Original Medicare may or not cover you if you have an emergency while traveling. Before you travel in or outside the U.S. it’s important to learn how you are covered.

Medicare Covers You in the U.S.

With the largest network of doctors and hospitals in the U.S., Original Medicare has you covered if you travel within the States and its territories. You just have to check if the doctor or hospital accepts Medicare assignment. Remember in case of emergency you can go to any U.S. hospital, and Medicare will cover you.

Medicare Coverage Outside the U.S. is Very Limited

Medicare does not cover you if you travel outside of the U.S. and its territories, except for a few situations. The following are a few circumstances that Medicare may cover your services outside of the U.S.:

1. If you’re in the U.S. when you have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital Medicare may cover you.

2. If you’re traveling through Canada from Alaska (without unreasonable delay) to another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital, Medicare may cover you. It is important to remember that Medicare determines what qualifies as “without unreasonable delay” on a case-by-case basis.

3. If you live in the U.S. and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, Medicare may cover you. This is regardless of whether it’s an emergency.

Medicare Most Likely Won’t Cover You When Cruising

This will come as a surprise to many, but when traveling by Cruise ship you are more than likely not covered. To be covered you would have to be at a U.S. port or within 6 hours of a U.S. port, as well as the cruise doctor must be allowed by law to treat you. The U.S. Passports and International Travel stresses that, "Medicare does NOT cover health care overseas. We highly recommend that you obtain health insurance to cover emergency medical and dental treatment and for medical evacuation to the United States."

Travel Healthcare Options to Add to (or Replace) Medicare

There are a few ways in which you can cover your travel healthcare expenses:

1) Private travel insurance

2) Medicare Advantage

3) Medigap

Below each will be detailed on how they cover boomer health emergencies while traveling.

Private Travel Health Insurance

Private travel insurance is an option for many who want to add coverage to their foreign trip. However, there are a few things we suggest considering when purchasing. Private travel insurance can be very expensive –up to 11% of your total trip cost. Don’t skimp, because if you have an emergency and didn’t calculate properly your insurance could be void. It also doesn’t always cover preexisting conditions, and when it does it can be complicated. You have to be medically stable and able to travel at the time of purchase, and at the time of travel.

Medicare Advantage

Medicare Advantage plans are similar to a local, HMO network. What this means for you is that many MA plans will not cover you when you travel within the U.S. However, some Medicare Advantage plans will cover when you travel outside of the U.S. Since Medicare Advantage plans are not standardized you’ll have to ask to see how you’d be covered in the U.S. and abroad.

Medicare Supplement

Medicare Supplement Insurance, otherwise known as Medigap, fills in the gaps by supplementing Medicare’s deductibles, coinsurance, and copays. This supplemental plan maintains the large network of doctors and hospitals that Original Medicare covers. Therefore when traveling in the U.S. you would be covered. If you travel outside of the U.S. 6 out of 10 Medigap plans will cover you for foreign emergencies, up to $50,000. One of the above three might be the right option for you. Make sure to research all of your options before making a decision.

Amy Devore (senior65.com)

June 6, 2023