According to www.medicare.gov., as a general rule a person living or traveling abroad, otherwise covered with Medicare Parts A and B, will continue to have Medicare coverage, however (and this is an important “however”) must return to the United States to receive the care. Medical expenses, including prescription costs, incurred by a Medicare recipient in a foreign country are not covered. Medical expenses, incurred the United States territories outside the United States are covered if the territories are Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Northern Mariana Islands.
Medicare Part A covers inpatient hospital care when the admission to the hospital is by a doctor (Remember doctor admission is essential for coverage). Medicare Part B covers ambulance and doctor services received immediately and during a “covered” stay in the hospital.
If, instead of original Medicare (Parts A and B), the person purchases a Medicare Supplement Plan, then, depending of the particular supplement plan, medical care and medical supplies may be covered. All supplement plans do not provide this coverage so it is best to check prior to purchasing a specific Medicare Supplement Plan.
There are exceptions to the non-coverage rule. Remember, the exceptions – meaning that coverage will be provided — apply to Medicare Parts A and B. First exception: if the person is traveling through Canada on his/her way from the United States to Alaska without unreasonable delay, and a medical emergency occurs, the person may receive Medicare covered medical treatment in Canada.
Second exception: if a medical emergency occurs in the United States, and the nearest hospital is in a foreign country, the person may receive Medicare covered medical treatment in that country.
Third exception: if a person covered by Medicare lives in the United States, and the hospital or doctor that can “best treat” the medical condition is in another country, then Medicare will provide coverage even though an emergency does not exist.
Fourth exception: Medicare will provide coverage if the cruise ship is docked in the United States or is no further than 6 hours from a United States port even though an emergency does not exist.
A person covered by a private insurance policy is advised to inquire as to whether the policy provides coverage foreign medical treatment and, if so, under what circumstances. In many cases, it will not. Also, there are private policies that may be purchased to cover foreign medical treatment.
Banker Phares is writing a series of columns of the Patient Protection and Affordable Health Care Act. He is a John and Karen Mast Professor at SFA, director of Financial Planning Programs in the Department of Economics and Finance and board certified in estate planning and probate law. He teaches risk management and insurance, a part of which is devoted to the health care act.