If your travel plans include venturing across state borders or collecting passport stamps, it’s essential to know what your health insurance will cover while you’re far from home. Facing an illness or injury abroad can be more than just unpleasant—it could lead to hefty out-of-pocket costs, even if you’re enrolled in Medicare. Many standard health insurance policies also do not cover international travel.
Medicare isn’t universally accepted outside the United States, and coverage can vary domestically as well. The extent of your coverage depends on your Medicare configuration: whether you have Original Medicare (Parts A and B), plus Part D, or a Medicare Supplemental Insurance (Medigap) policy, or perhaps a Medicare Advantage plan. Almost certainly, purchasing extra supplementary coverage like travel insurance is a wise course of action, irrespective of your existing Medicare plan, and especially if traveling out of the country.
Here’s an overview of your health benefits and steps to take if your insurance coverage falls short during your travels.
Original Medicare (with Medigap)
While traveling within the United States, have peace of mind knowing Original Medicare covers you across all 50 states and U.S. territories like Puerto Rico and the U.S. Virgin Islands. However, it won’t cover medical costs incurred abroad—unless:
– If you’re on a cruise within U.S. waters, you’re covered, but sail beyond six hours from a U.S. port, and Medicare won’t pay your medical bills. However, a supplemental Medicare policy, such as Medigap, can help patch these coverage gaps—internationally included.
– Most Medigap policies offer limited emergency coverage outside the U.S.—generally with a $250 annual deductible, a 20% copay, and a lifetime limit of $50,000 but typically restricted to your trip’s first 60 days. Before departing, confirm details with your insurance provider.
Medicare Advantage
All Medicare Advantage plans must at least match Original Medicare, covering emergency and urgent care anywhere within the U.S. Yet, standard coverage may not apply outside your service area—a significant drawback if you frequent a secondary home, an alternate state, or another country. Ensure you understand limitations with your plan provider when outside your service area. You may need to adjust your insurance as necessary.
Despite drawbacks, some Medicare Advantage plans include foreign travel protection, albeit with restrictions. For instance, paying out-of-pocket first and seeking reimbursement later, or capped overseas benefits, are possible. Study your policy in detail before traveling to comprehend what’s covered and what’s not.
On cruises, Medicare Advantage applies domestic coverage while in U.S. waters and foreign travel rules when in international waters.
Read the Fine Print
For plans providing international travel coverage, understand your provider’s definitions of emergency care—a condition risking severe health detriment—and urgent care for less severe issues, like an ear infection, to avoid unwelcome expenses. Also, prescription refills from foreign pharmacies aren’t covered, so pack extra meds for potential delays.
Given these restrictions, it’s wise to research further. Consider travel insurance or travel health insurance. Besides nonrefundable trip costs and cancellations, most travel insurance policies cover emergency medical care for sudden illnesses or injuries needing immediate attention—within specific limits. For example, some plans omit accidents from adventure activities or expenses related to preexisting conditions, prompting a need for comprehensive coverage. Travel health insurance is useful for extended trips, providing for more routine care.
Although supplemental coverage can be costly—averaging between 5% and 6% of travel costs—it offers the peace of mind and freedom to enjoy your trip without looming concerns of unforeseen medical expenses.
Safe travels!