What Medicare Doesn’t Cover & How Travel Insurance Can Help

Key Takeaways

Medicare does not typically cover medical expenses outside the United States, with rare exceptions for emergencies near Canadian or Mexican borders or during travel between Alaska and the lower 48.
Medicare will likely not cover medical costs on cruise ships that are more than 6 hours away from a U.S. port.
Medical evacuation by air ambulance can cost over $100,000 internationally, and Medicare does not guarantee coverage for emergency medical evacuations even within the U.S.
Generali Global Assistance travel protection plans offer emergency medical coverage up to $250,000 per person and emergency assistance and transportation coverage ranging from $250,000 to $1 million per person.

Does Medicare Cover International Travel?

The answer is almost always: no.

Original Medicare provides domestic coverage for seniors and others within the United States. However, outside U.S. borders, Original Medicare typically does not pay for health care or medical supplies.

In addition to the 50 states and the District of Columbia, Medicare will also cover you in Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

Three Rare Exceptions to Medicare's No-Coverage Rule

There are a few rare exceptions to Medicare’s lack of coverage abroad:

If you have a medical emergency in the United States and the closest hospital that can treat you is in Canada or Mexico.
If you're traveling between Alaska and the lower 48, and the closest hospital to treat you is in Canada.
If you live near the Mexican or Canadian border and the closest hospital that can treat you is in the neighboring country.

Outside of these exceptions, services such as dialysis treatment while traveling abroad generally aren’t covered by Original Medicare.

How to Submit a Rare Foreign Medicare Claim

Foreign hospitals may not file Medicare claims for you. If one of these exceptions applies, you may need to submit an itemized bill to Medicare yourself.

But these are exceptions – not the rule.

Why Travel Protection Matters Even With Medicare

It’s not mandatory, but it’s worth serious consideration. Given Medicare’s limited international coverage, travel protection with medical coverage may be one of the most important steps you take before traveling abroad. To understand why you may need both, it helps to compare what your health coverage does with what travel protection may add.

Why? Because medical providers abroad are not part of the Medicare network or virtually any other U.S. healthcare insurance network, and they often demand payment upfront –sometimes in cash. In many destinations, medical care may cost less than it does in the U.S., but it’s still possible to run up a huge bill for even a relatively minor ailment. And should you need an Emergency Medical Evacuation, this may result in significant expenses.

Not all travel protection plans include medical coverage, so be sure to check before you buy. But the good news is that all our plans include Medical and Dental coverage. Our plans also provide a No Out-of-Pocket Medical Expenses service. In select areas, this service may allow us to schedule your doctor’s appointment and arrange upfront payment of up to $1,000 for covered incidents if you have an acute illness during your trip, while traveling in an area where this service is available.

If you’re comparing options, our guide to travel protection for seniors may help.

What If You Have a Medicare Supplement (Medigap) or Medicare Advantage Plan?

Some Medicare arrangements change the answer slightly, but they usually don’t remove the need to review your coverage carefully before you travel. Some Medigap plans offer Medigap foreign travel emergency coverage, and some Medicare Advantage plans cover emergency care abroad, but benefits vary by carrier and plan.

Plan Type	Foreign Emergency Care	Evacuation	Prescriptions	Major Coverage Limits
Original Medicare	Usually no, except for rare exceptions	Generally not included	Generally not covered when purchased abroad	Very limited outside the U.S.
Medigap	Some plans may include limited foreign emergency care	Usually limited or not included	Typically limited for foreign purchases	Plan-specific limits may apply
Medicare Advantage	Some plans may include emergency or urgent care abroad	Varies by carrier and plan	Varies by plan	Carrier- and plan-specific limits may apply
Travel protection	May cover unexpected, covered emergency medical care abroad	May include Emergency Assistance and Transportation	May include covered prescription costs related to a covered illness or injury	Up to the plan limits you choose

Even when you have Medigap or Medicare Advantage, foreign benefits may still leave gaps for evacuation, deductibles, exclusions, or claim handling.

If your Medigap or Medicare Advantage plan still leaves gaps abroad, get a travel protection quote and compare plans.

Medicare Coverage on Cruise Ships

Medicare generally does not cover medical care received on cruise ships if the ship is more than six hours away from a U.S. port. Coverage may apply only in limited situations when specific conditions are met, including: the ship is within six hours of a U.S. port
the doctor is legally allowed to provide medical services on the cruise ship
The services are provided in a manner that meets Medicare’s coverage requirements

Necessary health care services on a cruise ship may be covered if these conditions are met when the medical services are received.

How Travel Protection Helps Cover Medicare's Gaps Abroad

Generali Global Assistance has many services and coverages that Medicare-eligible travelers may need when they go overseas.

Emergency medical treatment

Generali Global Assistance’s travel protection plans may cover expenses related to emergency medical treatment and transportation for unexpected, covered illness or injury that occurs during your trip, 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.

Transportation and repatriation benefits apply when a physician determines the transport is medically necessary, in accordance with the plan terms. With our travel protection, you may be reimbursed for costs that aren’t covered by Medicare or standard health insurance for covered event. For more detail on travel insurance and medical expenses, see our resource.

Our medical case managers are experienced in working with international medical providers and may help you get the treatment you need. We may also help coordinate transportation to an appropriate medical facility, whether that’s in-country or back home, when a physician determines that transport is medically necessary, in accordance with plan terms.

One of the upsides about travel medical protection is that it’s uncomplicated. If a medical expense is covered, it may be paid directly up to the limits of the plan, or you may be reimbursed afterward, depending on the situation. Straightforward medical coverage like this is so important when you’re sick or injured overseas and need treatment. When choosing travel protection, look for the highest levels of emergency medical coverage you can afford. With Generali Global Assistance’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 due to a covered incident, coverage may be included to fly one person of your choosing to accompany you. Our plans may also provide coverage for their lodging, meals, local transportation, and telephone calls during this time (up to a $10,000 limit applies for companion hospitality expenses).

flight crew, doctor, paramedics airlifting a woman, helicopter, stretcher, medical

Emergency Assistance and Transportation

When it comes to Emergency Assistance and Transportation coverage, 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 typically need to pay.

If you’re a Medicare-age senior, having travel protection with coverage for emergency medical evacuation may be one of the most important steps you take before traveling, even if you’re just traveling domestically. Travel protection with coverage for medical evacuation may help keep travelers from getting stuck with the 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 if you are traveling internationally. In remote areas, the cost can be even greater.

Learn more about medical evacuation and repatriation.

Generali Global Assistance 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 occurs, we monitor the situation and, when a physician says you are well enough to travel, we use our network of resources to help you get home safely. For non-emergency situations, the plan may provide coverage for medically necessary transportation to a hospital or to your place of residence when a physician determines the transport is medically necessary, in accordance with plan terms.. In some cases, instead of returning to your place of residence, you may choose to be transported to an alternative U.S. city if appropriate care for your condition is not available locally.

You Live. We Care.

As part of Redion, our plans give you access to a worldwide leader in 24/7 Travel Assistance:

400+ medical professionals in-house
4,500 medical facilities and doctors in our global network
5,000+ medical repatriations and evacuations each year
12,000+ people behind the promise
40 million calls received each year
1 intervention every 3 seconds
#1 largest worldwide proprietary integrated medical network
1st travel assistance provider in history

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 Global Assistance travel protection plans may help reimburse unused, prepaid, non-refundable travel expenses and may also cover transportation back home if a covered event, such as a medical emergency, forces you to interrupt your trip. To learn more about what travel protection covers, see our guide.

24/7 Travel Assistance

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

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

Our team is there when you need it and may provide live help with issues while traveling.

FAQ

Does Medicare cover prescriptions I buy in another country?

Original Medicare generally does not cover prescription drugs purchased abroad. Medicare drug coverage may also be limited outside the U.S. Some travel protection plans may include covered prescriptions related to a covered illness or injury, subject to plan terms.

Will I lose my Medicare coverage if I travel abroad for more than 6 months?

Traveling abroad for more than six months does not usually end your Medicare enrollment. But Original Medicare usually won’t pay for care outside the U.S., and Medicare Advantage plan rules may vary, so it’s smart to review your plan before a long stay.

Do I need to carry my Medicare card when traveling internationally?

It’s a good idea to carry your Medicare card, your travel protection documents, and emergency contact numbers. Your Medicare card may still be useful if you return to the U.S. for care or need to reference your Medicare information while traveling.

What if I have a Medigap plan—does that cover me abroad?

Some Medigap plans may offer limited foreign emergency care abroad, but deductibles, exclusions, and lifetime limits may apply. Even with Medigap foreign travel emergency coverage, you may still want travel protection for evacuation, assistance services, and other gaps.

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

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