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In nearly all cases, Original Medicare will not cover medical services received outside of the United States and its territories. Even in the event of an emergency, it is unlikely that Medicare Parts A or B will cover services or offer reimbursement. Some Medicare Advantage (MA) plans may include a form of travel insurance. In many cases, this coverage may apply only to medical emergencies.
Under certain circumstances, Original Medicare may cover some emergency medical expenses incurred abroad. For example, you may be covered for care you receive in Canada if the emergency occurred while you were in the process of driving the most direct route possible between Alaska and another state. Medical emergencies that occur on cruise ships in U.S. territorial waters (within 6 hours of arrival or departure from a U.S. port) may qualify as well.
The Centers for Medicare and Medicaid Services (CMS) makes no guarantees about this coverage and reminds beneficiaries that only Medicare-approved expenses are covered. Even in these instances, beneficiaries are responsible for their Part B deductible and, once the deductible is met, pay 20% of the Medicare-approved fee for services.
Traveling Within the United States
Anyone with Original Medicare is covered nationwide, regardless of their state of residence. For Original Medicare, the network of providers includes every provider in the country who accepts Medicare. In most cases, the beneficiary is responsible for paying 20% of the total Medicare-approved amount for emergency services after the deductible is met.
MA plans typically require their policyholders to stay within a network of local healthcare providers. A network is the geographic region for which your plan provides coverage, as well as the providers within the region. While policyholders may incur additional costs for routine care received outside of their plan’s network, they will not pay more for emergency care. MA plans are required to cover emergency care, whether or not that care is received within the plan’s provider network.
Original Medicare beneficiaries who reside in multiple locations throughout the year do not need to update their plans to accommodate their travels, as long as doctors in both regions accept Medicare. They will be asked to select one location as their primary residence. A primary residence is where an individual votes and pays taxes.
Beneficiaries with second homes outside of the United States are only covered while residing in the U.S.
Americans who are moving abroad can contact Medicare directly to suspend their coverage (1-800-633-4227). Those who neglect to suspend their Medicare coverage will continue paying their plan’s monthly premium even while going uncovered. For more information on how moving abroad will affect your coverage in both the short and long term, take a look at this page.