Why Medicare Almost Never Covers You Outside the U.S.

Many older Americans assume their Medicare card works the same way overseas as it does at home. It does not. Original Medicare (Part A and Part B) almost never pays for medical care received outside the United States. That includes hospital stays, doctor visits, prescription drugs, and emergency care in Mexico, Canada, the Caribbean, Europe, or anywhere else abroad.

There are a handful of narrow exceptions. Medicare may pay if you have a medical emergency in the U.S. and the closest hospital is in a foreign country (rare). It may also pay for emergency care if you are traveling through Canada by the most direct route between Alaska and another U.S. state. Beyond these unusual cases, you are on your own.

Some Medicare Advantage (Part C) plans and Medigap supplement policies do offer limited foreign travel emergency benefits, often with a $50,000 lifetime cap and a 20 percent coinsurance after a $250 deductible. That sounds helpful until you realize a serious hospital stay in Europe can run $30,000 to $80,000, and a medevac flight home can top $200,000.

The solution older travelers reach for is a standalone travel medical insurance policy. These pay for foreign hospital bills, evacuation, and trip interruption. Premiums for travelers over 65 usually run 5 to 10 percent of the trip cost, with the bigger jump happening at age 70 and again at 80.

(Sources: Medicare.gov — Travel Outside the U.S.; AARP — Travel Insurance for Seniors)