Medicare guidance
Medicare Outside the United States
Original Medicare usually does not cover care abroad. Limited exceptions, a narrow cruise-ship rule, certain Medigap foreign-travel benefits and plan-specific Medicare Advantage extras require separate review.
Medicare Includes U.S. States and Territories
For this rule, the United States includes all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands. Care anywhere else is considered outside the United States.
Foreign Care Is Covered Only in Limited Situations
| Situation | General Medicare rule |
|---|---|
| Emergency begins while you are in the United States near a border | A foreign hospital may qualify when it is closer than the nearest U.S. hospital able to treat the condition. |
| Emergency while traveling through Canada between Alaska and another state | Coverage may apply when you travel without unreasonable delay by the most direct route and the Canadian hospital is closer than the nearest appropriate U.S. hospital. |
| You live in the United States near a foreign hospital | Coverage may apply when the foreign hospital is closer to your home than the nearest U.S. hospital able to treat the condition, even if the situation is not an emergency. |
When one of these exceptions applies, Medicare pays only for otherwise covered services. The foreign hospital may not submit a Medicare claim, so you may need an itemized bill and may have to file the claim yourself.
The Six-Hour Rule Is Narrow
Medicare Part B may cover medically necessary services received from a doctor who is legally allowed to provide care on the ship when the ship is in a U.S. port or no more than six hours away from a U.S. port. This can apply whether or not the condition is an emergency.
Some Plan Letters Include a Limited Foreign-Travel Emergency Benefit
Standard Medigap Plans C, D, F, G, M and N include foreign-travel emergency coverage up to plan limits. Plans C and F are not available to certain people who became newly eligible for Medicare on or after January 1, 2020, although eligible existing policyholders may keep them.
80% plan benefit
The policy pays 80% of the billed charges for qualifying medically necessary emergency care after the foreign-travel deductible.
$250 annual deductible
The standardized foreign-travel emergency benefit has a $250 deductible for the calendar year.
First 60 days
The emergency must begin during the first 60 days of the trip.
$50,000 lifetime maximum
The standardized benefit is limited to $50,000 over the life of the policy.
Learn how Medicare Supplement insurance works and compare Plan G versus Plan N.
International Benefits Are Plan-Specific Extras
Medicare Advantage plans generally do not cover medical care outside the United States. Some plans offer an extra benefit for emergency or urgently needed services abroad, with their own geographic limits, definitions, cost sharing, claim procedures and maximums.
- Read the current Evidence of Coverage, not only a benefits summary.
- Ask whether you must pay first and request reimbursement.
- Confirm emergency, urgent, ambulance, evacuation and repatriation rules separately.
- Ask what documentation and deadlines apply.
- Do not assume an international extra benefit covers routine care.
For domestic network questions, use Medicare Advantage travel networks.
Part D Does Not Cover Drugs Purchased Abroad
Medicare drug plans do not cover prescription drugs bought outside the United States. Ask the plan, prescriber and pharmacy about an appropriate supply before leaving, and review Medicare prescriptions while traveling.
Compare the Gaps, Not Just the Premium
Because Medicare’s foreign-care coverage is limited, some travelers consider a separate travel medical policy. Travel cancellation coverage and travel medical coverage are not necessarily the same product.
- Emergency medical maximum and deductible
- Preexisting-condition rules or waivers
- Emergency evacuation and repatriation
- Provider assistance and direct payment versus reimbursement
- Geographic, cruise, activity and trip-length exclusions
- Prescription and follow-up coverage
- Claims documentation and filing deadlines
A travel policy is not Medigap and does not change Original Medicare’s coverage rules.
International Medicare Checklist
- Identify whether you have Original Medicare, Medicare Advantage, Medigap and Part D.
- Read each current policy’s foreign-care language and exclusions.
- Record international assistance and claims telephone numbers.
- Arrange prescriptions before leaving and carry an accurate medication list.
- Ask how to obtain itemized medical records and proof of payment.
- Consider evacuation and transportation-home exposure separately.
- Leave coverage and contact information with a trusted person.
Medicare Abroad FAQ
Does Original Medicare cover an emergency in another country?
Usually not. Coverage applies only in limited situations described by Medicare, including certain border, Alaska-through-Canada and closer-foreign-hospital circumstances.
Does Medicare cover care on a cruise ship?
Part B may cover medically necessary shipboard care from an eligible doctor when the ship is in a U.S. port or no more than six hours away. This does not provide broad cruise, evacuation or foreign-port coverage.
Which Medigap plans cover foreign travel emergencies?
Standard Plans C, D, F, G, M and N include the benefit up to standardized limits. Eligibility to buy Plans C or F is restricted for certain newer Medicare beneficiaries.
Does Medicare Advantage cover international travel?
Plans generally do not cover medical care outside the United States, but some offer an extra emergency or urgently needed care benefit. Check the exact current plan documents.
More Medicare guidance
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Independent Medicare guidance
Review Foreign-Travel Coverage Before You Leave
Thompson Medicare Brokerage can help Missouri and Illinois residents understand the Medicare and Medigap plans it represents and identify foreign-travel questions to verify with the policy.
Thompson Medicare Brokerage is not connected with or endorsed by the U.S. government or the federal Medicare program. Foreign-care coverage, costs, exclusions and claims procedures vary. This page is general educational information; current Medicare rules and official policy documents control.