Medicare cover does not cover international travel. Medicare Part A and Part B cover only within the US territories, and in some cases Canada and Mexico. They do not cover international travel to other countries. You can still get health care abroad if you get coverage from your employer or an overseas travel insurance policy. Medicare does not provide any coverage for international travel outside the mentioned regions.
Circumstances in which Medicare pays for medical care services outside the US:
- If you are in Canada or Mexico, Medicare Part B may pay for necessary emergency care after you have been transported back to the US. If you have to have emergency services because of an injury or illness that arose outside the United States and resulted in disability, hospitalization, or death, Medicare might pay.
- If you live near the border with Canada and the nearest hospital is in Canada, Medicare may pay for some services at a hospital, clinic, or health care provider in Canada. The claim should be done after you have been transported back to the US.
- If you are on a ship within six hours of the US port, Medicare will pay for emergency care if you are injured or become ill.
- If you travel from Alaska through Canada to another state using the most direct route and an emergency occurs, Medicare might pay for some medical services in Canada if the nearest hospital is in Canada.
In the cases above, Medicare covers the following services.
- Medicare part A will cover all the inpatient and outpatient services and drugs.
- Medicare part B covers emergency ambulance and doctor’s services you get before and during your hospital stay.
How to file a claim in the above cases:
- Go to the nearest Social Security office near you and show them your original Medicare card, proof of your identity, proof of citizenship, documents describing the services you received in Canada or Mexico, records of any hospitalization, and all bills.
- The social security office will send your documents to the Health Care Financing Administration (HCFA), which pays Medicare claims.
- HCFA will let you know if it will pay your claim and how much it will pay.
- In case you receive medical care on a ship 6 hours to our port, that doctor should submit the Medicare claims.
There are many things to remember when filing a Medicare claim.
- The time it takes for the claim to be processed by the HCFA depends on how complex your claim is and how soon it is filed.
- Sometimes, the date the HCFA receives the claim can vary depending on whether or not you send in proof of service or if a social security office requests that you do so.
- Sometimes, it can take a long time for the HCFA to decide whether to pay your claim. For example, sometimes Medicare will ask you for additional information and decide that it can’t pay your claim.
- Sometimes, there are mistakes in the process, and some doctor’s bills may be denied by Medicare because there is no proof of service.
There are several types of Medicare coverage choices:
- Original Medicare
This includes Parts A and B, it does not cover additional doctors, drugs, or hospitals. Premiums are deducted from your monthly Social Security benefit check.
- Medicare Advantage (MA) Plans: These plans, also known as Medicare Advantage plans, offer prescription drug coverage and, in some cases, additional medical benefits. These plans also cover medically-necessary care received outside the United States (although you may need to pay for extra coverage). Private insurance companies approved by Medicare sell MA plans. A monthly premium fee is deducted from your Social Security benefit check. It varies depending on the plan you choose and your state.
- Supplemental (Medigap) Plans: These plans can be purchased to help pay for some of the costs that Original Medicare doesn’t cover. Private insurance companies approved by Medicare sell them. You can purchase a Medigap plan during your initial enrollment period, which begins three months before you turn 65 and runs three months after you turn 65. A Medigap plan’s overall monthly premium is less than or equal to the sum of its parts (deductibles, coinsurance, and copayments).
Medicare Part A and Part B and their benefits are not the same for all people. Different types of Medicare programs provide different benefits. For example, Original Medicare and Medigap plans cover outpatient care only.
Medicare Advantage Plans (Parts C and D of Medicare) – Medicare Advantage plans are also known as “Part C”. It combines Part A, Part B, Part D, and prescription drug coverage. Instead of Original Medicare, you get this coverage through private insurance companies approved by Medicare. A monthly premium fee is deducted from your Social Security benefit check. The monthly premium varies depending on the plan you choose and your state.