When planning a foreign trip, it’s highly unlikely your first thought would be: 'Will Medicare pay if I get injured or have a medical emergency before I get back home?'
Many patients think their Medicare benefits will provide coverage, wherever they go. Unfortunately, this isn’t true and can lead to costly, and avoidable, mistakes.
Generally speaking, Medicare doesn’t pay for medical services to patients outside of the United States. When we say ‘United States,’ we mean the 50 States, the District of Columbia, Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands, the Northern Mariana Islands, and the territorial waters adjacent to these areas.
‘United States,’ in this interpretation, would not include any United States Armed Forces bases. So whether you are heading to Europe, the Caribbean, or anywhere outside the U.S., you may wish to consider travel insurance. Here’s why:
Medicare only pays, under very limited circumstances, for a limited number of services outside the United States.
Medicare won’t pay for medical treatment or prescription drugs, even if you receive them on board cruise ships, unless the ship is in U.S. territorial waters. ‘Territorial Waters’ means the ship is in a U.S. port, or within six hours of when the ship arrived at, or departed from a U.S. port.
The Centers for Medicare and Medicaid (CMS) have listed the rare instances in which other coverage may exist, such as for:
- Emergency inpatient hospital services if you fall ill in the U.S, but the closest hospital that can treat you is outside of the U.S.
- Emergency treatment at a Canadian hospital if you are traveling straight through Canada (between Alaska and another state) and the closest hospital you can be treated at is in Canada
Should the services meet criteria for payment in those situations, physician and ambulance services may be covered as part of, or immediately prior to, that stay. However, Medicare will not pay for transport back to the U.S. after a medical emergency which occurs outside of the U.S.
Knowing this, when you plan a trip abroad, you may want to look into what coverage you do have. Some Medigap or Medicare supplemental plans have travel-related benefits. If you don’t have a supplemental plan, or that plan does not pay for services you might receive outside of the United States, you may want to purchase a travel insurance plan that includes medical coverage.
Don’t let the expense of an unplanned medical emergency ruin your travels. Plan ahead and have a great trip!
If you have questions about your Medicare benefits, you can call our toll-free Beneficiary Contact Center at 800-833-4455, Monday through Friday, from 8:30 a.m. until 7:00 p.m. ET. We offer a TTY/TDD line at 877-566-3572. This line is for the hearing impaired with the appropriate dial-up service and is available during the same hours Customer Service Representatives are available.
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