Many seniors take vacations during retirement. A cruise ship may be at the top of their list of things to do during their retirement years. There are cruise ships to Alaska, the Caribbean, and even ones in Europe. Planning the cruise and the various stops included within the trip can be exciting. However, it is equally important to plan and prepare for a medical emergency. Medical emergencies can happen anywhere, but it is critical to know how your coverage works in unfamiliar areas.
Medicare coverage outside of the U.S. can be tricky as Medicare only covers a beneficiary in specific situations.
Medicare Coverage on a Cruise
First, a Medicare beneficiary needs to understand that Original Medicare Part A and Part B covers medically necessary procedures that help treat, diagnose, or monitor a health condition. Therefore, Medicare does not cover cosmetic procedures or routine procedures.
While on a cruise ship, a doctor can perform medical services to someone in need under specific laws. Additionally, for Medicare to cover the medical assistance, the cruise ship must be within 6 hours from the U.S. port.
If the cruise ship is more than six hours outside the U.S. port, Medicare will not cover the medical service. When Medicare does not cover a service, the beneficiary would be responsible for the entire cost of the medical services performed.
However, suppose you are at a U.S. port located in Puerto Rico, the Northern Mariana Islands, Guam, U.S. Virgin Islands, or American Samoa. In that case, you will have the standard Medicare coverage as those are U.S. territories and are not considered to be “outside the U.S.”
Will a Medigap Plan or Medicare Advantage Plan Provide Coverage on a Cruise?
Medigap plans, also known as Medicare Supplement plans, can provide foreign travel emergency coverage. There are only a few plans that provide this coverage including, Plans C, D, F, G, M, and N. There is a $250 deductible that the beneficiary must pay first before the Medigap plan pays 80% of the cost of the medical emergency services. The plan will only cover a total of $50,000 in foreign travel emergency services. The other catch is that the medical emergency must occur within the first 60 days of being outside the U.S.
Additionally, a Medicare Advantage plan can provide worldwide emergency coverage. The beneficiary is responsible for the copay or coinsurance associated with this benefit. A foreign hospital or clinic may bill your plan, but if they don’t bill your plan, you can keep the receipts and submit them for reimbursement once you return to the U.S. Again, this is for emergencies only.
Does Part D Provide Coverage on a Cruise?
Medicare Part D plans do not provide coverage while outside the U.S. and, therefore, will not provide coverage while on a cruise ship. It is best to stock up on necessary prescriptions so you have enough while on vacation. If you purchase any drugs while outside of the U.S., you will pay the total cost for those drugs.
Additional Circumstances for Medicare Coverage Outside the U.S.
There are three other scenarios where Medicare may provide coverage while outside the U.S. Those three scenarios include:
- If you are in the U.S., need emergency medical attention, and a foreign hospital or clinic is closer than a U.S. hospital.
- You are traveling through Canada to Alaska without unreasonable delay, and a Canadian hospital is closer than a U.S. hospital, and it is a medical emergency.
- You live within the U.S., but a foreign hospital is closer to you than a U.S. hospital, and you need immediate medical attention.
There are very few circumstances where Medicare will provide coverage on a cruise ship or when you are outside of the U.S. Before you leave for a cruise, you will want to be sure you check your plan’s benefits, so you are aware of your coverage while you are not in the U.S.