Medicare when you travel: other states, abroad and cruises

Where you can get covered care while you're away from home depends on how you get your Medicare.

Traveling in the U.S.

• Original Medicare: you can use any doctor or hospital that takes Medicare, anywhere in the U.S.
• Medicare Advantage: for routine care you may need to use doctors in the plan's network and service area. Ask your plan before a long trip what it covers away from home. If you spend part of each year in another state, see moving with Medicare.

For Medicare, the U.S. includes the 50 states, DC, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa.

Traveling outside the U.S.

In most cases Medicare doesn't pay for care outside the U.S. Original Medicare may pay for care in a foreign hospital in only 3 situations:

• You're in the U.S. when you have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital that can treat you.
• You're traveling through Canada by the most direct route between Alaska and another state when an emergency happens, and the Canadian hospital is closer.
• You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat you, emergency or not.

Even then, Medicare covers the inpatient stay and the doctor and ambulance services just before and during it, not a return trip home. Foreign hospitals don't have to bill Medicare, so you may need to pay and then file a claim. Medicare drug plans don't cover drugs you buy outside the U.S.

Medigap and Medicare Advantage abroad

• Medigap: Plans C, D, F, G, M and N (and older E, H, I and J policies) cover emergency care abroad. They pay 80% of the billed charges after a $250 yearly deductible, up to $50,000 in your lifetime, if the emergency starts in the first 60 days of your trip.
• Medicare Advantage: plans generally don't cover care outside the U.S., but some offer an extra benefit for emergency and urgent care abroad. Check before you go.
• Travel insurance: you can buy it for more coverage. Read the terms: not every travel policy includes health care.

On a cruise

Medicare may cover medically necessary care on a cruise ship if the doctor is legally allowed to treat you there and the ship is in a U.S. port or no more than 6 hours from one. It doesn't cover care when the ship is farther away.

Before you go

Part D covers the vaccines the CDC's advisers recommend, including some you may need for travel, with no copay or deductible. Ask your plan which ones apply to you.