October 6, 2016
Before you travel for vacation or business, it’s a good idea to know what health-care coverage you’ll be able to get while you’re away from home. Medicare doesn’t generally provide health-care coverage when you travel outside the country, but some Medicare Supplement (Medigap) plans do offer limited coverage for emergency medical care you receive outside the U.S. Coverage within the U.S. depends on the kind of Medicare plan you have.
Medicare coverage while traveling within the U.S.
If you’re enrolled in Original Medicare, Part A and Part B, most of your coverage is the same whether you receive care where you live or anywhere else in the U.S. (including the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa). Whenever practical, check in advance to see if the doctor or hospital where you are traveling accepts Medicare assignment. If so, you will not be billed more than your deductible and coinsurance amount for covered services you receive while away from home.
Medicare Supplement (Medigap) plans help pay for some of your out-of-pocket costs under Original Medicare, including cost-sharing expenses and emergency overseas travel coverage. Plan benefits are standardized across 10 plan types (labeled letters A through N), and each plan includes different benefits and level of coverage. In 47 states, including North Carolina, Medigap plans offer the same standardized benefits for plans of the same letter type.
If you’re enrolled in a Medicare Advantage plan, depending on the plan’s rules, it’s possible that your costs may be higher if you received care outside the plan’s network. Medicare Advantage plans are offered by private insurance companies contracted with Medicare to provide the same coverage as Medicare Part A and Part B (except hospice care, which is covered under Part A). Often Medicare Advantage plans provide additional benefits. Many Medicare Advantage plans pay for emergency care you require while outside the plan’s service area and from health providers who do not participate in the plan’s network; you might still have to pay some costs, such as deductibles and copayments.
If you have any other type of Medicare coverage — such as a stand-alone Medicare Part D Prescription Drug Plan (Medicare Part D) — you may want to contact your plan (contact information should be on your member card) for details about your coverage when traveling.
Medicare coverage outside the U.S.
Most Medicare coverage outside the country is very limited, but several types of Medicare Supplement plans and some Medicare Advantage plans may help pay for health-care services received abroad.
Original Medicare coverage while traveling abroad
If you’re enrolled in Original Medicare, Part A and Part B, your health-care coverage in a foreign country is limited to these special circumstances:
- You’re traveling in the U.S. when you have a medical emergency, and the nearest hospital happens to be outside the country (for example, in Canada).
- You’re traveling through Canada between Alaska and another state “without unreasonable delay,” you have a medical emergency, and the nearest hospital is in Canada.
- You live in the U.S., and the nearest hospital that can treat your medical condition is outside the country (for example, in Canada or Mexico), regardless of whether you have an emergency.
- You’re traveling on a ship in U.S. territorial waters (closer than 6 hours away from a U.S. port), and the ship’s doctor is allowed to provide medical services in your situation.
In some cases, Medicare also provides limited coverage for doctor, ambulance, and hospital services connected with hospitalization in another country.
Medicare Supplement (Medigap) coverage while traveling abroad
Some Medicare Supplement plans cover medical emergencies outside the country. However, plans labeled A, B, K, and L don’t cover these emergencies, and Massachusetts, Minnesota, and Wisconsin plans have separate rules. For more information, see Medicare Insurance Plans by State.
Medicare Supplement plans labeled C, D, E, F, G, H, I, J, M, and N pay for 80% of certain medical emergency care received outside the U.S. after you pay the annual $250 deductible. (Plans E, H, I, and J are no longer sold, but some beneficiaries may still have these plans.) These Medicare Supplement plans may cover medical emergency care outside the U.S. if it starts during the first 60 days of your trip, unless this care is paid for by your other Medicare coverage. Medicare Supplement plans generally have a lifetime limit of $50,000 for emergency coverage outside the country
Medicare Advantage coverage while traveling abroad
If you’re enrolled in a Medicare Advantage plan, specific rules vary according to the plan. Check your plan’s website or call the Customer Service phone number on the back of your card for details.
To see details about Medicare plan options, you can use our no-obligation plan comparison tool . You can also compare plans at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227) (TTY users 1-877-486-2048), 24 hours a day, seven days a week.
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