Does Medicare Cover Expenses Overseas?

Any great relationship starts with a conversation, so let’s start there.

Some very important questions we are asked a LOT are:

“Does my Medicare plan cover me…

  • …overseas?”
  • …when I travel overseas?
  • …when I live abroad?”

We will answer these important questions for you and offer you a few additional resources below.

Original Medicare Coverage

It’s important to note that Original Medicare does not cover medical expenses or prescription drugs purchased overseas. There are a few territories that are under U.S. control such as U.S. Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands, where Medicare does cover expenses.

Medicare Supplement

While Original Medicare does not cover overseas expenses, medicare supplements (aka medigap plans) F, G, and N do provide limited coverage for emergency care within the first 60 days abroad.

  • $50,000 lifetime maximum benefit
  • $250 annual deductible
  • 80% coverage up to the $50,000 benefit

Because providers overseas are ineligible to submit claims for reimbursement to–and are also clueless about the Medicare program, you’ll need to pay the expense upfront and be sure to gather your receipts, itemized medical bill, medical notes, and submit to your insurance company for review afterwards. Make sure the expense you’re submitting was necessary, and an emergency or urgently needed.

UnitedHealthcare Medicare Advantage Coverage

UnitedHealthcare does include coverage for emergency medical expenses incurred while traveling overseas. Below is an excerpt directly pulled from one of their Evidence of Coverage documents. (Be sure to check your plans Evidence of Coverage document to ensure it states the same.)

Section 3.1 Getting care if you have a medical emergency

What is a “medical emergency” and what should you do if you have one?
A “medical emergency” is when you, or any other prudent layperson with an average knowledge of health and medicine, believe that you have medical symptoms that require immediate medical attention to prevent loss of life, loss of a limb, or loss of function of a limb.

The medical symptoms may be an illness, injury, severe pain, or a medical condition that is quickly getting worse. If you have a medical emergency:

  • Get help as quickly as possible.
  • Call 911 for help or go to the nearest emergency room or hospital.
  • Call for an ambulance if you need it.
  • You do not need to get approval or a referral first from your PCP.

What is covered if you have a medical emergency?
You may get covered emergency medical care whenever you need it, anywhere in the world. Our plan covers ambulance services in situations where getting to the emergency room in any other way could endanger your health. For more information, see the Medical Benefits Chart in Chapter 4 of this booklet.

If you receive emergency or urgently-needed services outside of the United States or its territories, you generally will be required to pay the bill at the time you receive the services. Most foreign providers are not eligible to receive reimbursement directly from Medicare, and will ask you to pay for the services directly. Ask for a written, detailed bill or receipt showing the specific services provided to you. Send a copy of the itemized bill or an itemized receipt to us to pay you back. You should be prepared to assist us in obtaining any additional information necessary to properly process your request for reimbursement, including medical records. If you have an emergency, we will talk with the doctors who are giving you emergency care to help manage and follow up on your care. The doctors who are giving you emergency care will decide when your condition is stable and the medical emergency is over. After the emergency is over you are entitled to follow-up care to be sure your condition continues to be stable. Your follow-up care will be covered by our plan.

If you get your follow-up care from out-of-network providers, you will pay the higher out-of-network cost-sharing.

What if it wasn’t a medical emergency?
Sometimes it can be hard to know if you have a medical emergency. For example, you might go in for emergency care – thinking that your health is in serious danger – and the doctor may say that it wasn’t a medical emergency after all. If it turns out that it was not an emergency, as long as you reasonably thought your health was in serious danger, we will cover your care. However, after the doctor has said that it was not an emergency, the amount of cost-sharing that you pay will depend on whether you get the care from network providers or out-of-network providers.

If you get the care from network providers, your share of the costs will usually be lower than if you get the care from out-of-network providers.

Additional Coverage

Generally, it is also advised to pick up travel medical insurance for the term of your cruise or overseas trip. While your policy provides emergency coverage, there are many non-emergency situations that may arise that could be costly as well. Buffer Insurance agency provides several options from top-travel insurance companies, IMG and Trawick.

COVID Insurance

Meeting COVID insurance requirements for select countries. If you’re traveling overseas and are required to provide proof of COVID insurance (ie Costa Rica), Trawick will be your least costly option. Feel free to ask your agent about these plans.

As always, we believe your future matters and that it is worth protecting. If you do go on a trip, we’d love to see some pictures.

Conclusion

While most Medicare beneficiaries have some coverage overseas, we recommend purchasing a travel medical plan to supplement your stay abroad. And if you are living overseas, or staying more than 60 days, you should not rely on Medicare to cover you beyond this period.

Safe travels 🏖️

1 Comment

  1. Maureen Einspanier

    Thanks for the info. We went to Cancun last month stayed at Grand Serenis with friends. They were great and staff and golf personnel of Bahia Principa ( ask if they have gotten new carts: very important) were amazing and very Covid safe. ie Mask, sanitizing, gave Covid test for required US reentry.

    Reply

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