Medicare Coverage Outside the United States

Revised June 2014

This fact sheet explains coverage under Original Medicare.

Medicare coverage outside the United States is limited.

In most situations, Medicare won’t pay for health care or supplies you get 

outside the U.S. The term “outside the U.S.” means anywhere other than the 50 

states of the U.S., the District of Columbia, Puerto Rico, the U.S. Virgin Islands, 

Guam, American Samoa, and the Northern Mariana Islands. This fact sheet 

explains some of the exceptions that would allow you to get coverage outside 

the U.S. under Original Medicare Part A (Hospital Insurance) and/or Medicare 

Part B (Medical Insurance).

When does Medicare cover health care services in a 

foreign hospital?

There are 3 situations when Medicare may pay for certain types of health care 

services you get in a foreign hospital (a hospital outside the U.S.):

1. You’re in the U.S. when you have a medical emergency, and the foreign 

hospital is closer than the nearest U.S. hospital that can treat your illness or 

injury.

2. You’re traveling through Canada without unreasonable delay by the most 

direct route between Alaska and another state when a medical emergency 

occurs, and the Canadian hospital is closer than the nearest U.S. hospital 

that can treat your illness or injury. Medicare determines what qualifies as 

“without unreasonable delay” on a case-by-case basis.

3. You live in the U.S. and the foreign hospital is closer to your home than the 

nearest U.S. hospital that can treat your medical condition, regardless of 

whether it’s an emergency.

Remember, in these situations, Medicare will pay only for the Medicarecovered services you get in a foreign hospital.
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What kind of health care services does Medicare pay for in 

the 3 situations described on page 1?

Original Medicare covers these services:

•	 Part A covers inpatient hospital care (care you get when you’ve been formally 

admitted with a doctor’s order to the foreign hospital as an inpatient). 

For more information on understanding your hospital status, visit 

Medicare.gov/publications to view the publication “Are You a Hospital 

Inpatient or Outpatient?”

•	 Part B covers emergency ambulance and doctor services you get immediately 

before and during your covered foreign inpatient hospital stay. However, if 

Medicare doesn’t cover your hospital stay, and/or you get ambulance and doctor 

services outside the hospital after your covered hospital stay ends, Medicare 

generally won’t pay for these services. For example, Medicare won’t cover return 

ambulance trips home.

•	 Part B covers non-emergency doctor and ambulance services that you get 

immediately before and during your covered foreign inpatient hospital stay. 

However, if Medicare doesn’t cover your hospital stay and/or you get doctor 

services outside the hospital, Medicare generally won’t pay for these services. 

For example, Medicare won’t cover doctor services you get in Canada after your 

covered Canadian hospital stay ends.

Remember, Medicare only pays for its share of services covered by Original 

Medicare. If you only have Part A, Medicare only covers inpatient hospital care.

Does Medicare pay for dialysis treatments when I travel 

outside the U.S.?

Unless it’s an emergency in which you get dialysis at a hospital, Medicare doesn’t 

cover dialysis when you travel outside the U.S.

Does Medicare pay for prescription drugs outside the U.S.?

Medicare drug plans can’t cover prescription drugs you buy outside the U.S. Call 

your drug plan for more information.
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Will Medicare pay for medically necessary health care services 

I get on a cruise ship?

Medicare may cover medically necessary health care services you get on a cruise ship 

in these situations:

•	 The doctor is allowed under certain laws to provide medical services on the cruise 

ship.

•	 The ship is in a U.S. port or no more than 6 hours away from a U.S. port when you 

get the services, regardless of whether it’s an emergency.

Medicare doesn’t cover health care services you get when the ship is more than 6 

hours away from a U.S. port. 

What do I pay if I get Medicare-covered services outside 

the U.S.?

Except in the limited situations described in this fact sheet, Medicare doesn’t pay for 

health care services you get outside the U.S. If your circumstances don’t meet these 

limited exceptions, you pay the full cost to the health care provider.

If your situation matches one of the exceptions in this fact sheet, and Medicare 

covers the items or services you get, you still pay the coinsurance or copayments and 

deductibles you would normally pay if you got these same services or supplies inside 

the U.S.

Although U.S. hospitals must submit claims to Medicare for you, foreign hospitals 

aren’t required to file Medicare claims. If you’re admitted to a foreign hospital under 

one of the three situations described on the first page, and if that hospital doesn’t 

submit Medicare claims for you, then you must submit an itemized bill to Medicare 

for your doctor, inpatient, and ambulance services.

If you got Medicare-covered services on a cruise ship under a situation described 

in the previous question, the doctor must ordinarily submit the Medicare claim. 

However, you may also file a claim directly to Medicare in these rare circumstances.

For information on where to send a foreign claim, please visit 

Cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS012949.html to 

get the “Patient’s Request for Medical Payment” form (CMS 1490S). You should print 

out the form and instructions that apply to your situation (like for services you got 

on a cruise ship or during other foreign travel). You can also call 1-800-MEDICARE 

(1-800-633-4227). TTY users should call 1-877-486-2048.
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What if I have a Medigap (Medicare Supplement Insurance) 

policy?

Your Medigap policy may offer additional coverage for health care services 

or supplies that you get outside the U.S. A Medigap policy is supplemental 

health insurance sold by private insurance companies to fill “gaps” in Original 

Medicare coverage. A Medigap policy must be standardized in all states, 

except Massachusetts, Minnesota, and Wisconsin. (These states have Medicare 

supplemental coverage similar to the standardized Medigap plans and may offer 

similar foreign travel benefits.) Most states identify the policies as lettered plans, 

so you can compare them easily.

Standard Medigap plans C, D, F, G, M, and N provide foreign travel emergency 

health care coverage when you travel outside the U.S. Plans E, H, I, and J are no 

longer for sale, but if you bought one before June 1, 2010, you may keep it. All of 

these plans also provide foreign travel emergency health care coverage when you 

travel outside the U.S.

Medigap plans C, D, E, F, G, H, I, J, M, and N pay 80% of the billed charges for 

certain medically necessary emergency care outside the U.S. after you meet a $250 

deductible for the year. These Medigap policies cover foreign travel emergency 

care if it begins during the first 60 days of your trip, and if Medicare doesn’t 

otherwise cover the care. Foreign travel emergency coverage with Medigap 

policies has a lifetime limit of $50,000.

Before you travel outside the U.S., talk with your Medigap company or insurance 

agent to get more information about your Medigap coverage while traveling. 

To learn more about Medigap policies, visit Medicare.gov/publications to view 

the booklet, “Choosing a Medigap Policy: A Guide to Health Insurance for People 

with Medicare.” You can also call 1-800-MEDICARE (1-800-633-4227) for more 

information. TTY users should call 1-877-486-2048.

What if I get my health care from another Medicare health 

plan rather than Original Medicare?

If you have a Medicare Advantage Plan (like an HMO or PPO) or another 

Medicare health plan, your plan may offer additional coverage for health care 

services you get outside the U.S. Check with your plan before traveling to see 

what’s covered.
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Can I buy travel insurance to help pay for the cost of health 

care services?

Yes. Because Medicare has limited coverage of health care services outside the U.S., 

you can choose to buy a travel insurance policy to get more coverage. An insurance 

agent or travel agent can give you more information about buying travel insurance. 

Travel insurance doesn’t necessarily include health insurance, so it’s important to 

read the conditions or restrictions carefully. 

Where can I get more information?

•	 Visit Medicare.gov to find out what Medicare covers.

•	 Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 

1-877-486-2048.
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Notes
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Notes
CMS Product No. 11037