Mexico offers plenty of amazing destinations for travel, especially when Americans don’t want to be too far from home. In fact, Mexico is often cited as one of the top vacation spots for retirees and older Americans who qualify for Medicare. Unfortunately, even the most relaxing vacation is not immune from unforeseen health issues, and many Medicare recipients wonder whether they will be covered by the program when traveling.
Does Medicare Cover Your Healthcare in Mexico?
As a general rule, Medicare only provides coverage for recipients within the United States, including its territories. Even though Mexico is right next door, it is a separate country, and therefore, Medicare does not provide coverage for health-related expenses in Mexico. Mexican healthcare providers have their own system of care and social cost sharing, and foreigners are typically not able to access these programs without special circumstances.
With that stated, there may be a few exceptions where Medicare would cover some or all of the cost of healthcare in Mexico. The first would be when a Medicare recipient requires emergency care and the nearest medical facility is in Mexico. Such a situation may arise if you were to get sick at or near the border and a United States facility would be too far away to administer care in a crisis.
Additionally, a cruise that takes a Medicare recipient within six hours of a United States port would require healthcare to be administered within the United States. If, however, a Medicare recipient required hospitalization while on a cruise that was outside of the six-hour timeframe and Mexico was the closest country, then Medicare may provide coverage for care in Mexico.
What Parts of Medicare May Apply?
If Medicare insurance does provide coverage for a recipient in Mexico, the standard parts of the program would still apply. This means that prescription drugs would be covered according to the recipient’s plan and its formulary under Part D. Outpatient care in a clinic or doctor’s office would be covered under Part B. Lastly, a hospitalization or temporary stay in a skilled nursing facility would be eligible for Medicare coverage under Part A.
Does Medicare Cover Medical Transport?
Because the circumstances of each medical emergency are different, there is no way to state for certain that Medicare would cover medical transportation while traveling in another country. In general, Medicare does cover traditional ambulance services to a medical facility in an emergency, but it does not cover the cost of rides to or from scheduled doctor’s appointments or appointments at a clinic.
Medicare may cover air transport in certain situations where traditional ambulance transport does not make sense or is unavailable. Using the example of experiencing a medical emergency on a cruise, a Medicare recipient may require air transport to a hospital since there would be no way to drive there and the emergency could not wait until the vessel docked at a port. Medicare does not cover membership in programs like Life Flight.
Should You Purchase Travel Insurance?
In addition to the coverage Medicare insurance may provide, travel insurance may be a good idea to purchase if you’re going to be traveling abroad. Travel insurance is issued by insurers for short periods of time, and it can often cover medical expenses, including expenses that may not be covered by Medicare. To learn more, contact an insurer to discuss your travel plans, your Medicare coverage and your medical concerns prior to embarking on your journey.
Medicare Supplement Coverage for Foreign Travel
If you have Original Medicare, you may be able to purchase a policy to supplement your coverage and help pay for some of the expenses that Part A and Part B do not cover, including traveling abroad. Consider Medicare Supplement, also known as Medigap, policies sold in your state. When you turn 65 and are enrolled in Part B, you’ll have a guaranteed issue right to buy any policy sold in your state during your Initial Enrollment Period. After that period ends, you may be turned down or charged more based on pre-existing conditions.