Medicare – Doesn’t cover you outside the USA!

Are you covered by Medicare when you’re traveling outside the United State? This is one of the most common questions that we get from senior travelers. And the answer is basically no! You are not. According to the 2013 Medicare Handbook:

Travel (health care needed when traveling outside the United States): Limited to medical services provided in Canada when you travel on the most direct route through Canada between Alaska and another state. Medicare also covers hospital, ambulance, and doctor services if you are in the United States, but the nearest hospital that can treat you isn’t in the United States (the United States means the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa). In some cases, Medicare may pay for services that you get while on board a ship within the territorial waters adjoining the land areas of the United States.

What does it mean? Basically if you travel outside of the USA, even if it’s just a cruise to the Bermuda, you will not be covered by Medicare so don’t rely on them for coverage. That still leaves a question about the Medicare supplement policies that are called Medigap policies. In 1992, the Federal Government created national standards for Medicare Supplement plans(Medigap). They are now identified as Medigap plans A through L. According to the guide, 2013 Choosing a Medigap Policy, on plans C, D, E, F, G, H, I, J, M and N will provide limited coverage outside of the USA. The standards for these plans  are the same:

  • Life time maximum total benefit: $ 50,000
  • Yearly deductible: $ 250.
  • Will pay eligible medical expenses
    for a foreign travel emergency: 80% of eligible expenses for up to 60 days per trip.

If you reside in Massachusetts, Minnesota, or Wisconsin your benefits will be slightly different.  A good source of information is obtained directly from the Medicare publication:  Medicare Coverage Outside the United States.

Our advice? Check you current coverage closely. If you only have the above coverage than you probably want to buy a travel insurance plan that will supplement your current policies and provide you with an adequate level of medical expense coverage. Also only buy a plan that offers “primary” coverage. Most travel insurance plans only offer secondary medical coverage which means that you have to submit your travel medical claim to the MediGap policy first and then the unpaid balance to the travel insurance company. The result is a reduction or elimination of your lifetime benefit of $50,000. With a primary plan you submit the medical claim to the travel insurance company first thus saving your lifetime benefit as a backup.