The holidays are one of the most popular times for Medicare beneficiaries to travel - whether it’s to visit family, escape to warmer weather, or enjoy a winter getaway. But before you pack your bags, it’s important to understand how your Medicare coverage works when you're away from home. Benefits can vary widely depending on whether you have Original Medicare (with or without a Medigap plan) or a Medicare Advantage plan and the rules for overseas travel are especially important. Here’s a simple breakdown to help you travel confidently this holiday season!

Original Medicare (Parts A & B) Coverage While Traveling

If you’re enrolled in Original Medicare, you can generally see any doctor or hospital in the U.S. that accepts Medicare.

✔️ What’s Covered

Emergency care anywhere within the U.S. and its territories (50 states, D.C., Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, Northern Mariana Islands)
Non-emergency care, as long as the provider accepts Medicare
Urgent care centers that take Medicare

❌ What’s Not Covered

Health care or supplies you get outside the U.S., except in three very limited CMS-defined situations (details below)
Prescription drugs purchased outside the U.S. (Medicare Part D can’t cover foreign pharmacies)

Original Medicare Coverage Outside the U.S.

There are three circumstances under which Medicare may coverage care outside the US. Medicare may cover certain services at a foreign hospital only when:

1. The foreign hospital is closer than the nearest U.S. hospital during a medical emergency.

2. You’re traveling through Canada “without unreasonable delay” on a direct route between Alaska and another state, and an emergency occurs. Medicare decides case-by-case what counts as “without unreasonable delay.”

3. You live in the U.S., and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat you, even if it’s not a medical emergency.

✔️ What Original Medicare Covers in These Cases

Part A: Inpatient hospital care when you are formally admitted by a doctor
Part B: Ambulance services immediately before or during the covered inpatient stay and doctor services during the covered stay

❌ What Medicare Doesn’t Cover in These Cases

Outpatient or doctor care after the covered inpatient stay ends
Return ambulance trips back to the U.S.
Dialysis outside the U.S. (unless it occurs during a covered inpatient stay)
Prescription drugs purchased overseas

If the foreign hospital doesn’t submit claims to Medicare, you may have to pay upfront and file a CMS-1490S form for potential reimbursement. Source: CMS - Medicare Coverage Outside the US

Medigap Coverage for Foreign Travel

Original Medicare is often coupled with a Medicare Supplement (Medigap plan) that covers the “gaps in Original Medicare”. Many Medigap plans offer valuable foreign travel benefits. Plans C, D, F, G, M, and N include:

80% coverage of medically necessary emergency care abroad
Coverage for the first 60 days of travel

There is a $250 annual deductible and a lifetime limit of $50,000. Always confirm details with your Medigap company before traveling.

Cruise Ship Travel

Cruises are a popular holiday escape for many Medicare beneficiaries, but Medicare’s coverage rules at sea are very specific. Medicare can pay for certain medically necessary services you receive on a cruise ship, but only when all requirements are met.

✔️ **When Medicare May Cover Care on a Cruise Ship**

Medicare may cover medically necessary doctor services you receive on board only if both conditions below are met:

1. The ship is in a U.S. port or not more than 6 hours away from one.

If your ship is docked in a U.S. port, Medicare treats it as if you’re on land, and covered services may apply. If your ship is sailing but still within 6 hours of reaching a U.S. port, Medicare may cover eligible services, even if you’re in international waters. If the ship is more than 6 hours from port, Medicare will not cover care and this is the most common reason claims are denied for cruise-related care

2. The doctor is legally authorized to provide medical services on the ship.

This means the physician must meet specific laws and regulations that allow them to treat patients aboard a cruise ship in a way Medicare can recognize.

The doctor must be credentialed and permitted under maritime/U.S. law to deliver care on the vessel.
The service must qualify as medically necessary - not elective, routine, or for convenience.

Medicare Advantage Coverage While Traveling

Medicare Advantage (MA) plans follow Medicare rules but operate with networks, so benefits vary.

✔️ What’s Usually Covered

Emergency and urgent care anywhere in the U.S. at in-network cost-sharing
Worldwide emergency coverage on some plans
PPOs may cover out-of-network routine care, but usually at a higher cost

❌ What’s Usually Not Covered

Routine care outside your plan’s service area (especially on HMO plans)
Non-emergency out-of-network care unless your plan permits it

📝 Tips for Snowbirds

Look for plans with:

Visitor/travel benefits
Nationwide networks
Extended network arrangements

Prescription Drug Coverage While Traveling

Within the U.S.

With a standalone Part D plan or an MAPD (Medicare Advantage plan with Rx coverage), you can:

Fill prescriptions at any in-network pharmacy
Use national chains (CVS, Walgreens, Walmart)
Request a “vacation override” for extra medication

Outside the U.S.

Part D cannot pay for medications purchased abroad
But Part D does cover ACIP-recommended travel vaccines, such as yellow fever, Chikungunya, and Japanese encephalitis. These vaccines come with no copay and no deductible.

Emergency vs. Urgent Care: Key Difference When Traveling

Knowing how Medicare treats emergency versus urgent care can give you peace of mind while you’re away from home.

Emergency: Life-threatening or severe risk - ALWAYS COVERED!
Urgent: Needs quick attention but not life-threatening - usually covered even out of area.

When in doubt, get care first; billing can be sorted later.

Smart Travel Checklist for Medicare Beneficiaries

✔️ Pack your Medicare card and/or Medicare Advantage ID
✔️ Bring a medication list and doctor contact information
✔️ Know your plan’s rules for out-of-state care
✔️ Locate nearby in-network urgent care centers (for MA plans)
✔️ Review your plan’s foreign travel rules
✔️ Consider travel medical insurance, especially for international trips

Travel With Confidence This Holiday Season

Understanding how your Medicare plan works - especially when traveling far from home - can help you avoid unexpected bills and enjoy peace of mind during the holidays. If you’d like help reviewing your plan before your trip or want to explore options with better travel benefits, I’m here to help!

Care Compass is an independent insurance agency that helps seniors navigate the complexities of Medicare and other Senior Products. Our services are offered at NO COST! Care Compass is proudly owned and operated in Blair County, Pennsylvania. We provide Medicare insurance assistance to the residents of Altoona, Hollidaysburg, Duncansville and the surrounding region. If you need assistance with Medicare, contact Care Compass today!

Holiday Travel? Here’s What Medicare Covers And What It Doesn’t