When it’s time to enroll in Medicare, there are many things to consider. Your future travel plans should be one of them. If you’re considering international travel during the next year, it can impact your health insurance choices and Medicare decisions.
Medicare itself doesn’t cover international travel. However, some Medicare Advantage (Part C) plans may cover certain emergencies if they occur outside the United States. In most cases though, you’ll need supplemental travel insurance.
If you plan to travel out of the country, it’s a good idea to review the details of your current Medicare or private health insurance plans to be sure you’re covered in case of an emergency.
If you’re not covered for international travel, you can explore other options to help fill any gaps in your coverage. We’ll explore your options, including Medicare supplemental plans (Medigap), short-term traveler’s insurance, or long-term coverage through Medicare Advantage.
Medicare is a broad term to describe healthcare coverage for Americans over the age of 65. The government program is broken down into four parts: A, B, C, and D.
You aren’t automatically enrolled in these programs — you must sign up during the enrollment period. You can choose the best plans for your healthcare needs.
Most Americans sign up for Medicare parts A and B. To qualify for other Medicare coverage, you must also be enrolled in parts A and B.
Medicare Part B is essentially traditional medical coverage that covers outpatient doctor’s visits. Part A provides hospital coverage. If you need prescription drug coverage, then you may consider signing up for Medicare Part D.
Medicare Advantage plans involve Medicare Part C coverage. Depending on the plan you choose, your plan may include vision, hearing, dental, and prescription drug coverage.
Medicare Advantage plans generally limit you to the doctors and facilities within an HMO or PPO and may or may not cover out-of-network care.
In order to buy a Medicare Advantage plan, you must already be enrolled in Medicare parts A and B. Coverage through a Medicare Advantage plan is offered through a private insurance plan.
Medicare Advantage plans may
Medicare Advantage is offered through private insurance companies that have contracts with the federal Medicare program. However, like traditional private insurance, Medicare Advantage won’t necessarily cover health concerns that arise if you’re outside the United States.
If you have Medicare parts A and B, there are three exceptions for coverage outside the United States and its territories:
- You have a medical emergency that arises while you’re in the United States, but the nearest hospital is outside the country.
- You need care, regardless of if it’s an emergency, where you live in the United States, and the closest hospital to your home is outside the country.
- You’re traveling between Alaska and the mainland United States via Canada and you have a medical emergency that requires you to go to a Canadian hospital. (It’s important to note that Medicare only covers this situation if you can prove that you were traveling through Canada “without unreasonable delay.”)
With any of the above scenarios, your traditional Medicare plan will still only cover those expenses that would be covered in the United States.
If you’re on a cruise ship, your Medicare coverage will only apply if you are at a U.S. port or within 6 hours of one. Otherwise, you’re considered in international territory.
If you’re treated in a foreign hospital, it’s important to know that the staff may not file any claims with Medicare. In such cases, you’d need to pay out of pocket for treatment and then file a claim with Medicare for reimbursement only if you meet one of the above criteria.
Medicare Advantage may automatically cover you in the case of an emergency outside the country regardless of the three scenarios above. However, that depends on the specific coverage included in the exact plan you have with your private carrier.
There are no rules that dictate whether Medicare Advantage will cover a certain percentage of foreign hospital bills.
If you plan on traveling out of the country and are also undergoing treatment for chronic illness, then a Medicare Advantage plan may be worth the extra cost if your specific plan covers medical care outside the United States.
It’s important to check with your insurance carrier before you travel to know how much, if any, your individual plan covers international healthcare emergencies.
To qualify for any Medicare Advantage plan, you must be enrolled in Medicare parts A and B. This ensures you have domestic hospital and outpatient care services.
In some cases, you may be reimbursed if you’re traveling internationally and need to see a doctor. However, it’s possible you’ll pay high out-of-pocket costs.
Medicare Advantage (Medicare Part C)
Medicare Advantage plans may offer more international coverage because they’re through private insurance providers. However, not all plans are created equal.
If you plan on traveling on a frequent basis and you’re looking for a plan that includes the benefits of Medicare parts A and B, you may want to pay more up front for a Medicare Advantage plan that covers costs away from your home state or out of the country.
Medicare supplemental insurance (Medigap)
Medigap is the official supplemental insurance offered through the Medicare program. It’s different from Medicare Advantage plans in that it doesn’t cover things like long-term care, vision, dental, hearing aids, eyeglasses, or private-duty nursing.
Medigap is another private insurance option within Medicare that’s designed to help cover costs like deductibles, copays, and other medical services not covered by other Medicare parts.
Medigap plans provide coverage for care related to medical emergencies that happen while you’re outside the United States. This type of insurance is often used to provide coverage during international travel.
Medigap can also help offset high deductibles and copays for insurance while you travel. In fact, depending on the plan you choose, Medigap may cover up to 80 percent of international medical emergencies once you’ve met your deductible and you’re within your policy’s maximum limit.
You must already be enrolled in Medicare parts A and B to be eligible for Medigap. Since Medigap is offered through private insurance companies, the amount of international healthcare coverage, if any, will depend on the specific plan you purchase.
Tips for enrolling in Medicare
- Start early. Begin investigating your Medicare plan options a few months before you turn 65.
- Collect the required documents. At minimum, you’ll need your driver’s license, social security card, and birth certificate. You may need a copy of a W-2 form if you’re still working.
- Understand your current healthcare needs. Know how often you see the doctor each year, how many prescription medications you take, and any special medical needs you have.
- Know your budget. Consider whether you want to spend extra money for the additional benefits that a Medicare Advantage (Part C) plan offers.
- Consider your travel plans. If you’re planning on traveling extensively, consider additional Medigap coverage.
If you’re on a budget, another option is to obtain supplemental traveler’s insurance. This isn’t medical insurance, but is instead a short-term plan that covers emergencies while you’re out of the country. You may also be able to buy short-term insurance through a travel planner.
The catch is that you’ll need to buy the coverage ahead of time for a specified itinerary. You can’t buy traveler’s insurance once you’ve already left the country.
Also, not all supplemental plans cover preexisting conditions. If you have chronic health conditions, be sure to review the exclusions before you purchase travel insurance.
Puerto Rico is a U.S. territory, so your Medicare plan will cover your travels to the island. Residents of Puerto Rico are also eligible for Medicare.
The same rules apply to other U.S. territories, including:
- American Samoa
- The Northern Mariana Islands
- U.S. Virgin Islands
If you travel, Medicare Advantage (Part C) plans may have advantages over Medicare parts A and B for you. However, since these are private insurance plans, Medicare Advantage doesn’t automatically cover costs during international travel.
It’s important to review your policy before you travel and consider supplemental coverage with either Medigap or traveler’s insurance if you’re concerned about the potential cost of medical care while you’re out of the country.