Does Medicare Cover Care Outside the U.S.?

The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S. Anywhere else is considered outside the U.S.

Because Medicare has limited travel medical coverage outside the U.S., you may choose to buy a travel insurance policy to get more coverage. An insurance agent or travel agent can give you more information about the cost of travel medical insurance. Travel insurance doesn’t necessarily include health insurance, so it’s important to read the conditions or restrictions carefully.

Medicare supplement insurance (Medigap) policies may cover emergency care when you travel outside the U.S.

In some cases, Medicare Part B (Medical Insurance) may pay for medically necessary services that you get on a cruise ship if:

• The doctor is legally allowed to provide medical services on the ship.
• The ship is in a U.S. port, or no more than 6 hours away from a U.S. port, when you get the services (regardless of whether it’s an emergency).

If you get Medicare-covered services on a cruise ship, the ship’s doctor must submit the Medicare claim. You can also file a claim directly to Medicare.

• Medicare may also pay for inpatient hospital, doctor, and ambulance services you get in a foreign country in rare cases, if you’re eligible.
• Medicare may cover medically necessary ambulance transportation to a foreign hospital only with admission for medically necessary covered inpatient hospital services.
• Medicare drug plans don't cover prescription drugs you buy outside the U.S.
• Medicare drug coverage (Part D) covers all vaccines that the Advisory Committee on Immunization Practices (ACIP) recommends, including certain vaccines you might need to get before you travel outside the U.S. (like yellow fever, chikungunya, and Japanese encephalitis). Your Part D plan won't charge you a copayment or apply a deductible for vaccines ACIP recommends. Contact your Medicare drug plan for details and talk to your provider about which ones are right for you.

• You're in the U.S. when a medical emergency occurs, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
• You're traveling through Canada without unreasonable delay by the most direct route between Alaska and another U.S state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
• 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 medical condition, regardless of whether an emergency exists.

You pay all of the costs, in most cases.

If you’re eligible and in rare cases, Medicare pays only for services covered under Original Medicare:

• Medicare Part A (Hospital Insurance) covers hospital care (care you get when you've been formally admitted with a doctor's order to the foreign hospital as an inpatient).
• Part B covers emergency and non-emergency ambulance and doctor services you get immediately before and during your covered foreign inpatient hospital stay. Medicare generally won't pay for services (like return ambulance trips home) in either of these cases:
• Medicare didn't cover your hospital stay.
• You got ambulance and doctor services outside the hospital after your covered hospital stay ended.

If you’re eligible, you pay the part of the charge you would normally pay for covered services. This includes any medically necessary doctor and ambulance services you get in a foreign country as a part of a covered inpatient hospital stay. You also pay the coinsurance, copayments, and deductibles you'd normally pay if got these same services or supplies inside the U.S.

Foreign hospitals aren’t required to file Medicare claims for your travel medical costs. You need to submit an itemized bill to Medicare for your doctor, inpatient, and ambulance services if both of these apply:

• You're admitted to a foreign hospital under one of the situations above.
• The foreign hospital doesn't submit Medicare claims for you.