Medicare Travel Benefits
This post will give you some information about Medicare Travel Benefits. You should understand what medical coverage you have while you are away from home. In most cases, Medicare does not cover either health care services or supplies when you travel outside of the United States. Some exceptions to this rule are listed below.
In some instances, Medicare Part B may pay for services you get if you are on board a ship within the territorial waters that join land areas of the U.S.
Rarely, Medicare might pay inpatient hospital, doctor, ambulance services, or dialysis when the following happens
If you are in the U.S. and a medical emergency occurs and the closest hospital that can treat your condition is a foreign hospital.
While you are traveling through Canada an emergency occurs that needs treatment without unreasonable delay. If the Canadian hospital is closer than the nearest U.S. hospital that can treat you.
When 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 condition. This is the case, if there is an emergency or not.
In some instances, Medicare may cover medically necessary health care services you get on board a ship. This is the case if you are within the territorial waters that join land areas of the U.S. Although, Medicare will not pay for health care services you receive on a ship that is more than 6 hours away from a U.S. port.
Please note: If you are admitted to the hospital under the circumstances listed above; foreign hospitals are not required to file Medicare claims for you. You are responsible to submit an itemized bill directly to Medicare for all the services you receive.
If you do not fit into one of the situations described above:
You will have to pay 100% of the costs, in most cases. If you do fit into one of the situations above, you do not get the 80% coverage provided by Original Medicare.
For services that are covered, Medicare pays only for services that are covered under Original Medicare.
Medicare Part A
Part A covers care received when formally admitted as an inpatient by a doctor’s order to a foreign hospital.
Medicare Part B
Part B covers both emergency and non-emergency ambulance and doctor services you receive for your covered foreign inpatient hospital stay. You will be responsible for your portion of the charge for covered services. Your portion includes coinsurance & co-payments as well as deductibles, the same way it would if you received care in the U.S. You may want to ask your doctor for prices for tests, supplies and services. This way you will know how much you will owe your provider. There are various things that may decide your costs. This includes whether or not you have other insurance, how much the doctor charges, the type of facility, as well as where you get your tests, items or services.
Medicare does not pay for services such as return ambulance trips home when:
- Medicare refused to cover your hospital stay.
- You used either ambulance or doctor services outside the hospital after your covered hospital stay ended.
Medicare Travel Benefits, Please note:
The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are all considered part of the U.S.
Medicare drug plans don’t cover prescription drugs you buy outside the U.S.
Some Medicare supplement insurance (Medigap) policies cover you when you travel outside the U.S.
Medicare Supplement/Medigap coverage when you are outside the U.S.
Medicare Supplement Plans C, D, E, F, G, H, I, J, M or N. Plans C,F,G,M and N can actively be purchased.
- Does Cover foreign travel emergency care that begins during the first 60 days of your trip, if Medicare does not cover the care.
- Once you have met the $250 deductible for the year, Medicare supplements pay 80% of the billed charges for certain medically necessary emergency care outside the U.S..
There is a lifetime limit of $50,000 for foreign travel emergency coverage with Medigap policies.
If you would like more information on Medicare supplement plans, CLICK HERE
Be aware of your Medicare Travel Benefits before you go.
Before you take that trip outside the U.S., It is best to talk to either the customer service department of your insurance plan carrier or your insurance agent to get more information about your coverage before you travel.
Sometimes Travel insurance will help make up for limited Medicare coverage for health care services outside the U.S.
You can get information about travel insurance through your insurance agent or travel agent. Travel insurance doesn’t necessarily include health insurance, so it’s important to read the conditions or restrictions carefully.