Medicare usually doesn’t cover health care while you’re traveling outside the U.S. Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands are considered part of the U.S. There are some exceptions, including some cases where Medicare Part B (Medical Insurance) may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S.
Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis you get in a foreign country in these rare cases:
- You’re in the U.S. when a medical emergency occurs that requires immediate medical attention to prevent a disability or death, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
- You’re traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
- You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.
In some cases, Medicare may cover medically necessary health care services you get on board a ship within the territorial waters adjoining the land areas of the U.S. Medicare won’t pay for health care services you get when a ship is more than 6 hours away from a U.S. port.
Medicare drug plans don’t cover prescription drugs you buy outside the U.S.
Medicare supplement insurance (Medigap) policies may cover you when you travel outside the U.S.
Your costs in Original Medicare You pay 100% of the costs, in most cases. In the situations described above, you pay 20% of the Medicare-approved amount, and the Part B deductible applies.
In the situations above, Medicare pays only for services covered under Original Medicare:
- Medicare Part A (Hospital Insurance) covers hospital care (care you get when you’ve been formally admitted with a doctor’s order to the foreign hospital as an inpatient).
- Medicare Part B– ( Medical Coverage) covers emergency and non-emergency ambulance and doctor services you get immediately before and during your covered foreign inpatient hospital stay. Medicare generally won’t pay for services (like return ambulance trips home) in either of these cases:
- Medicare didn’t cover your hospital stay.
- You got ambulance and doctor services outside the hospital after your covered hospital stay ended.
- You pay the part of the charge you would normally pay for covered services. This includes any medically necessary doctor and ambulance services you get in a foreign country as part of a covered inpatient hospital stay. You also pay the coinsurance , copayments, and deductibles you’d normally pay if you got these same services or supplies inside the U.S.
- Medicare Supplements– Some plans will give you a $50,000 lifetime benefit for international travel.