Does Medicare Work Overseas?

Can you use Medicare overseas?
Can you use Medicare overseas? Here’s what you need to know.|©iStock/miniseries

Most people find the many laws and applications Medicare spans to be boring, confusing, and completely absurd.

Not me.

I'm a student of Medicare.

I research its rules and regulations; they fascinate me. Every year I spend hours in classrooms, on webinars, and toiling over online certification classes, enduring quizzes and testing to remain certified and current in the ever-changing Medicare rules, regulations, and applications.

I am also a storyteller. I use that skill to weave the cold facts of Medicare rules and regulations into personal and applicable events.

I make Medicare relatable to our everyday lives through stories that bring the chaos of governmental rules and regulations into human form.

I've found it's a great way to unmask the seemingly unrelatable. It also brings insight into the absurdities found in this massive, ingenious, health insurance program called Medicare.

I specialize in an obscure area of Medicare: Medicare for travelers, roving retirees, and expats. That comes as a surprise to many people. Indeed, one of the Medicare questions most frequently put to me is, "Medicare doesn't work outside the US, does it?"

The answer isn't straightforward. It's yes… and no. The ins-and-outs of Medicare overseas fills a lot more space than I have here.

It fills a book.

I would know, I wrote it.

It's called Medicare Made Easy: What Expats, Frequent Travelers, and You Need to Know. (If you'd like a copy, take a look here.)

But, to return to the question of whether you can use Medicare overseas, here's a brief overview…

Original Medicare, Parts A and B, have very limited coverage for travelers outside the US. The three exceptions are:

  • If you are traveling through Canada between Alaska and the US and have an emergency, Original Medicare will cover your emergency services.

  • If the nearest doctor or hospital is over the border in Mexico or Canada, Original Medicare will cover your emergency services.

  • If you are on a cruise ship and are within six miles of the US or its territories, Original Medicare will cover your emergency services.

If you do not qualify for one of these exceptions, then no, Original Medicare does not cover you outside the US or its territories. (You'll find a full explanation of the coverage and limitations for Original Medicare in my book in chapters 1 and 7.)

However, some Medicare Supplement (Medigap) Plans and many Medicare Advantage Plans have varying levels of emergency and urgent care services covered throughout the world. If you have one of these plans, your answer may be "yes" to emergency coverage overseas.

Both programs require you to pay for the services up-front and submit for reimbursement.

In my book, I explore the various circumstances in which Medicare can be used while traveling or living overseas. (You can get your hands on a copy here).

Worldwide emergency coverage is very comprehensive, but limitations are unique to each type of program and the circumstances under which treatment is received.

Supplement Plans C, D, F, G, M, and N offer worldwide emergency coverage during the first 60 days of each trip outside the U.S. Their terms require that the beneficiary pay a $250 copay per incident and 20% of covered services received. They are limited to $50,000 in coverage over your lifetime. (Chapters 3 and 7 of my book detail these plans and their coverage while traveling or living overseas.)

Advantage Plans offer a broader spectrum of coverage. Although it will vary from plan to plan, most allow you to be out of the US anywhere from six months to one year per trip. Their terms require a copayment (usually between $85 and $250 per incident), but most have no 20% coinsurance, and many have no limitation on coverage amounts.

It is best to research which plans in your area have the best worldwide travel coverage, as their terms of service vary widely. (In chapters 4 and 7 of my book you'll find a full understanding of how Advantage Plans work while traveling and living overseas.)

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