Original Medicare plans provide coverage throughout the United States, the District of Columbia, and five major U.S. territories. However, the same rules may not apply to other Medicare plan types.
Whether traveling or temporarily residing in another state, people may wonder if they can use their Medicare benefits while away from home.
In this article, we look at where Medicare is useable and provide information on Medicare coverage when a member is traveling or living in another country.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
If a person has Original Medicare parts A and B, they will have Medicare coverage anywhere within the 50 U.S. states, the District of Columbia, or in five major U.S. territories, including:
- Puerto Rico
- the Virgin Islands
- Guam
- American Samoa
- the Northern Mariana Islands
Most United States healthcare professionals accept Original Medicare.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
If a person decides to move to another state, they need to report their change of address to the Social Security Administration (SSA) by:
- updating their online account
- calling the SSA at 1-800-772-1213
- visiting a local SSA office
People will not lose their Original Medicare coverage when moving to another state as long as their new doctor, healthcare facility, or other provider accepts Medicare. However, they need to check what their plan covers because Medicare coverage for many tests, items, and services depends on where someone lives.
Plans with private insurance companies
Private insurance companies administer:
If a private insurance company administers a person’s Medicare plan, they will need to contact the plan provider directly to change their address.
Most companies provide an option for contacting them online, by phone, or by mail.
Not all plans are available by all insurers in all states or counties. Upon moving, an individual may need to change their insurance provider, plan, or both, which could bring different benefits and rules.
If a person travels outside the United States or its territories and requires healthcare, Medicare may not provide coverage.
However, there are a few exceptions, and services that could be eligible for coverage include:
- inpatient hospital care
- doctor visits
- ambulance services
This section discusses the exceptions in more detail.
Onboard a ship
Medicare Part B will cover health services provided while a person is on board a ship currently in U.S. territorial waters and adjoining U.S. land areas.
If a ship is over 6 hours away from a U.S. port, Medicare may not pay for medical services.
Medical emergency
If a medical emergency requires immediate attention while a person is in the United States, but a foreign hospital is closer than a U.S. hospital to treat the medical condition, coverage is usually available.
Medical emergency when traveling from Alaska
Services typically receive coverage if a person is traveling between Alaska and another U.S. state when a medical emergency occurs and a Canadian hospital is closer than the nearest U.S. hospital.
Non-U.S. hospital closer to residence
When residing in the United States and the nearest U.S. hospital is further from a person’s home than the closest non-U.S. hospital, coverage may gain approval regardless of whether a medical emergency takes place.
If a member purchases prescription drugs outside the United States, Medicare usually will not cover the cost.
Medigap plans may offer coverage for medical services or supplies a person receives outside the United States or when traveling.
If a person has a Medigap plan, their coverage may include emergency non-U.S. medical care when traveling, which is applicable if the medical incident occurs during the first 60 days of the trip and if Original Medicare does not cover the care.
It may also include 80% of costs after a person has met the yearly deductible. The 80% coverage relates to some kinds of necessary emergency care outside the United States.
Currently, most Medigap plans have non-U.S. emergency coverage, which has a lifetime limit of $50,000.
People who already have original Medicare insurance can keep it while living outside the United States. However, this typically does not cover medical care they receive outside the country.
If they qualify for Part A coverage, they can contact their nearest U.S. Social Security office, U.S. Consulate, or U.S. Embassy to enroll.
If an eligible person lives outside the United States and wants to enroll in Medicare Part B, they can only do so the month they return to the United States. They may pay higher premiums depending on their situation.
Late enrollment penalties may apply if an individual does not enroll in Part B within 3 months of returning to the United States.
Original Medicare members receive coverage while they reside and travel within one of the 50 U.S. states, the District of Columbia, or one of the five principal U.S. territories.
If a Medicare member moves to another state, they need to report the change of address to their local Social Security office.
People typically do not lose their Original Medicare coverage when moving to another state. However, if a private insurance company administers a person’s Medicare plan, the benefits and rules of their plan may change when they move.
If a Medicare recipient travels outside the United States or its territories and requires care, Medicare may not cover services. However, there are exceptions to this rule.
If a Medicare-eligible person resides outside the United States, they may be able to receive Medicare coverage. However, this typically does not cover medical care they receive outside the country.