Am I covered through Medicare outside the USA?

 

Many people look forward to retirement for one specific reason – to travel. As a matter of fact, nearly 30 million baby boomers have bucket lists that focus on travel. According to AARP, the top travel destinations outside the USA that baby boomers most want to travel to are Europe, the Caribbean, and Asia. 

However, traveling internationally isn’t the only way baby boomers wish to spend their retirement. Many baby boomers have or plan to retire abroad. According to the Social Security Administration, over 400,000 retired Social Security beneficiaries live outside the USA. 

Some seniors retire abroad because of family ties in the foreign country or because they want to feel like they’re on vacation for their entire retirement. No matter what the reason for traveling outside the USA is, it’s important to know how Medicare covers you while you’re gone. 

Vacationing outside the USA with Medicare

Before your set out on your adventure, you should learn how Medicare will cover you during your vacation. Ultimately, your coverage depends on the type of Medicare plan you’re enrolled in. Original Medicare and Medigap plans cover you differently than Medicare Advantage plans. 

Original Medicare and Medigap plans

Original Medicare comprises of Parts A and B. These two parts supply you with your hospital and medical coverage. Original Medicare offers very little in terms of foreign travel coverage. There are only three types of scenarios where Original Medicare may cover your healthcare outside the USA.

  1. An emergency occurs while you’re in the USA, but a foreign hospital is closest.
  2. You’re traveling directly to or from Alaska through Canada, and an emergency occurs, and a Canadian hospital is closest.
  3. You are home in the USA when an emergency occurs, and a foreign hospital is closest.

Other than these three scenarios, Original Medicare doesn’t offer any foreign travel coverage. However, keep in mind that if you travel to any of the U.S. territories, such as Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, or the Northern Mariana Islands, Original Medicare will cover you just like it does in the states.

Medigap plans generally only pay if Original Medicare first pays. However, some Medigap plans have an additional benefit outside of Original Medicare called foreign travel emergency coverage. Medigap Plans C, D, F, G, M, and N all offer this benefit. The benefit is only viable during the first 60 days of your trip and comes with a $250 deductible and $50,000 lifetime limit. 

Medicare Advantage plans

Medicare Advantage plans are required to offer coverage as good as Original Medicare. Therefore, if Original Medicare covers it, so should the Medicare Advantage plan. However, the coverage can vary from plan to plan. Most Medicare Advantage plans office foreign travel coverage similarly to Medigap plans. However, your coinsurance may be more or less than 20%. If your Medicare Advantage plan offers this benefit, you will likely have a deductible as well as other restrictions. 

Living outside the USA with Medicare

Medicare barely offers foreign travel coverage, let alone full-time coverage while living outside the USA. So, unless you live in one of the U.S. territories mentioned above, Medicare will not cover you while living outside the USA. Also, if you have a Medicare Advantage plan and then move out of the country, your plan will automatically disenroll you once you have been outside of your plan’s service area for six months. 

You might be thinking, why would you even get Medicare if you plan to live outside the USA in retirement. Well, because if you don’t enroll in Medicare when you’re first eligible and later decide to enroll, you’ll have a hefty lifelong late penalty. 

Another reason why expats enroll in Medicare is to have the option to come back to the USA when and if they ever get sick. If you were to be diagnosed with a serious health condition, Medicare would allow you to get top-notch healthcare in the states. Also, some people who retired outside the USA get Medicare just in case they ever move back to the states. So if you plan to travel or retire outside the USA, be prepared to research other forms of insurance. 

Paul Petersen

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