you receive your Medicare coverage through a Medicare Advantage plan, instead of Original Medicare, the rules for out-of-state coverage are different and will depend on the type of Medicare Advantage plan you’re enrolled in. Certain types of Medicare Advantage plans, such as HMOs, have provider networks that you must use to be covered for routine care. You generally need to get health-care services from doctors and hospitals in the plan network, although you’ll still be covered if you need emergency medical care, out-of-area urgent care, or out-of-area kidney dialysis.
Other Medicare Advantage plans, such as PPO plans, are more flexible and may let you see health-care providers outside of your plan’s preferred provider network. Depending on the rules of your plan, however, you could have to pay a higher copayment or coinsurance to receive non-emergency care from an out-of-network provider. If you will be traveling out of state, contact your Medicare Advantage plan for more information on coverage while out of your plan’s service area.
If you are traveling overseas, Medicare Advantage plans must provide at least the same level of coverage as Original Medicare, so you’ll be covered in the same limited situations described above. However, some Medicare Advantage plans may provide additional coverage when you are traveling outside of the United States. Check with your Medicare Advantage plan for more information.
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Medigap coverage outside of the United States
As another coverage option for Medicare beneficiaries traveling outside of the United States, some Medicare Supplement insurance plans may offer emergency medical coverage when you’re out of the country. Also known as Medigap, these plans work alongside Original Medicare and may help with certain costs that Medicare doesn’t pay for.
Specifically, Medigap Plans C, D, F, G, M, and N provide some degree of emergency foreign travel coverage (up to plan limits). As mentioned, some Medicare Advantage plans provide coverage for travel abroad also.
If you are interested in enrolling in either a Medicare Supplement or a Medicare Advantage plan, then our eHealth plan comparison tool on this page can help you review available Medicare plan options in your area.
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