Medicare Away From Home: Travel Coverage in the US and Abroad

When traveling within the United States, Original Medicare generally covers care nationwide. Medicare Advantage plans usually cover emergencies and urgent care outside their service area. For international travel, Original Medicare typically does not cover services, and Medicare Advantage plans offer very limited benefits.

Key takeaways

• Original Medicare covers care anywhere in the U.S. and its territories.
• Medicare Advantage plans usually limit routine care to their service area. They must cover emergencies and urgent care when you are away from home.
• Original Medicare generally does not cover healthcare received outside the U.S.
• Some Medicare Advantage plans and certain Medigap policies may offer limited foreign travel emergency coverage.
• It is crucial to understand your plan's rules before any trip, especially international ones.

How does Medicare cover you in the US?

Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). It covers medically necessary services from any doctor or hospital that accepts Medicare, anywhere in the United States. This includes all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

So, if you have Original Medicare, you do not need to worry about coverage limitations when traveling from one state to another. You can see any Medicare-approved provider across the country. This flexibility is a key feature of Original Medicare, allowing you to seek care without needing referrals for in-network providers. Many people with Original Medicare also choose to buy a Medigap (Medicare Supplement Insurance) policy to help cover out-of-pocket costs, and these policies also work nationwide. For more details on what each part covers, you can read about Medicare Parts A, B, C, D: What Each Covers & Your Choices.

Medicare Advantage plans (Part C) work differently than Original Medicare. These plans are offered by private insurance companies approved by Medicare. They provide your Part A and Part B benefits, and often include Part D (prescription drug) coverage and extra benefits. However, Medicare Advantage plans usually have a defined service area. This area is typically a county or a group of counties.

This means that for routine care, you typically need to use doctors and hospitals within your plan's network and service area. If you travel outside this area, your coverage for non-emergency care might be limited or not available at all. It's important to understand your plan type, such as an HMO or PPO, as they have different rules for out-of-network care. Generally, HMOs offer the least flexibility for out-of-area care, while PPOs offer more, often at a higher cost. You can learn more about these plan types in HMO, PPO, PFFS, MSA: How Each Medicare Advantage Plan Type Works.

What if you have a Medicare Advantage plan and travel in the US?

If you have a Medicare Advantage plan and travel within the U.S., you are still covered for emergency and urgent care. Medicare rules require all Medicare Advantage plans to cover these services anywhere in the country. An emergency is when you have an illness, injury, or symptom so severe that it could put your health at serious risk if not treated right away.

Urgent care is when you need medical attention for an illness or injury that is not life-threatening. However, it is serious enough that you cannot wait for your regular doctor. For example, a bad sore throat or a minor sprain. Your plan may have different cost-sharing for urgent care outside its service area compared to within its network. For instance, you might have a higher copay for an urgent care visit outside your home area. Always keep your plan ID card with you when you travel.

Before traveling, it's wise to call your Medicare Advantage plan directly. Ask them about their specific rules for care when you are away from home. Some plans, especially PPOs (Preferred Provider Organizations) and PFFS (Private Fee-for-Service) plans, may offer limited coverage for non-emergency care outside your service area, but usually at a higher cost. HMOs (Health Maintenance Organizations) generally offer no coverage for non-emergency care outside their network. Understanding your plan's specific rules helps you avoid unexpected bills.

What about Medicare outside the US?

Original Medicare generally does not cover healthcare services you receive outside the United States. The U.S. generally means the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. If you get sick or injured while traveling in a foreign country, you will usually be responsible for the full cost of your medical care.

There are very limited exceptions where Original Medicare might pay for healthcare outside the U.S. These include: if you are in the U.S. or its territories and need care in Canada or Mexico. This is only if the foreign hospital is closer than the nearest U.S. hospital that can treat your condition. Another exception is if you are on a ship within the territorial waters of the U.S., and the doctor is authorized to provide Medicare services. However, if the ship is more than 6 hours away from a U.S. port, Medicare usually will not pay. These situations are rare and specific, so relying on them for coverage is not advised.

Does Medicare Advantage cover travel abroad?

Some Medicare Advantage plans may offer limited coverage for emergency care when you travel outside the U.S. This is not a standard benefit for all plans. If your plan does offer this, it usually applies only to true medical emergencies. It might come with specific limits on how much the plan will pay. For example, there might be a lifetime maximum benefit for foreign travel emergencies, such as $50,000. You would likely pay a deductible and coinsurance for these services. Often, you will need to pay for the services upfront and then submit a claim to your plan for reimbursement.

It is crucial to check with your specific Medicare Advantage plan before any international travel. Ask if they offer foreign travel emergency coverage, what it covers, and what your out-of-pocket costs would be. Understand the definition of an "emergency" according to your plan, as it can be very strict. Keep detailed records and receipts for any care you receive abroad. This table compares how Original Medicare and a typical Medicare Advantage plan might cover you internationally.

This table shows that neither Original Medicare nor most Medicare Advantage plans provide broad coverage for international travel. This makes additional planning very important for trips outside the U.S.

How Medigap helps with foreign travel

Medigap (Medicare Supplement Insurance) plans work differently. These plans help pay some of the out-of-pocket costs that Original Medicare does not cover. Certain Medigap plans offer a foreign travel emergency benefit. These plans are Medigap Plans C, D, F, G, M, and N.

If you have one of these Medigap plans, it may cover 80% of approved costs for foreign travel emergency care. This applies after you meet a $250 deductible each year. The benefit has a lifetime limit of $50,000. So, for example, if you have a medical emergency abroad costing $1,000, you would first pay the $250 deductible. Then, your Medigap plan would pay 80% of the remaining $750, which is $600. You would pay the remaining $150, for a total of $400 out of pocket.

This foreign travel emergency benefit covers care that begins during the first 60 days of your trip abroad. It only covers services that would generally be covered by Medicare Part A and Part B in the U.S. This benefit can provide important financial protection for unexpected medical needs while you are overseas. However, it is still an emergency benefit with a lifetime limit. It is not meant for extensive medical treatment abroad or for pre-planned procedures. It helps with sudden, unexpected health events.

Prescription drugs when traveling

Medicare Part D plans (prescription drug coverage) generally do not cover prescriptions filled outside the United States. This applies whether you have a stand-alone Part D plan or a Medicare Advantage plan with drug coverage. The reasons include different drug regulations, pharmacy networks, and formularies (lists of covered drugs).

If you need medications while traveling internationally, you will usually have to pay the full cost out of pocket. It is wise to bring an adequate supply of your prescription medications for your entire trip, plus a few extra days for unexpected delays. Always carry them in your carry-on luggage with their original labels. Also, bring a copy of your prescriptions or a letter from your doctor, detailing your medical conditions and medications, including generic names. This can be helpful for customs officials and in case you lose your medication or need to get a refill in an emergency. Some countries have strict rules about certain medications, so research those before you go.

If you are traveling within the U.S., your Part D plan should cover your prescriptions as usual. However, you might need to use a network pharmacy. If you are away from home, use your plan's website or call member services to find a network pharmacy in your travel location. Always plan ahead for refills to avoid any interruptions in your medication. For longer trips, inquire with your plan about early refill exceptions or mail-order options. For more information on drug coverage, see Medicare Part D: Your Prescription Drug Coverage Choices.

Planning your healthcare for a trip

Before any trip, especially international ones, take these steps to prepare your healthcare: If you have Original Medicare, decide if you need supplemental coverage. This could be a Medigap plan with foreign travel benefits or a separate travel insurance policy. If you have a Medicare Advantage plan, contact them directly. Ask about their rules for out-of-area care in the U.S. and any foreign travel emergency benefits. Clarify the claims process for international care, as it often requires you to pay upfront.

For any trip, carry your insurance cards, a list of your medications, and your doctor's contact information. Create a medical information sheet with your allergies, current health conditions, and emergency contacts. If traveling abroad, also keep copies of your prescriptions. Research local medical facilities at your destination, especially for international travel. Knowing where to go in an emergency can save valuable time and reduce stress.

It's also a good idea to enroll in the Smart Traveler Enrollment Program (STEP) if you are traveling internationally. This free service from the U.S. government allows you to receive alerts from the nearest U.S. Embassy or Consulate. It also helps your family and friends contact you in an emergency. Being prepared can help you enjoy your travels with peace of mind. Check the U.S. State Department website for any travel advisories or health warnings for your destination.

What if Medicare doesn't cover your international care?

If Medicare does not cover your medical needs while traveling abroad, you will be responsible for the full cost. This is why many people choose to buy separate travel insurance. Travel insurance plans can offer broader coverage than what Medicare or Medigap provides for international travel. They can cover medical emergencies, trip cancellations, trip interruptions, lost luggage, and more. Look for a comprehensive policy that fits your specific travel itinerary and health needs.

When choosing travel insurance, look for a policy that includes medical evacuation coverage. This pays for transporting you to a medical facility or even back home if you have a serious medical emergency. These costs can be very high and are rarely covered by standard health insurance or Medigap plans. Compare different policies to find one that fits your travel plans and health needs, paying attention to coverage limits and exclusions.

Remember to read the fine print of any travel insurance policy carefully. Understand what it covers, its exclusions, and how to file a claim. Be aware of any pre-existing condition clauses; some policies waive these if purchased within a certain number of days after your initial trip deposit. Choosing the right travel insurance is a key step in planning for safe and enjoyable international travel, providing an important safety net for unexpected situations.

Have questions? Call 1-877-443-3251 to talk it through with a licensed insurance agent. They're paid by the plans they represent, never by you, and the decision stays yours.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information.