It is widely known that the United States spends more money per person on healthcare than any other developed nation in the world. If you are living in a country which has socialized medicine, the cost of medical treatments, office visits, etc. are typically much lower than in the U.S. Generally, speaking to cost only and not quality or ease of care, you will see the costs of healthcare in developed nations to be at least 50% lower than what you might pay in the U.S. Am I covered for Travel Under Medicare?
Original Medicare is a national plan. The Medicare coverage is the same no matter what U.S. state you are visiting. With Medicare, you can travel domestically and still be covered under the same, identical Medicare coverage that you have when you are at home.
Medigap plans “follow” Medicare. In other words, anywhere that takes Medicare will also take your Medigap plan. This, obviously, includes any doctor, hospital, facility in the United States that takes Medicare. Medigap plans provide additional coverage for the gaps that your existing Original Medicare does not cover. So, when traveling domestically, your Medigap plan will continue to supplement the costs of your care.
Medicare Advantage plans are based on geographical areas. The plans you are eligible for depend upon where you reside and in which county you live. Please be aware that if you have been outside of your service area for 6 months or longer, your Medicare Advantage plan provider may automatically disenroll you.
While original Medicare covers you without interruption within the United States and its territories, including Guam and the U.S. Virgin Islands, there is no coverage for any healthcare costs outside of the United States or any of its territories. You will be responsible for all the costs. Once you cross the border, you can say goodbye to your health coverage. The good news though, is that there are a few exceptions to this:
For all the above exceptions, the total costs of your hospital stay will be covered. In addition, your emergency room visit will also be covered if you are not admitted to the hospital. Please note, your medical transportation or follow up care will not be covered until you return to the United States.
Medigap plans C, D, F, G, M, and N, will provide coverage for foreign travel emergency health care when you travel outside the U.S. (or its territories). Although plans E, H, I, and J are no longer available, if you bought one of these plans prior to June 1, 2010, you have had the opportunity to keep it. If you are still on one of the discontinued plans, they also provide for foreign travel emergency health care coverage. The following provisions are included in this benefit:
Medicare Advantage plans do not function like Medigap plans. Part C plans work differently. Each plan can decide which benefits to offer and that pertains also to foreign travel. To find out what the foreign travel coverage benefits are, you will have to ask your plan provider. Some plans cover travel emergencies and some do not. Part C plans also may not cover you in every country.
If you plan to travel outside of the U.S. for an extended period, there are long-term options for foreign health insurance, which is called “expatriate insurance”. Benefits may differ for each country.
The best advice you can have prior to travel abroad or within the U.S. and its territories, is to be prepared. Ask your plan provider or Medigap insurance company what coverage they will provide during your trip. Be aware of where you are covered and under what circumstances, and then plan accordingly.
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Garrett is the founder/President of Secure Medicare Solutions, a leading, independent Medicare insurance agency. Since 2007, Garrett has worked with tens of thousands of people turning 65 or already on Medicare to understand, compare and choose Medicare insurance that fits their specific needs and situation.
His latest project is 65Medicare.org, an online hub for people just starting with Medicare, which is focused on distilling difficult Medicare questions into easy-to-understand resources.
Garrett resides in North Carolina with his lovely wife, Celeste, and three spirited children.View All Articles