For those that travel outside of the United States or perhaps spend extended periods of time in other countries, having dependable health coverage is important. Outside of the U.S. is defined by any location other than the 50 states, District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands. Medicare coverage outside of the United States can be tricky. In general, Medicare will not pay for care or medical supplies that are provided outside the U.S. There are some exceptions, but they are few and far between. Generally, things such as prescription drugs, treatments such as dialysis and other routine medical procedures are not covered.
There are some limited situations in which Medicare may cover services outside of the U.S. For example, you are in the U.S. and have a medical emergency and the closest hospital to receive care is foreign. Or you’re traveling through Canada from the U.S. to Alaska “without unreasonable delays”, taking the most direct route and the Canadian hospital is the closest medical facility. In each of these cases, Medicare determines what does and does not qualify including ambulance transports, medical procedures, and various services and prescriptions.
With regards to travel outside the U.S. on a cruise ship, Medicare may cover some necessary services. However, Medicare may not cover services you receive if the cruise ship is more than 6 hours away from a U.S. port.
Foreign hospitals are not regulated or required by any laws to submit Medicare paperwork and claims. If you’re admitted to a foreign hospital under certain provisions which may be covered by your Medicare plan, you are responsible for submitting itemized bills and documentation to be eligible for reimbursement. You will be responsible for all medical bills should you not meet one of the above-mentioned exceptions.
Medigap coverage may offer additional coverage for health care services provided outside the U.S. Before you travel, it’s important to know your benefits. Many opt to purchase additional travel insurance or evacuation coverage to cover health care services in which Medicare may not approve. If you’re planning to travel outside of the U.S. in the future, or relocate to another country, do your research. Contact us at SENIORx Patient Advocates for more information and to make the best health care coverage decisions based on your specific plans.