Greg Dill
Courtesy: Medicare
Are you traveling abroad this summer? Before you leave, keep in mind that Medicare usually does not cover health care services or supplies while you are traveling outside of the United States.
That doesn’t mean you have to travel abroad without health coverage. Here are three ways you can get health coverage outside of the U.S.:
1) If you have a Medicare Supplement Insurance (Medigap) policy, check your policy to see if it includes coverage when traveling outside of the U.S.
2) If you have Medicare Advantage or another Medicare health plan (instead of Original Medicare), check with your plan to see if it offers coverage outside of the U.S.
3) Consider buying a travel insurance policy that includes health coverage.
In some cases, Medicare may cover medically necessary health care services that you receive on board a ship within the territorial waters adjoining land areas of the U.S. Medicare will not pay for health care services you get when a ship is more than six hours away from a U.S. port.
Medicare also may pay for inpatient hospital, doctor, ambulance services or dialysis you get in a foreign country in these rare cases:
• You are in the U.S. when a medical emergency occurs, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
• You are traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
• You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists.
Medicare drug plans (Part D) do not cover prescription drugs you buy outside of the U.S.
If you get sick or injured while abroad, in most cases you will pay 100 percent of the costs. In the situations described above, you pay 20 percent of the Medicare-approved amount, and the Part B deductible applies.
In the situations above, Medicare pays only for services covered under Original Medicare:
• Medicare Part A (Hospital Insurance) covers hospital care (care you receive when you have been formally admitted with a doctor’s order to the foreign hospital as an inpatient).
• Part B covers emergency and non-emergency ambulance and doctor services you get immediately before and during your covered foreign inpatient hospital stay. Medicare generally will not pay for services (like return ambulance trips home) in either of these cases:
-Medicare did not cover your hospital stay.
-You got ambulance and doctor services outside the hospital after your covered hospital stay ended.
• You pay for the part of the charge that you would normally pay for covered services. This includes any medically necessary doctor and ambulance services you get in a foreign country as part of a covered inpatient hospital stay. You also pay the coinsurance, co-payments and deductibles you would normally pay if you got these same services or supplies inside the U.S.
The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa are considered part of the United States.
Foreign hospitals are not required to file Medicare claims for your medical costs. You need to submit an itemized bill to Medicare for your doctor, inpatient and ambulance services if both of these apply:
• You are admitted to a foreign hospital under one of the situations above.
• The foreign hospital doesn’t submit Medicare claims for you.
Safe travels!
Greg Dill is Medicare’s regional administrator for Hawai‘i, California, Nevada, Arizona and the Pacific Territories. You can get answers to your Medicare questions by visiting www.Medicare.gov or calling 1-800-MEDICARE (1-800-633-4227).
