Medicare

International Medicare and Medigap Coverage

When you’re planning a trip outside the U.S., take a close look at your health insurance coverage. International Medicare coverage may not be available, though some Medigap and Medicare Advantage plans may offer limited coverage. Learn how Medicare overage works when you’re overseas or outside the country.

International Medicare and Medigap Coverage

Travel is a popular pastime for older adults. In 2022, 67% of people 50 and older planned to take at least one trip; out of this 67%, there was an average of 4 planned trips per person. Whether you’re planning a road trip in your RV, a cruise through the Caribbean, or a once-in-a-lifetime trek through Europe or Asia, don’t forget to consider your health coverage.

Unexpected injuries or illnesses can happen on vacation, just like at home. However, when you’re traveling out of state or out of the country, your health insurance may not travel with you. Medicare beneficiaries in particular may be disappointed to learn that their coverage generally doesn’t work outside the United States.

Learn how Original Medicare coverage functions when you’re traveling within the U.S. or internationally, as well as the international Medicare coverage that may be available through Medigap or Medicare Advantage for those who want to bring health coverage overseas.

Will Medicare Cover You When You Are Traveling Within the U.S.?

Original Medicare works throughout the United States, including all 50 states and Washington, D.C. Coverage also extends to some U.S. territories, such as Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands, and the Northern Mariana Islands.

People with Original Medicare (Parts A and B) can get care from any healthcare provider or healthcare facility in the U.S. that accepts Medicare. Medicare-covered services are the same whether you’re at home or traveling in another state. For example, if you plan to spend the winter in a warmer state, you could use Original Medicare for routine, urgent, and emergency care — just like you could in your home state.

Medicare Advantage plans, a private alternative to Original Medicare, may have different rules. Insurers may limit coverage to a network of doctors and providers in the plan’s service area unless you need emergency care. Plan members who travel within the U.S. but outside their plan’s service area might not have coverage for non-emergency care at their destination. Check your plan’s summary of benefits to learn how it covers out-of-network care before traveling.

Will Medicare Cover You When You Are Traveling Internationally?

Original Medicare doesn’t generally pay for healthcare services outside the U.S., but there are a few exceptions. People with Medicare could get coverage for emergency health services outside the U.S. through a Medicare Supplement (Medigap) or Medicare Advantage plan.

Do You Have Medicare Part A Coverage Overseas?

Medicare Part A doesn’t generally cover care outside the U.S., but it may cover inpatient care in a foreign hospital in special circumstances. Overall, Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and home healthcare.

There are three situations where Medicare may pay for foreign hospital care:

  1. You have a medical emergency in the U.S., but the closest hospital is in another country. Travelers who experience a medical emergency in the U.S. could receive Medicare-covered care in a foreign hospital if it’s the nearest hospital that can manage the situation. For example, Medicare may cover inpatient care in a Canadian or Mexican hospital if you have an emergency while traveling near the border.
  2. You have a medical emergency while traveling between Alaska and another U.S. state. In some cases, Medicare may pay for care in a Canadian hospital if it’s closer than the nearest U.S. hospital that could handle your emergency. However, travelers must be on a direct route to their U.S.-based destination when the emergency occurs for coverage. For example, Medicare may not cover your stay in a Canadian hospital if you were traveling from North Dakota to Alaska but planned to tour through Quebec first.
  3. You need hospital care, but the closest hospital to your home is in a foreign country. This exception isn’t limited to emergencies and could apply if you live near the U.S.-Canada or U.S.-Mexico borders.

Do You Have Medicare Part B Coverage Overseas?

Medicare Part B covers medically necessary and preventive outpatient services. Like Part A, it doesn’t generally work outside the U.S., except for the three situations previously highlighted.

In the limited circumstances when Original Medicare covers care in a foreign hospital, Part B may cover the following services immediately before and during the hospital stay:

After a covered stay in a foreign hospital ends, Part B typically doesn’t pay for outpatient services in the foreign country. For example, it doesn’t cover the follow-up services a patient might need once discharged, such as the ambulance ride to return to the United States.

Do You Have Medicare Part C (Medicare Advantage) Coverage Overseas?

Medicare Advantage plans, also known as Part C, may offer worldwide emergency and urgent care coverage as a supplemental benefit. Some plans extend this coverage to include worldwide ambulance services.

Medicare Advantage is an alternative to Original Medicare sold by private insurance companies. These plans are required to cover the same medically necessary services as Original Medicare, and many also offer additional benefits, such as Medicare coverage overseas. These travel benefits could be included as part of the plan’s standard coverage or offered to members for an additional cost.

Before traveling, check your plan’s summary of benefits and coverage for details about limitations and restrictions, such as:

  • Lifetime maximums: Some Medicare Advantage plans may limit worldwide coverage to a set dollar value, such as $50,000.
  • Coverage exclusions: Medicare Advantage plans may exclude some services from out-of-network coverage, such as dental care.
  • Residence requirements: Medicare Advantage plans are generally required to disenroll members who have lived outside the plan’s service area for at least 6 months. Keep this in mind if you intend to long term.

Do You Have Medicare Part D Coverage Overseas?

Like Original Medicare, Part D does not offer international Medicare coverage. Part D is optional prescription drug coverage offered by private insurance companies regulated by Medicare. It’s available as stand-alone plans for people with Original Medicare, or bundled into Medicare Advantage plans. 

Part D drug plans don’t cover prescription drugs obtained outside of the United States because only FDA-approved drugs are covered, and drugs available in foreign countries are generally considered unapproved. Before leaving the U.S., consider refilling your prescriptions to ensure you have adequate medication supplies on your trip.

Will Medigap (Medicare Supplement) Cover You When Traveling Within the U.S.?

Medigap, also known as Medicare Supplement, can get care from any doctor or hospital in the U.S. that accepts Medicare. Medigap is an optional plan for Original Medicare beneficiaries. It helps pay for out-of-pocket costs in Original Medicare, such as deductibles and coinsurance. There are 10 federally standardized Medigap plans available: Plans A, B, C, D, F, G, K, L, M, and N. Residents of Wisconsin, Minnesota, and Massachusetts have different options.

Since these plans are designed to supplement Original Medicare, they use the same nationwide network and apply to any situation where Medicare is accepted overseas.

Those with Medicare Select plans may not have coverage for out-of-pocket Medicare costs when they leave their local area, except in emergencies. Medicare Select limits beneficiaries to in-network healthcare providers, even though Original Medicare is accepted nationwide.

Will Medigap (Medicare Supplement) Cover You When Traveling Internationally?

While Original Medicare generally doesn’t cover care you receive outside the U.S., some Medigap policies add international Medicare coverage to their benefits. Plans that include the Medicare Supplement foreign travel benefit may help pay for out-of-country emergency care.

Medigap Plans C, D, F, G, M, and N cover 80% of medically necessary emergency medical expenses in a foreign country. This coverage extends to the policy’s limit after paying a $250 deductible. Note that Plans C and F are only available to those who became eligible for Medicare before Jan. 1, 2020.

Before leaving for an international trip, there are some Medicare Supplement foreign travel conditions and restrictions to be aware of:

  • Time restrictions: Medigap plans cover foreign emergency care if the medical emergency starts within 60 days of leaving the United States. Travelers are responsible for the costs of medical emergencies that occur later than 60 days into a trip.
  • Care exclusions: The foreign travel benefit is limited to medically necessary emergency care services and supplies. For example, it will not cover cosmetic surgery received abroad.
  • Lifetime limits: The Medicare Supplement foreign travel benefit has a lifetime limit of $50,000. Travelers are responsible for all costs beyond this limit.

Will Medicare Cover You When You’re On a Cruise?

Original Medicare may cover healthcare services you need on a domestic cruise, while Medigap or Medicare Advantage plans may cover care on a cruise ship outside of U.S. waters. 

Cruise vacations are popular among older adults. In 2021, nearly one-third of cruise passengers were 60 or older. Domestic cruises don’t leave U.S. waters, like a Great Lakes or Mississippi River cruise. International waters begin 24 miles from shore, so cruises to Alaska may not be covered.

Original Medicare offers limited coverage for cruises to international destinations. It may cover medically necessary care when the cruise ship is within U.S. waters, meaning it’s within 6 hours of a U.S. port. 

Some Medigap plans include a foreign emergency travel benefit, and some Medicare Advantage plans cover worldwide emergency and urgent care services. Both types of policies may cover care in a cruise ship’s medical center, even when you’re outside of U.S. waters. Before going on an international cruise, check your policy to determine if you have Medicare coverage overseas.

Other Options for Foreign Travel Coverage

People with Original Medicare may consider purchasing travel insurance before leaving the United States. Travel insurance could be a traveler’s sole source of overseas medical coverage or a supplement for their Medigap plan’s foreign travel benefit.

Travel insurance policies are separate from your Medicare coverage. You can buy a policy directly from the company that sells it or through an insurance agent. Policies vary, but they typically combine three types of trip-related coverage:

  1. Travel medical insurance: This coverage helps pay for unexpected illnesses or injuries during an international vacation. Some plans include medical evacuation coverage to help travelers return to the U.S. for care.
  2. 24-hour assistance: Navigating care options in a foreign country can be challenging, especially if there’s a language barrier. Insurers may offer a 24-hour helpline where travelers can get help finding doctors and hospitals.
  3. Reimbursement for travel mishaps: This coverage can help pay for situations like canceled flights or lost baggage, as well as delays relating to an unexpected health event.

The cost of a travel insurance policy could vary depending on the traveler’s age and destination. However, it generally costs 4% to 8% of the overall trip cost. That means for a trip that costs $2,000, travel insurance might cost between $80 and $160.

Before traveling outside the U.S., consider talking to an insurance agent about your Medicare coverage overseas. They can provide more information about your current coverage and, if necessary, help you find supplemental coverage for your travel needs.