Haris Ashley
Medicare is a health insurance program offered by the federal government of the United States. It is important to note that Medicare generally does not cover healthcare outside of the US. However, there are some rare cases where Medicare may pay for inpatient hospital, doctor, and ambulance services in a foreign country. For example, if you experience a medical emergency in the US but the nearest hospital that can treat your condition is in a foreign country. If you are planning to move abroad, it is important to explore other health coverage options in your country of residence. You may qualify for national health insurance or be able to purchase private health insurance. Additionally, if you are a US citizen, you can continue to receive Social Security retirement benefits while living abroad.
| Characteristics | Values |
|---|---|
| Medicare coverage outside the US | Medicare usually doesn't cover healthcare outside the US. |
| Medicare Part A | Most people qualify for premium-free Part A, which covers most medically necessary hospital inpatient care. If you pay for Part A, you may only be able to enrol if you live in the US. |
| Medicare Part B | Part B covers medically necessary doctor services, preventive care, hospital outpatient care, durable medical equipment, laboratory tests, x-rays, mental health services, and some home health care and ambulance services. You must pay a monthly premium for Part B, even if you live abroad. |
| Medicare Advantage and Part D | If you have these plans, you should disenroll when moving abroad as they require you to live in their service area. |
| Medigap | Supplemental insurance plans that cover medical emergencies that Medicare doesn't cover during the first 60 days of your trip. |
| Social Security Benefits | You can receive Social Security benefits while living abroad in most countries if you're eligible. |
| Travel Insurance | Travel insurance doesn't always include health insurance, so check carefully. |
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What You'll Learn
Medicare Part A and Part B enrolment
Medicare Part A, also known as hospital insurance, covers most medically necessary hospital inpatient care, skilled nursing facility (SNF) care, home health care, and hospice care. Most people qualify for premium-free Part A, meaning they will pay nothing for coverage. However, if you must pay a premium for Part A, you will be faced with high monthly costs for maintaining Part A coverage.
Medicare Part B, also known as medical insurance, covers most medically necessary doctor services, preventive care, hospital outpatient care, durable medical equipment (DME), laboratory tests, x-rays, mental health services, and some home health care and ambulance services. To maintain Part B coverage, you must pay the monthly Part B premiums.
If you are 65 or older and qualify for Medicare, you can enrol in Medicare Parts A and B, also known as Original Medicare. Almost all doctors and hospitals in the U.S. accept Original Medicare. Even if you are moving abroad, it is usually best to keep Part A because it is typically free. However, keeping Part B may not be worth the cost if you live abroad permanently and do not take frequent trips to the U.S.
To enrol in Medicare Parts A and B, you must meet certain requirements. Firstly, you must be a U.S. resident and either a U.S. citizen or a lawful permanent resident who has resided in the United States for at least five continuous years prior to filing an application for Medicare. Secondly, you must contact the Social Security Administration (SSA) to apply for Medicare. The easiest and fastest way to sign up is to apply online by creating a secure my Social Security account. However, you can only sign up for Part B (or Part A if you pay a premium for it) at certain times, known as Special Enrollment Periods. These Special Enrollment Periods allow you to sign up without penalties during specific windows. For example, if you have been covered by an active employer group health plan that ended within the last eight months, you can enrol in Part B during a Special Enrollment Period without any penalty.
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Foreign hospital Medicare claims
Medicare typically does not cover healthcare outside the US. However, there are some specific circumstances in which Original Medicare plans are required to pay for inpatient hospital bills, doctor bills, ambulance charges, or dialysis expenses abroad.
Medicare Part A (Hospital Insurance) covers hospital care when you've been formally admitted with a doctor's order to a foreign hospital as an inpatient. Medicare Part B covers emergency and non-emergency ambulance and doctor services before and during a covered foreign inpatient hospital stay.
Medicare may pay for inpatient hospital, doctor, and ambulance services in a foreign country in the following rare cases:
- You're in the US when a medical emergency occurs, and the foreign hospital is closer than the nearest US hospital that can treat your medical condition.
- You're travelling through Canada without unreasonable delay by the most direct route between Alaska and another US state when a medical emergency occurs, and the Canadian hospital is closer than the nearest US hospital that can treat the emergency.
- You live in the US and the foreign hospital is closer to your home than the nearest US hospital that can treat your medical condition, regardless of whether an emergency exists.
It is important to note that foreign hospitals are not required to file Medicare claims for your travel medical costs. You will need to submit an itemized bill to Medicare for your doctor, inpatient, and ambulance services if the foreign hospital doesn't submit Medicare claims for you.
Medicare supplement insurance (Medigap) policies may cover emergency care when you travel outside the US. Travel medical insurance (also referred to as travel health insurance) is temporary health coverage designed to pay for emergency medical expenses stemming from unexpected illness or injury abroad.
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Medicare coverage abroad
If you are planning to move abroad, your Medicare coverage will become limited. Medicare usually doesn't cover healthcare outside the US, so it's important to explore your options for health coverage in your new country of residence. You may qualify for national health insurance, or you may need to buy private health insurance.
If you are enrolled in premium-free Medicare Part A, you can keep this even if you are moving abroad, because it is free. Part A covers most medically necessary hospital inpatient care, skilled nursing facility (SNF) care, home health care, and hospice care. However, if you have to pay a premium for Part A, you may only be able to enrol if you live in the US, and the monthly cost is high. If you are enrolled in Part A, you cannot disenrol without paying back all the benefits you have received.
Medicare Part B covers medically necessary doctors' services, preventive care, hospital outpatient care, durable medical equipment (DME), laboratory tests, x-rays, mental health services, and some home health care and ambulance services. If you plan to move back to the US or travel back frequently, you may want to keep Part B, as it will ensure you have coverage when you travel to the US and you will not face premium penalties or gaps in coverage. However, if you do not plan to return to the US, keeping Part B may not be worth the cost, as you must continue to pay monthly premiums even though Medicare will not cover your care.
Medicare Advantage and Part D plans require that you live in their service area, so you should disenrol from these plans when you move abroad.
Medicare may pay for inpatient hospital, doctor, and ambulance services you receive in a foreign country in the following rare cases:
- You experience a medical emergency in the US, but the nearest hospital that can treat you is in a foreign country.
- You experience a medical emergency while travelling through Canada via the most direct route between Alaska and another US state, and the Canadian hospital is closer than the nearest US hospital that can treat the emergency.
- You live in the US and the nearest hospital is in a foreign country.
Medicare supplement insurance (Medigap) policies may cover emergency care when you travel outside the US. You could also look into buying a travel insurance policy to get more coverage.
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Foreign national health insurance
If you are a foreign national looking to obtain health insurance in the US, there are several options available to you. The US does not offer universal healthcare, so you will need to purchase health insurance from a private provider. Here are some options for foreign nationals seeking health insurance in the US:
- GeoBlue Xplorer: This is a popular health insurance provider in the US, offering comprehensive benefits and a premium level of customer service. GeoBlue Xplorer is a partner of Blue Cross and Blue Shield of America (BCBS), which gives it a wider network of high-quality doctors and hospitals included in its policies.
- IMG: IMG offers several affordable medical insurance plans in the US, making it a good option for foreigners on a budget. Their Bronze and Silver plans provide basic-level coverage, while their Gold and Platinum plans offer more comprehensive benefits.
- Visitor Guard®: Visitor Guard offers a range of visitor health insurance policies designed to cover medical expenses for foreign nationals during their visit to the US. Their plans are affordable and flexible, tailored to meet the unique needs and travel schedules of non-residents.
- Venbrook Premier: Venbrook Premier is a leading travel medical insurance plan, providing coverage for non-US citizens travelling outside of their home country. They offer competitive rates, secure transactions, and 24/7 support.
- Safe Travels USA Comprehensive: This is a popular health insurance option for foreigners in the US, offering coverage for individuals and families. It covers the acute onset of pre-existing conditions within predetermined limits and offers flexible deductibles and policy maximums.
- Atlas America: Atlas America insurance covers the acute onset of non-chronic pre-existing conditions and includes benefits like emergency medical evacuation and adventure sports coverage. This plan covers individuals up to the age of 70 years.
- Patriot America Plus: Patriot America Plus offers policy maximum options ranging from $50,000 to $1 million.
It is important to note that the cost and coverage of health insurance plans can vary widely, so it is recommended to research and compare different options before purchasing a plan. Additionally, certain visas, like the J-1, require proof of insurance from an approved provider, so be sure to check the requirements for your specific visa type.
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Private health insurance
If you're planning to live in a foreign country and are wondering about your Medicare insurance coverage, there are a few things to keep in mind. Firstly, Medicare typically does not cover healthcare costs outside the US, with some rare exceptions. For example, Medicare Part B may cover services received on a ship within the territorial waters adjoining the US land areas. In some emergency cases, where a foreign hospital is closer than a US hospital, Medicare may cover inpatient hospital, doctor, and ambulance services in a foreign country. However, these instances are rare, and generally, you will pay 100% of the costs when travelling outside the US.
Medicare Supplement Insurance (Medigap) policies may cover emergency care when travelling outside the US, but this is limited. As such, you may need to purchase a separate travel insurance policy for more coverage.
If you plan to live abroad permanently, it is recommended to explore health coverage options in your new country of residence. You may qualify for national health insurance, or you may need to purchase private health insurance. Expat health insurance is specifically designed for expatriates and their families, allowing access to private healthcare both locally and overseas. This can be beneficial as it provides quicker access to healthcare services and covers the costs of medical treatment in your new country.
When considering private health insurance, it is important to work with a licensed broker who can guide you through the process. Most global health plans require you to apply 30 to 45 days before your departure date to complete the approval process. You may also need to provide an updated health declaration to ensure there are no new health conditions that were not included in the initial application.
The monthly cost of expat health insurance will vary depending on the type of plan and level of coverage chosen. Some providers offer a range of packages to suit different needs and budgets, including essential cover for hospitalization and major medical events, as well as more comprehensive coverage for pre-existing conditions.
It is important to carefully review the terms and conditions of any private health insurance plan to ensure it meets your specific needs and provides adequate coverage for your intended country of residence.
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Frequently asked questions
Medicare insurance is a federal government-provided health insurance programme that pays providers directly for the services you receive.
Medicare rarely covers healthcare outside of the US. However, there are some exceptions. Medicare Part B may pay for services received on board a ship within US territorial waters. In some cases, Medicare may also pay for inpatient hospital, doctor, and ambulance services in a foreign country.
If you have either of these plans before moving abroad, you should disenroll and stop paying premiums when you move, as these plans require you to live in their service area.
If you plan to move abroad but want to keep your Medicare coverage, it is recommended that you enrol in Parts A and B. This will ensure that your care is covered when you travel to the US, and you will not face premium penalties or gaps in coverage.
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