Medicare Benefits for U.S. Citizens Living Abroad

By Suzan Haskins

“In 2009, there is currently the best opportunity yet seen to bring Medicare services to eligible retirees living in Mexico. This is due to a confluence of political and economic events in the United States and Mexico.” So says a group called AMMAC (Americans for Medicare in Mexico) who have increased efforts to affect changes to the Medicare program through a pilot program in Mexico.

Mexico has the largest number of U.S. retirees outside the U.S., and health care costs are significantly lower in Mexico than in the U.S., but Congressional authorization and waivers of a number of provisions in the Medicare legislation will be required in order to implement a pilot program for seniors living in Mexico.

What you should know about using Medicare benefits elsewhere in the world:

Medicare doesn’t usually cover health care outside the U.S. (And the government’s definition of the U.S. includes the 50 states and the District of Colombia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Northern Mariana Islands.)

However, there are some small exceptions. If you are traveling in the U.S. and have a medical emergency but the nearest hospital is in Canada or Mexico, you can qualify for Medicare coverage at that hospital. Similarly, you can use your benefits if you are traveling to or from Alaska via Canada and the nearest hospital is in Canada.

If you are on a cruise…and you become ill or have an emergency, you must seek assistance from the doctor on that particular cruise ship. If the ship is no more than six hours from a U.S. port, you will be covered by Medicare. And if the doctor determines you require hospitalization…in a hospital in Mexico or Canada, for instance, Medicare will pay for services provided by hospital staff.

Importantly, though, the ship’s doctor must have taken care of you while on board, and while the ship was within six hours of a U.S. port – and the doctor must send you to the hospital on the same day for the same medical condition.

How to be prepared

If you travel a lot internationally, consider one of the Medicare C through J supplement (Medigap) plans sold by private companies that provide foreign coverage. And especially if you relocate overseas, consider an evacuation plan (many are available) that will cover the cost of your transportation back to the U.S. for treatment. One such company is Medical Air Services (MASA).

If you relocate overseas, many countries offer its residents a government-sponsored health insurance plan. And often you can buy a private plan for far less than it might cost in the U.S. Some countries and insurance companies have age limits on participation, however, so be sure to do your homework.

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Further Resources

Medicare coverage outside the U.S fact sheet. (From the Department of Health and Human Services).

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