Traveling Abroad and Your Healthcare Coverage
If you are planning a trip outside of the United States and its territories, it’s important not to assume you can take your Medicare coverage with you. Unfortunately, most of Medicare’s payments for emergency and/or non-emergency services cease once you are beyond the U.S. borders, which include the 50 states, District of Columbia, Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, the Northern Mariana Islands, and the territorial waters adjacent to these areas.
Rare Circumstances in Which Medicare May Pay for Medically Reasonable and Necessary Services Outside of the U.S.:
- Medical treatment you receive on a cruise ship when the ship is in U.S. territorial waters. This means while the ship is in a U.S. port, or is within six hours of arriving at or departing from a U.S. port.
- Emergency inpatient treatment you receive at a Canadian hospital when you are traveling straight through Canada between Alaska and another state, and the closest hospital that can treat you is in Canada. There is no benefit when you are vacationing in Canada.
- Emergency inpatient treatment you receive at a foreign hospital when the emergency occurs in the U.S. but the closest hospital that can provide necessary treatment is outside of the U.S.
- In addition to when you are traveling, Medicare may also cover emergency or nonemergency inpatient treatment you receive at a foreign hospital when you live in the U.S., but the foreign hospital is closer, or substantially more accessible, to your U.S. residence than the nearest participating U.S. hospital that can provide the care needed. Physician and ambulance services performed as part of a covered foreign inpatient hospitalization.
- Please remember, being an ‘inpatient’ means you have been admitted to the hospital and are not there in observation status only. Spending the night in a hospital does not mean you have been admitted.
Note: Some Medicare Advantage Plans and Medicare supplemental plans (not Original Medicare/Railroad Medicare) may pay for additional services, but you need to check with your plan before you travel to be sure.
When Medicare Won’t Pay:
- Medicare won’t pay for any services related to a foreign hospital stay if the hospital stay is not covered by Medicare (this includes ambulance services)
- Medicare won’t pay for foreign ambulance transports or physician services after your foreign hospital stay is over (even if Medicare pays for the inpatient hospital stay)
- Medicare won’t pay for services in a foreign hospital owned or operated by the U.S. Government unless that hospital is within the U.S. borders as defined above
What You Can Do:
- Consider buying travel insurance. Because some travel insurance plans don’t cover health care services, be sure to talk to your insurance or travel agent about this topic. If the cost of travel insurance seems prohibitive, please keep in mind that most foreign services you receive require payment in full prior to leaving the facility, and in some instances, prior to receiving services.
- If you have received Medicare-covered services as mentioned above, you may have to file a claim yourself since foreign hospitals are not required to file claims to Medicare. For information on how to file a claim, please visit our article called ‘Filing a Claim to Railroad Medicare: Using the Railroad Retirement 'Patient's Request for Medicare Payment' (G-740S) Form’ located on our website at www.PalmettoGBA.com/RR/Me. Enter ‘G-740S’ in the Search box located on the top right-hand side of the page, and the results link will take you to this article.
If you have question about your Part B coverage, please call our Beneficiary Contact Center at 800-833-4455, between 8:30 a.m. and 7 p.m. ET Monday through Friday. We also encourage you to visit our Facebook page called 'My RR Medicare' at www.facebook.com/MyRRMedicare.