As we enter the sunny summer season, thoughts turn to getting away from it all and planning a relaxing vacation. If you’re retired, summering in the Mediterranean might seem very appealing. However, if you have Medicare and get sick, it might not feel quite so appealing, since Medicare coverage outside of the United States is very limited.
Why It Matters
The U.S. is considered the 50 states, D.C., Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa. Outside of these areas, traditional Medicare coverage is limited. Medicare Advantage Plans may or may not cover illness when traveling outside of the U.S. (you need to verify coverage). Also, watch out for cruise ships outside of U.S. waters; Medicare will only cover you if you’re within six hours of a U.S. port.
If you’re soaking up the sun in Italy and become ill, prescriptions are not covered. Physicians’ visits are not covered either, unless immediately before and during an inpatient hospital stay. Medicare A will pay for emergency inpatient hospital care when you’re formally admitted to a foreign hospital. It will also cover an emergency ambulance only in connection with the inpatient stay.
If you need a physician’s services after the inpatient stay or an ambulance trip or plane ride home, Medicare will not cover that cost. If the stay is covered, you still need to pay for covered services plus the co-insurance or deductibles you would normally have to pay.
Moreover, foreign hospitals are not required to submit an insurance claim on your behalf. You may have to first pay the bills yourself. Then, you must submit to Medicare an itemized bill for the stay and any doctor or ambulance services if you want reimbursement, provided you’re covered under your policy.
But Wait, There’s More
Outside of these limited coverage reasons, none of your medical bills for seeing a doctor or obtaining a prescription will be covered. A case of Montezuma’s revenge could get mighty pricey in Mexico. So, be careful about what you eat and drink, and follow any precautions recommended by your travel agent or booking company. Obtain all inoculations required for the countries you plan to visit. Carry prescription medications and over-the-counter remedies in your carry-on luggage.
Finally, you might want to consider a travel insurance policy to cover medicals bills and travel costs home as a result of an illness. Read the policy closely, though, because not all offer typical health insurance. You may need to contact a private health insurance provider to purchase specific trip health insurance.
Don’t forgo a trip abroad simply because of a worry about your health care. Just plan ahead and make sure you’re prepared. Bon Voyage!
*Laurie G. Steiner is a member of the law firm of Solomon, Steiner & Peck, Ltd. She was named as a 2019 Super Lawyer by Thompson-Reuters Co. She is a Certified Elder Law Attorney by the National Elder Law Foundation and the Ohio State Bar Association and an Accredited attorney for the preparation, presentation and prosecution of claims for veterans’ benefits before the Department of Veterans Affairs (VA). She practices in the areas of Elder Law, Medicaid, VA and Disability Planning, and Estate and Trust Planning and Administration.
