In most cases, your Medicare insurance plan does not cover you during any travel time outside the United States. In this instance, the definition of “United States” is anywhere outside of the U.S., District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
Medicare Part A and Part B Travel Coverage Exceptions
During international travel, three exceptions may occur, causing your Medicare insurance coverage to make an exception and provide you with coverage.
- You may be located in the U.S. when a medical emergency occurs, but the foreign hospital is closer than the hospital located in the United States.
- You are traveling through Canada without unreasonable delay by the quickest route directly between Alaska and a different state when a medical issue happens. The hospital located in Canada is closer than the hospital located in the U.S. to treat your illness.
- You reside within the United States, but the foreign hospital is closer to your home than the hospital located in the U.S that can treat your illness effectively, even if it is not an emergency.
It is important to remember that Medicare will only provide coverage for the Medicare-approved services provided in the foreign hospital.
Health Services Covered By Medicare Travel Exceptions
Medicare Part A provides coverage for the following service:
Inpatient hospital care. If you are an inpatient, you have been formally admitted into the hospital due to orders directly from the physician. You are considered an outpatient if you receive emergency or observation services, lab tests, or X-rays without formal inpatient admission. This still applies even if you stayed in the hospital overnight but were not ever formally admitted. To understand more about inpatient status vs. outpatient status, consult your 2021 Medicare handbook online at https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf.
Medicare Part B provides coverage for the following services:
- Emergency ambulance services
- Doctor services
*These are covered if you receive them immediately and before your admitted Medicare-covered hospital stay.
If Medicare does not cover your hospital stay, they generally will not provide coverage for either of these services. They will not cover these services once your Medicare-covered foreign hospital stay ends. Be sure to remember that Medicare will only provide coverage for Medicare-approved services, which means Medicare Part A will only cover inpatient hospital care.
What Else Does Medicare Not Cover or Cover When I Travel Internationally?
When you are in the United States and are receiving dialysis treatments, Medicare will cover those treatments. If you receive dialysis treatment in a foreign country, Medicare will not cover this service for you. Your Medicare Part D prescription drug plan is also ineffective when traveling internationally as well.
Suppose you are traveling on a cruise ship internationally. In that case, Medicare may allow some coverage exceptions due to the circumstances of the situation. Medicare may cover the following services provided to you that are deemed “medically necessary”:
- Under certain laws, the physician is allowed to provide medical services to individuals on the cruise ship.
- The ship is located in a U.S. Port or is six hours or less from the U.S. Port when you receive the medical services, regardless of the emergency.
*If the ship is more than six hours away from the United States Port, the services that you receive will not be covered by Medicare.
Medicare makes exceptions by providing certain approved services during foreign travel, but it’s vital that you understand what these exceptions are and what you may receive coverage for. To learn more about Medicare coverage during your travels, give Medicare With Jake a call today!
