If you are planning an international trip and you are on Medicare, there is one question you would certainly need answered- Does Medicare cover emergencies abroad?
Medicare coverage abroad is extremely limited- this means that if you need medical care outside the U.S., you may have to foot the entire bill unless you plan ahead.
In this post, we offer insights into what Medicare coverage outside the U.S. includes, the rare exceptions and also your best options for staying protected while you are traveling.
Medicare Coverage Abroad: What It Covers and What It Doesn’t
Unfortunately, Medicare coverage abroad is not as substantial as many deem it to be. The original Medicare does not usually pay for medical care that you receive while traveling outside the United States.
Here is what it does cover- in very specific situations!
- You are in the United States however a foreign hospital is nearer than the closest U.S. hospital that can treat you
- You are on a direct route to Alaska by traveling through Canada, and a Canadian hospital is the nearest option during a medical emergency.
- You are on a cruise ship and within six hours of a U.S. airport when the medical emergency occurs.
In these rare instances, Medicare may provide coverage for hospital services, doctor visits as well as ambulance transport.
Exceptions to Medicare Coverage Outside the U.S.
As mentioned above, these exceptions are quite rare. For instance:
- If you live near the border of Canada and the closest hospital is international, Medicare coverage international travel rules may apply.
- Emergency medical services on cruise ships only qualify if the ship is within six hours of a U.S. port or is in U.S. territorial waters.
- You must meet Medicare’s definition of a medical emergency and prove that the foreign hospital was the nearest adequate facility.
However, it is important to note that even in these cases, coverage is limited and you will still be responsible for co-pays, deductibles and any care that is not approved by Medicare.
You must be wondering what happens when you want something more comprehensive. Follow along as we explore alternative options.
Traveling Abroad with Medicare and Medigap: What You Should Know
If you have a Medicare Supplement Insurance Plan, i.e. Medigap; you may be in better shape! Certain Medigap plans- specifically plans C, D, E, F, G, H, I, J, M and N- offer a Medicare foreign travel benefit that helps cover emergency care abroad.
Here is how it works!
- You must first pay a $250 deductible
- The plan will then cover 80% of eligible emergency care costs.
- Coverage is only provided for the first 60 days of the trip.
- There is a $50,000 lifetime limit on foreign emergency benefits.
It is vital to understand the Medigap will only pay if the original Medicare does not cover the care and the situation qualifies as a medical emergency.
So, while Medicare travel benefits under Medigap are helpful, they are not all-encompassing- and $50,000 does not go as it is used to when you are dealing with hospital bills abroad.
Does Medicare Cover Prescriptions Overseas?
Medicare drug plans (Part D) do not cover prescriptions that you buy while traveling internationally. If you get sick while overseas and require medication or antibiotics, you will likely have to pay for it out of pocket.
And unlike in the U.S., you may not have the option of submitting a claim for reimbursement.
Hence, there is a major gap in Medicare coverage for international travel and hence, another reason to look at additional insurance options before traveling abroad.
Alternative Options: Travel Insurance for Medical Emergencies
Given the limitations associated with Medicare coverage for international travel, your best bet for protecting yourself is travel medical insurance.
Since, Medicare travel insurance does not technically exist, you can and you should buy a separate travel insurance policy that includes emergency medical coverage. These plans are specifically designed to handle the unexpected- including hospitalization, medical evacuation, surgery and even repatriation of remains.
What to Look For in a Travel Insurance Plan
When looking for travel insurance, it is advised to look for policies that include:
- Emergency medical care- Covers the cost of doctor visits, hospital stays and surgeries etc.
- Emergency evacuation- Pays to transport you to a better medical facility or even back to the U.S.
- Repatriation of remains- Covers the return of your body to the U.S. in the event of death.
- Trip interruption coverage- Some plans even reimburse unused travel costs in the instance of you canceling your trip or returning early due to a medical issue.
These plans are usually more affordable than you would think, particularly when you consider the cost of a hospital stay overseas could run into tens of thousands.
Moreover, unlike Medigap, many travel insurance policies will cover you for the entire duration of your trip, and not only the first 60 days.
Endnote
Medicare coverage abroad is quite limited! Unless you are in one of a few rare situations, Medicare will not pay for care you receive outside the U.S. This means you may be responsible for 100% of the cost unless you have backup.
Medigap plans can provide a limited Medicare foreign travel benefit, but the coverage is capped and only applies under certain conditions. It is also important to remember that Medicare does not cover prescriptions overseas.
That said, for your peace of mind and financial protection, consider purchasing a Medicare travel insurance policy via a reputable provider before you leave the country. These plans can fill in gaps and ensure that a medical emergency abroad does not become a financial disaster.
Getting medical care should be the last thing you may be worried about when exploring the world. Hence, before you go, do check with your Medigap provider, look into travel insurance and ensure you are adequately covered.
