Many seniors want to plan a trip abroad but aren’t sure if Medicare will pay for healthcare services outside the country. In most situations, Medicare does not usually pay for health care abroad unless you are in a U.S. territory like Puerto Rico or the U.S. Virgin Islands. In many cases, Medicare does not cover costs “outside of the U.S.” With that said, there are some exceptions you could run across where Medicare will pay for your hospital fees abroad. Keep reading to find out these exceptions and how they could work for you.
When Does Medicare Cover Hospital Fees Abroad?
Medicare may pay for hospital fees abroad in three situations.
- If a health emergency occurs in the U.S., but the closest hospital is in another country.
- If you are traveling the route between Alaska and the U.S. and are in Canada, an emergency occurs.
- If you are in the U.S. and a hospital in another country is closer to treat you than a U.S. hospital.
If any of the above situations happen, Medicare will only pay for Medicare-approved services. As you have read, there is not a lot of wiggle room with those situations. For example, suppose you are traveling in Costa Rica and visit a foreign hospital there. That situation does not fall under the three cases where hospital fees could be covered.
What Kind of Service is Included in Those 3 Situations?
Medicare Parts A and B cover different services. So which kind of services are included in the three situations listed above? Part A will cover inpatient hospital care. Part A covers the care you receive when you’re formally admitted into a foreign hospital with a doctor’s order as an inpatient.
Medicare Part B may cover an emergency ambulance when you are traveling abroad. However, if you have a foreign hospital stay, it won’t cover ambulance trips to your home or any doctor services after being discharged from the hospital.
What Would I Have to Pay for Medicare-covered Services Abroad?
Besides the three listed situations above where Medicare will pay for hospital fees abroad, Medicare will not pay for health care you get outside of the U.S. You would pay the total price to the health care provider where you received service when traveling abroad.
Another thing to note is that U.S. hospitals will submit claims to Medicare on your behalf; foreign hospitals will not.
What About My Medicare Supplement Insurance Policy?
If you have a Medigap policy, otherwise known as a Medicare Supplement insurance policy, your policy may offer additional coverage abroad. Medigap Plans C, D, F, G, M, and N provide you with foreign travel emergency health care coverage when you travel abroad.
The plans listed will pay 80% of billed charges for emergency care after you meet a $250 annual deductible. The Medigap plans listed above will pay for foreign travel emergency care if it begins during the first 60 days of your trip. Medigap policies have a lifetime limit of $50,000 when traveling abroad.
Medicare does not usually pay for healthcare abroad unless you find yourself in one of the three emergencies above. If you have a Medigap policy and have plans C, D, F, G, M, or N, those plans will provide you with a lifetime limit of $50,000 while traveling abroad and pay 80% of billed charges for emergency care.
Medicare can be tricky, do your research before you travel to make sure you will be covered if something happens. You can even buy a travel insurance policy to get more coverage. Safe travels!