In what situations will Medicare pay for medical services in a foreign hospital?
Answered by 14 licensed agents
Medicare covers services in a foreign hospital in three situations. First, if you have a medical emergency in the U.S. and the foreign hospital is closer than the nearest U.S. hospital that can treat you. Second, if you are traveling through Canada without unreasonable delay between Alaska and another state and a medical emergency occurs, and the Canadian hospital is closer than a U.S. hospital. Third, if 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, regardless of whether it is an emergency.
This is a great question—and one many folks don’t think about when enrolling in Medicare—since Medicare is a U.S.-based benefit and doesn’t typically cover medical services abroad, though there are a few narrow exceptions worth knowing. Original Medicare (Parts A and B) will pay for a foreign hospital only if you’re traveling through Canada between Alaska and another state and the nearest hospital is Canadian during an emergency, if you live in the U.S. and the closest hospital for an emergency is foreign (like near the Mexican border), or if you’re on a U.S.-based cruise ship within six hours of a U.S. port when an emergency hits—verified exceptions straight from Medicare’s rules. Some Medicare Advantage plans offer limited international emergency coverage—often up to $50,000 per trip, depending on the plan—but Medigap plans like G or N can cover 80% of emergency care costs abroad (up to a $50,000 lifetime limit) during the first 60 days of travel after a $250 deductible. From my experience, I always tell seniors heading overseas to grab a standalone travel health insurance package—it’s affordable, usually $50-$150 for a two-week trip—and it’s the safest way to avoid big bills Medicare won’t touch.
Medicare usually doesn’t cover care outside the U.S., but there are a few exceptions — like if you’re in the U.S. and a foreign hospital is closer, or you’re traveling between Alaska and another state through Canada. Otherwise, you’ll need separate travel coverage.
Some Medicare Supplements have a Foreign Emergency Travel provision which has an 80% coverage after a $250 deductible and a lifetime coverage of up to $50,000 for emergency care if the illness/injury occurred within the first 60 days outside of the USA.
This answer depends on what kind of plan you have. If you have a Medigap plan, you have hospital coverage for foreign travel up to $50,000. If you have a Medicare Advantage, it depends on the plan that you are enrolled in. Many Medicare Advantage Plans do cover medical emergencies while in a foreign country. Keep in mind that with a Medicare Advantage there are co pays.
Typically if a beneficiary goes outside of the United States there isn't any coverage. Some plans may pay a fixed amount for Emergency medical care outside of the U.S. A few plans may cover a fixed amount for any medically necessary coverage outside of the U.S. It is best to speak to a knowledgeable agent who can speak about plans that may provide this coverage. Also a licensed agent may be able to offer advice on how to provide coverage outside of the U.S.
If you need to go to the hospital in another country, you'll likely need to pay for medical expenses upfront, even if you have insurance. Your U.S. health insurance may not cover medical costs abroad, and Medicare and Medicaid certainly do not. You'll need to make arrangements for payment, translation (if needed), and potentially medical evacuation if needed. Based on these results, my recommendation would be to purchase short term international health insurance which is very inexpensive.
Medicare typically doesn't cover medical services in a foreign hospital, except in specific limited circumstances. These include medical emergencies in the U.S. where a foreign hospital is closer than the nearest U.S. hospital that can treat the condition, or if you're in Canada traveling without unreasonable delay between Alaska and another U.S. state. Additionally, if you live in the U.S. and a foreign hospital is closer to your home than the nearest U.S. hospital, Medicare may cover certain services.
The only situation in which Medicare will pay for services outside of the United States is when you are NEAR the border of the United States; otherwise, you're out of luck. I ALWAYS suggest that my clients purchase a "Travel Medical" plan when they are outside the US. Its relatively cheap and VERY comprehensive
Medicare generally does not provide coverage when you are out of the country. It may extend some coverage in an emergency situation but it is always best to carry international coverage plans while travelling outside the country.
