Medical Services Abroad Not Covered by Medicare

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Medicare doesn't pay for medical services outside of the United States and its territories except in these extremely rare circumstances, including the following:

• You're traveling between Alaska and another state and have a medical emergency that means you must be treated in Canada.
• A medical emergency occurs while you're in the United States or its territories, but the nearest hospital is in a foreign country — for example, across the border in Canada or Mexico.
• You live within the United States or its territories and need hospital care (regardless of whether it's an emergency), but your nearest hospital is in a foreign country.

Some Medigap supplemental insurance policies (those labeled C, D, F, G, M, or N) cover emergency or urgently needed treatment abroad. (I explain Medigap insurance in Chapter 4.) In this situation, you pay a $250 deductible and 20 percent of the cost of the medical services you use up to a lifetime maximum of $50,000. Some Medicare Advantage plans also cover emergencies abroad, and so do some employer benefits and TRICARE military benefits. But otherwise, you need to buy travel insurance that includes medical emergencies when planning journeys abroad.

What if you live abroad? Medical treatment in other countries is almost always less expensive than in the United States, so paying out-of-pocket may not bankrupt you. And in some circumstances, you may be taken care of by the national health program of the country you're living in. But buying health insurance on the open market may be difficult or very expensive. One option is to join a nonprofit organization called the Association of Americans Resident Overseas, which has long lobbied Congress to make Medicare available abroad. AARO offers its members access to a variety of private health insurance plans that can be used in many countries. (You may be able to enroll in Medicare while living abroad, however.)