Does Medicare Cover Out of Country Healthcare?
It’s possible you’ve waited all your life to spend your golden years visiting quaint city cafes in Paris, exploring the glaciers of New Zealand, or crossing the Colosseum off your bucket list.
We realize international travel is more-or-less at a standstill right now, but when it’s safe to leave Illinois, you’ll want to make sure you have adequate healthcare coverage.
Having medical coverage when you’re out of the country is essential, so let’s take a look at what coverage is provided with Original Medicare, Medicare Advantage Plans, Medicare Supplements, the Lasso Healthcare MSA, and travel insurance you might purchase through your travel agent.
Original Medicare coverage includes all 50 states, the District of Columbia, Puerto Rico, the Northern Mariana Islands, Guam, American Samoa, and the U.S. Virgin Islands.
Foreign Travel with Original Medicare
Medicare coverage outside the United States is minimal at best. In most cases, Medicare won’t pay for healthcare or supplies you receive abroad.
The only foreign travel-related coverage you can get from Original Medicare is while you’re on a cruise ship, but there are limitations there as well.
If you’re on a cruise and have a medical problem, Medicare will only help out in a few situations, and it’s only if the doctor is actually licensed to give medical treatment. If the ship is in a U.S. port or is less than six hours away from a U.S. port, you may get coverage.
Aside from cruise travel, Medicare has strict restrictions when it comes to healthcare coverage outside the United States. If you’re in a foreign hospital, Medicare will only offer coverage under three circumstances.
- You’re in the U.S. when you have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital that can treat your illness or injury.
- You’re traveling through Canada 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 your illness or injury. You must be traveling through Canada and not staying for any other reason; then Medicare will determine if you qualify on a case-by-case basis.
- 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 it’s an emergency.
As you can tell, nothing is set in stone when it comes to Medicare coverage out of our country.
In sum, Medicare will only step in to help – maybe – if the out-of-country hospital is closer than the nearest U.S. hospital.
What services might Medicare pay for in these circumstances?
If you’ve been admitted to a foreign hospital for emergency care, here’s what you can expect Medicare to cover:
- Medicare Part A covers inpatient hospital care after you’ve been admitted to a foreign hospital.
- Medicare Part B covers emergency and non-emergency ambulance and doctor services you may have received immediately before being admitted for a foreign hospital stay.
If Medicare Part A doesn’t cover your hospital stay, then Part B probably won’t cover any costs either. Medicare also won’t pay for any services you might receive after your covered stay is over, like follow-up visits or an ambulance ride home.
Two important things you should know:
- Medicare drug plans don’t cover any medications you purchase outside of the United States.
- Foreign hospitals and doctors aren’t required to submit Medicare claims for you, although some will. If they don’t file your Medicare claims, you’ll have to pay for treatment upfront and file your paperwork to be reimbursed.
Foreign Travel with Medicare Advantage Plans
Medicare Advantage (MA) Plans, previously known as Medicare Part C, are considered an all-in-one alternative to Original Medicare. MA plans are offered by private companies like BlueCross BlueShield and Cigna.
These plans are approved by Medicare and must include Medicare Part A and Medicare Part B benefits. Oftentimes, they include drug coverage.
MA Plans also provide other benefits that might include foreign travel coverage. Since these plans are sold by private companies, each one offers something a little different.
The initial coverage for medical attention received outside the U.S. is the same that’s offered through Original Medicare – pretty limited. If you know you'll be traveling internationally, it's worth shopping around.
However, you should know the current MA plans available in Macon county don’t offer foreign travel coverage.
Medical Medicare Savings Accounts (MSAs)
Lasso Healthcare offers a Medicare MSA, a unique type of Medicare Advantage Plan. It’s a $0 premium, high deductible insurance plan that has a special deposit you can use for qualified medical expenses. There’s no networks, so it frees you up to see any doctor that accepts Medicare.
An MSA is a unique way to grow your medical savings account, because any funds you don’t use roll over to the next year. Then, those accumulated funds can be used to cover significant expenses you might encounter in the future.
The potential to grow your medical savings account is what sets an MSA apart from all of your other healthcare choices.
Even though this is an excellent MA Plan, it doesn’t offer extra foreign travel coverage, but it’s still worth checking out for the other great benefits it has to offer.
Note: you can’t buy Medigap insurance if you have an MA Plan.
Further reading: Medical Medicare Savings Account (MSA) in Decatur, IL
Foreign Travel with Medicare Supplement Plans
Medicare Supplement Insurance, or Medigap, is additional insurance that helps fill in the gaps that aren’t covered by Original Medicare, like copayments, coinsurance, and deductibles.
You must have Medicare Parts A and B to purchase a Medigap policy. The premium for a Medigap policy is separate from the Medicare Part B premium, but it’s guaranteed renewable as long as you pay it each month.
In other words, your Medigap Plan can’t be canceled as long as you make your payments on time.
Some Medigap plans have foreign travel coverage, and others offer nothing.
No Foreign Travel Coverage
Plans A, B, K, and L don’t offer foreign medical coverage. We don’t typically sell any of these plans, because they don’t offer as much coverage as we’d like.
Some Foreign Travel Coverage
Plans C, D, E, F, G, H, I, M, and N do offer some coverage if you travel out of the United States, but there’s a deductible, coinsurance, and a lifetime limit.
- The emergency must start within the first 60 days of travel
- $250 deductible
- After you meet the deductible, your plan pays 80%, and you pay 20%
- $50,000-lifetime limit
Note: you can’t purchase Plans E, H, I, and J any longer, but if you bought one of these plans before June 1, 2010, it’s still valid..
Also, as of January 1, 2020, Plan F is no longer available. If you already had it before this date, you can continue to keep it as long as you make your premiums on time.
Medigap’s Plan G is a nice alternative to Plan F because it offers almost all of the same benefits.
Foreign Travel with Alternative Insurance
While some Medigap plans do offer some foreign travel coverage, you might look into additional travel insurance.
Cruzely says the cost of insurance for a 65-year-old-traveler on a $5,000 cruise would run about $300-$600 dollars, or approximately 3%-13% of the cruise cost. This is based on your age and the amount of coverage you choose.
On the other hand, if you cruise several times a year, the costs of travel insurance could add up. It might be more economical to choose a Medigap Plan that will give you the coverage you need for any trip you take.
Keep in mind that Medigap Plans have more to offer than just foreign travel coverage. If one of the plans you like best will cover out-of-country emergencies then, hey, you’re in luck!
Making an educated decision can save you money, especially if you ever need to use the coverage.
Related reading: Medicare Costs for 2020
Whether you’re cruising to the Mediterranean with your family, vacationing in Italy for months at a time, or anything in between, knowing your emergency medical needs are covered will bring you peace of mind.
Original Medicare doesn’t have much to offer in the way of emergency medical coverage while traveling abroad, but the good news is you do have other options.
Planning is key to foreign travel, and your insurance coverage is no exception.
Before traveling abroad, be sure you are happy with your Medigap coverage. If you don’t have a Medigap Plan or want extra protection, ask your travel agent for travel insurance.
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