Will Medicare cover travel outside the USA?
When people are nearing retirement, they usually have big plans for them in store! According to Wealth Management, 63% of Americans that are aged 50+ say that traveling is an important retirement goal. What some retirees do not know is that their Medicare coverage will not travel with them. In most situations, Medicare will not pay for any health care services or supplies that you receive outside of the United States. With that said, that means that Medicare will still be effective anywhere within the 50 states of America, Puerto Rice, the District of Columbia, Guam, the U.S. Virgin Islands, Northern Mariana Islands, and American Samoa.
Some particular circumstances can take place in order for Medicare to cover your healthcare outside of the United States. Although, it will depend on which Medicare plan that you are currently enrolled in. Original Medicare, Medigap, and Medicare Advantage plans all have different rules. So, will Medicare cover travel outside the USA? Let’s find out!
When hearing the term “Original Medicare,” that is referring to the parts that America’s federal government offers its citizens that turn the age of 65. With that said, Original Medicare is an American healthcare system. Therefore, other countries do not have to accept Medicare if they do not want to.
When you are outside of the United States, it will be situational for Medicare to cover you. Those situations are:
You are in the United States and there is a medical emergency and a foreign hospital is closer to you than an American hospital. (For example, You live in Washington and a Canadian hospital is closer to you than one in your state.)
You are traveling through Canada to get to Alaska, and an emergency occurs and you have to stop at a Canadian hospital to treat your injury or illness. If there is not an “unreasonable delay,” then Medicare may cover your service.
You live in the United States and a hospital in a different country is closer to your home than a United States hospital, and they can treat your medical condition (it does not have to be an emergency.)
It is widely known that people travel to another country to receive a cheaper surgery or prescription. Original Medicare does not cover any cosmetics or prescriptions, so it is not recommended to travel to another country seeking a specific surgery or particular drug unless you want to pay the full price of the service.
Also, remember that Medicare only pays its share of services that fall under Part A and Part B. If you receive any health care services outside of the United States, you will still have your share that you will still need to cover.
If you are enrolled in a Medigap plan, then your carrier may offer additional coverage for healthcare services and supplies that you receive outside the United States. Medigap Plans C, D, F, G, M, and N offer emergency care outside of the United States. These Medigap plans will only cover your service in a foreign country if the service is performed within the first 60 days of your travel. Also, keep in mind that another country does not have to accept your Medigap plan. Luckily, Medigap’s foreign travel emergency coverage has a lifetime limit of $50,000.
Before you travel to another country, look over your summary of benefits or speak with your insurance agent to get more information about your Medigap coverage outside of the United States.
Medicare Advantage has service areas, which means you might even have some difficulty receiving services in your own state. With that said, Medicare Advantage plans may or may not cover your medical care outside of its service area. Medicare Advantage plans do not always have to offer or cover medical services while traveling outside of the United States. It will all come down to the kind of plan that you are enrolled in and how long you have been traveling for. If you travel outside your service area for more than six months, you will automatically be disenrolled from your plan. You will then be transferred over to Original Medicare.
If you receive any medically necessary service outside America, it is recommended that you hold on to any documents, bills, or receipts from your service. If a healthcare provider in a different country does not want to bill your Medicare Advantage plan, you can submit the documents to your Medicare Advantage company for possible reimbursement when you return to your service area.
With Medicare having limited coverage outside of the United States, you will see that some retirees purchase travel insurance. Although travel insurance is not the same type of coverage as Medicare, some seniors feel more secure knowing that they have that extra coverage in case of an emergency. Contact your insurance agent before you travel outside of the country so that you can be knowledgeable about your coverage while traveling before you take off!