For Medicare beneficiaries who are traveling outside of the United States, it is important to know what medical and hospital benefits may be covered in case of any emergencies.
Original Medicare (Part A and Part B) offers limited coverage outside of the United States. In a majority of situations, it will not cover any health care supplies or services received beyond the United States borders, meaning outside of the 50 states, the District of Columbia, the U.S. Virgin Islands, Guam, Puerto Rico, and American Samoa. However, Original Medicare may cover care in a foreign hospital in certain emergency and non-emergency situations.
Instances of Medicare Coverage Outside of the U.S.
There are three situations in which Medicare will cover services administered outside of the country, which include:
- If you are traveling through Canada on the most direct route between Alaska and another state without unreasonable delay when a medical emergency occurs and a Canadian hospital closer than the nearest United States hospital
- If you are in the United States and you have a medical emergency, but a foreign hospital is closer than the nearest U.S. hospital
- If you live in the United States, but the foreign hospital is closer to your home than the nearest U.S. hospital, regardless of whether it is a medical emergency
What does Medicare cover under these circumstances?
Medicare Part A, also known as hospital insurance, can cover inpatient hospital care when approved outside of the United States. To be considered an inpatient, a beneficiary must be formally admitted to a foreign hospital per a doctor’s order. If you are confused about your status as a patient, you may want to ask your doctor before moving forward with care.
Medicare will also cover emergency and non-emergency ambulance and doctor’s services that you receive before being admitted to inpatient care and during your hospital stay. However, if you are not admitted to inpatient care, then Medicare generally will not cover these services.
Additionally, Medicare does not cover dialysis unless it is an emergency, and Medicare drug plans do not cover the costs of prescription medications outside of the United States.
To hear more about Medicare coverage outside of the United States, watch the video below:
Medicare has neither reviewed nor endorsed this information.