Does Medicare Cover International Travel?

Kat Casna
Licensed Insurance Agent and Medicare Expert Writer
July 09, 2020

Travel is by far Americans' No. 1 retirement dream,1 and many of those who chase that dream end up crossing oceans and visiting other countries. If you're one of those people who wants to spend your later years traveling the globe, know this: Medicare might not cover you while you're away from home.

Original Medicare alone typically won't cover you while traveling abroad. Fortunately, you may be able to receive some coverage through Medigap or Medicare Advantage. And if you qualify for Medicare through the Railroad Retirement Board (RRB), you may have bonus international coverage in Canada.

Traveling internationally with Original Medicare

Made up of Part A (hospital insurance) and Part B (medical insurance), Original Medicare is the backbone of most retirees’  health-care coverage. But, for the most part, it doesn’t cover you unless both your feet are firmly planted on US soil. The good news is that US soil includes popular destination territories such as Puerto Rico, the Northern Mariana Islands, Guam, American Samoa, and the US Virgin Islands.

There are a few exceptions. You could receive coverage in the following situations:

  • You live in (or are visiting) a border town in the US, but the closest hospital is in another country.
  • You need emergency dialysis (not routine dialysis).
  • You’re on a cruise ship within six hours of a US port with a US-approved doctor.
  • You’re traveling to or from Alaska via Canada, and an emergency occurs. To receive coverage, you must be on a direct route and travel without delay. (Basically, an extended road trip to see the beauty of the Canadian wilderness probably won’t qualify, but driving from Seattle directly to Juneau to see your grandchild likely would.)

If you receive coverage in one of these situations, be prepared to file your own insurance claims. Foreign hospitals aren’t required to file Medicare claims for you like US hospitals are.

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Traveling internationally with RRB Medicare

If you were a railroad worker and qualified for Medicare through the Railroad Retirement Board, your benefits are slightly different from those most Medicare recipients have. In addition to the situations above, you could also receive some coverage while living in Canada with RRB Medicare.

This coverage is through Part A only, not Part B—which is to say you’re covered for hospital stays, but not doctors appointments; hospice, but not lab work. Learn more about Part A vs. Part B to better understand what your coverage limitations will be.

Traveling internationally with Part D

Part D prescription drug coverage is an optional plan you can add to Original Medicare. However, this coverage doesn’t add any benefits while traveling internationally. If you need prescriptions while outside the US, you’ll have to pay for them out of pocket unless you have travel health insurance that covers prescription drugs.

Traveling internationally with Medigap

If you have Original Medicare and you plan to travel abroad regularly, consider adding a Medigap (Medicare Supplement) plan to your coverage. You could have foreign travel coverage for emergencies.

There are 10 Medigap plans available, but not all of them cover international travel. Plans C, D, F, G, M, and N cover 80% of these expenses. If you already have Plan E, H, I, or J (they no longer accept new enrollees), you could receive coverage while traveling internationally. 

Other Medigap plans (A, B, and K, L) won't add any international coverage to Original Medicare.

All services must be medically necessary, and you may need to meet any applicable Medicare deductibles first (although most Medigap plans also cover the Part A deductible). Because this coverage applies only to emergency care, it's not for things like medical equipment or preventative care.

Medigap coverage may not be the most reliable health insurance option for long-term travelers. For one thing, you must begin care within 60 days of leaving the US. After that, you're on your own. Also, this coverage has a maximum lifetime benefit of just $50,000. If you plan to circumnavigate the globe or live abroad, you may need to look elsewhere for coverage, such as travel health insurance.

Traveling internationally with Medicare Advantage

Medicare Advantage is an optional plan that allows enrollees to receive their Medicare benefits in a way that's more like employer-sponsored coverage. Advantage plans cover everything Original Medicare covers (including international coverage under the rare circumstances mentioned above). But Medicare Advantage plans can also include extras such as prescription drugs, vision, dental, hearing, and fitness. 

Some Medicare Advantage plans cover enrollees while traveling internationally in more situations than Original Medicare will. Each policy varies, so contact your insurance company to learn more. If your plan won’t cover much travel or you don’t have Medicare Advantage, speak with a licensed Medicare agent to go over your options.

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Living abroad with Medicare

Medicare doesn't cover routine health care abroad. It includes emergency care in some situations, but there are typically too many limitations to entirely depend on in every situation. Instead, it's usually best to secure health insurance where you’ll be living. However, if your plans include being nomad (not staying put in any one country), you could rely on travel health insurance.

Either way, there’s one pitfall you should watch out for: Medicare late-enrollment penalties (LEPs). If you delay enrolling in Medicare Part B or Part D without having creditable coverage, you’ll rack up LEPs that will increase your premiums if you decide to enroll later. 

To be creditable, your insurance must be as good or better than Medicare, and most international plans fall short of this goalpost in the eyes of the Medicare program. That leaves you with the choice of enrolling in coverage you can’t use or risking exorbitant health costs later—neither of which is appealing.

A second Medicare rule makes LEPs particularly troublesome: you can’t enroll in Parts B or D if you don’t have a permanent address in the US. Even if you wanted to purchase this coverage solely to avoid penalties later, you might struggle to get it.

The Bottom Line: Medicare has limited coverage outside the US

Even though most people who have Medicare are past retirement age, Medicare doesn’t do a great job of covering Americans during one of their favorite retirement pastimes: traveling internationally. You could receive some coverage in emergencies, but you may need to purchase a Medigap or Medicare Advantage plan to do so. Even then, you’re limited to $50,000 of lifetime coverage.

Living abroad is even more complicated. You can’t get Medicare coverage for routine health care, and you could rack up late-enrollment penalties if you don’t enroll in Parts B and D when you’re first eligible for them. But you can’t purchase this coverage without a US address. What a pickle!

Medicare wasn't made to cover Americans while traveling internationally. But if you want to get the most from the international coverage Medicare does provide, speak with a licensed Medicare agent.


Sources:

1. Transamerica Center, “18th Annual Transamerica Retirement Survey of Workers

Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency (collectively "Medicare System Providers"). Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.

Kat Casna
Written by
Kat Casna
Kathryn is a Medicare and geriatric specialist who has appeared on Baby Boomers, OppLoans, and Best Company. Her readers don’t need a degree in government-speak to get the right coverage because Kathryn sifts through Medicare’s parts, plans, and premiums to distill only the most useful information. Her favorite place in the world is a hammock that swings peacefully between two crabapple trees somewhere in New Mexico’s Gila National Forest.
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