What Does Medicare Cover Outside the U.S.?

Remember, in most cases, you will pay 100% of the medical costs you incur while traveling internationally.

However, if you’re covered under Original Medicare due to one of the circumstances listed above, you will pay only 20% of the expenses approved under Medicare.

Note that you must pay your Part B deductible before your Original Medicare plan will begin to cover the approved charges. You must also pay any copayments you would normally owe if you received the same health services or supplies inside the U.S.

DON’T HAVE ORIGINAL MEDICARE? Learn about international Medigap coverage or international Medicare Advantage coverage.

Original Medicare will pay its share of the following expenses in covered situations:

• Hospital care you receive after your doctor formally orders you to be admitted to a foreign hospital as an inpatient (covered under Medicare Part A)
  
  
• Emergency and non-emergency ambulance services you receive before you are formally admitted to a foreign hospital as an inpatient for a covered stay (covered under Medicare Part B)
  
  
• Emergency and non-emergency doctor services you receive before and during your covered stay as an inpatient at a foreign hospital (covered under Medicare Part B)

Original Medicare will not cover:

• Any medical expenses stemming from an uncovered hospital stay
  
  
• Healthcare services you receive outside the hospital once you are no longer an inpatient

According to Medicare.gov, standard Medicare supplement insurance (Medigap) plans C, D, E, F, G, H, I, J, M, and N provide coverage for some emergency healthcare expenses incurred overseas if both the following are true:

• You receive emergency medical care during the first 60 days of your trip
• Medicare would not otherwise cover the care you receive

(Note that Medigap plans E, H, I, and J are no longer for sale. However, you may keep your E, H, I, or J plan if you purchased it before June 1, 2010.)

Here’s How Much You’ll Pay for Covered Medical Expenses Outside the U.S.

Medigap plans C, D, E, F, G, H, I, J, M, and N will pay 80% of your billed medical expenses for certain “medically necessary” treatments abroad. This means you will pay 20% of covered costs. However, your Medigap policy will only begin to pay its share after you have met your $250 deductible for the year.

DID YOU KNOW? “Medically necessary” healthcare refers to healthcare services, treatments, or supplies required to diagnose or treat an illness, ailment, condition, or disease.

Medigap policies have an overall lifetime maximum of $50,000 for eligible healthcare costs abroad. This means $50,000 is the maximum dollar amount your Medigap policy will pay toward your covered expenses during your lifetime.

PRO TIP: Contact your Medigap provider to learn more about your foreign healthcare coverage before you travel outside the United States.