What Medicare Doesn’t Cover and How Travel Protection Can Help

Many American retirees rely on Medicare for their medical insurance. However, Medicare’s ability to cover medical expenses that happen outside of the U.S. is really limited. This can be a real problem for seniors that love to travel.

So let’s get down to the nitty-gritty: What international medical expenses does Medicare cover, and how can Generali Travel Insurance help bridge those gaps?

Does Medicare cover you during international travel?

The answer is almost always: no.

Medicare provides domestic coverage for seniors and others within the United States, but outside of U.S. borders Medicare will not pay for health care or medical supplies in most situations.

Aside from the usual 50 states, Medicare will also cover you in Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

There are a few rare exceptions to this coverage abroad rule, like:

  • If you're traveling between Alaska and the Lower 48 and the closest hospital to treat you is in Canada

  • If you live on the Mexican or Canadian border and the closest hospital that can treat you is in the neighboring country

But these are exceptions – not the rule.

Do I need travel insurance if I have Medicare?

It’s not mandatory, but highly recommended. Given Medicare’s limited international coverage, travel insurance with medical coverage is a must-have for anyone of Medicare age who’s headed abroad.

Why? Because medical providers abroad are not part of the Medicare network or virtually any other U.S. healthcare insurer and they often demand payment up front – sometimes in cash.

While medical care generally costs less outside of the U.S., it’s still possible to run up a huge bill for even a relatively minor ailment. And should you need an emergency medical evacuation, that’s bank-breaking territory.

If you don’t have cash on hand to pay for the medical care you need, you could be in for a world of hurt. Literally.

Not all travel insurance plans include medical coverage, so be sure to check before you buy. But the good news is – all our plans include Medical and Dental coverage!

Our plans also provide No Out-of-Pocket Medical Expenses service, so we can schedule your doctor’s appointment and arrange upfront payment of up to $1,000 if you have an acute illness during your trip, while traveling in an area where this service is available. 

Will Medicare pay for medical emergencies on a cruise ship?

Medicare will not cover medical costs if the cruise ship is more than 6 hours from a U.S. port.

Necessary health care services on a cruise ship may be covered if the doctor is “allowed under certain laws to provide medical services on the cruise ship” and the ship is no more than 6 hours away from a U.S. port when the medical services are received.

How travel insurance and assistance services can help

Generali Travel Insurance has the coverage and assistance services that Medicare-eligible travelers need when they go overseas.

We’re talking about things like:

Emergency medical treatment

Generali’s travel protection plans may cover most types of expenses related to emergency medical treatments and transportation for unexpected illness or injury that occurs during your trip and are physician-ordered, including:

  • Physician/nurse services
  • Charges for hospital confinement and services
  • Local ambulance services and emergency medical evacuation
  • Necessary medical care en route
  • Prescription drugs and medicines
  • Therapeutic services
  • Emergency dental treatment
  • Repatriation to a hospital or to your place of residence in the U.S., when deemed medically necessary and approved.

With Generali travel insurance and assistance services, you can be reimbursed for costs that aren’t covered by Medicare or standard health insurance.

Because Generali’s medical case managers have been at this for years, they understand how to manage international medical providers so you get the treatment you need. Generali can help coordinate transportion to an appropriate medical facility, whether that’s in-country or back home.

One of the best things about travel medical insurance is that it’s uncomplicated. There are no deductibles or copays to deal with.* If a medical expense is covered it’s paid, up to the limits of the policy. Straightforward medical coverage like this is so important when you’re sick or injured overseas and need treatment. When choosing travel insurance, look for the highest levels of emergency medical coverage you can afford. With Generali’s Premium Plan, you get $250,000 per person of Medical and Dental coverage.

Hospital companion benefit: If you’re traveling alone and hospitalized for more than seven days, coverage is included to fly one person of your choosing to accompany you. Generali’s plans also provide coverage for their lodging, meals, local transportation and telephone calls during this time (up to $10,000 limit applies for companion hospitality expenses).

Medical evacuation and transportation

When it comes to emergency medical evacuation, Medicare is not guaranteed to cover an emergency medical evacuation or ambulance ride, even if it happens stateside. And if it is covered, there are copays and deductibles that you will need to pay.

If you’re a Medicare-age senior, having travel insurance with coverage for emergency medical evacuation is an absolute must, even if you’re just traveling domestically. Travel insurance with coverage for medical evacuation can help keep travelers from getting stuck with huge costs if seriously injured or sickened on a trip.

According to the Centers for Disease Control and Prevention (CDC), medical evacuation by air ambulance can cost more than $100,000 and if you are traveling internationally or in a remote area the cost can be even greater. 

Generali travel protection plans include Emergency Assistance and Transportation coverage limits from $250,000 to $1 million per person, depending on the plan you choose.**

Medical repatriation benefit: Once a covered medical evacuation happens, we monitor the situation and when you are well enough to travel, we use our network of resources to help you get home safely. For non-emergency situations, the plan provides coverage for medically necessary transportation to a hospital or to your place of residence. In lieu of returning to your place of residence, you may choose to be returned to an alternative U.S. city if proper care for your condition is not available.

Trip interruption coverage

The other part of an overseas medical emergency that Medicare doesn’t begin to touch is this: What happens to all the money you spent on the rest of your trip if a medical emergency forces you to interrupt your trip in order to receive treatment?

Generali travel plans may not only help reimburse you for unused, prepaid, non-refundable travel expenses, they may also help pay for transportation back home if your medical emergency forces you to interrupt your trip.

24/7 Travel Assistance

Navigating the medical system in a foreign country can be daunting.

Fortunately, Generali offers 24/7 Travel Assistance to help you understand the process, find a nearby hospital, arrange for medical transport, and handle all the collateral issues that go with a medical emergency – things like rescheduling itineraries, changing arrangements, and canceling reservations.

Generali travel assistance is there when you need it and can provide live help with almost any issue while traveling.



Medicare has an indispensable place within the American healthcare system, but once you leave the country Medicare stays behind.

International travel insurance for people covered under Medicare isn’t a luxury; it's a necessity, unless you don’t want coverage for a potentially expensive medical emergency abroad.

As you run the numbers for your next journey, factor in travel protection and peace of mind provided by Generali. Get a quote today.


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