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Medicare Coverage Overseas: How Does Medicare Coverage Work on Cruises?

Just the Essentials…

  • Medicare will cover treatment received in US waters, including near US territories.

  • Medigap plans can help cover emergency medical care overseas.

  • Medicare Advantage plans may offer health coverage for travelers.

Is the thought of falling ill on a cruise making you seasick?

Cruises can be a wonderful experience: a chance to see the world from the lap of luxury, experience international art and culture, and indulge in decadent cuisine. They’re so popular that some seniors elect to retire at sea, purchase long-term residences on ships, and cruise full time! 

There’s just one persistent problem: what happens when you need medical services at sea? Maybe you slip and fall on a wet deck or overindulge at the buffet. What do you do? Can you even get Medicare coverage while on a cruise?

Maritime Medicine 101

A Hospital Ward

If you’re sailing with a major cruise line or living on board a luxury residential ship, you can be confident that at least one licensed doctor is on board to handle medical emergencies. Larger ships will have multiple doctors and more advanced medical facilities. The onboard facilities will be more than sufficient for most emergencies, but you should be aware that they’re infirmaries, not hospitals. 

For anything seriously life-threatening, their main goal will be to stabilize you until you can get evacuated to a proper facility. In those cases, the ship will contact local medical services to get you evacuated to a proper facility ASAP. However, whether Medicare will cover these services depends on where you are.

If you suffer a medical emergency within six hours of a U.S. port, your on-ship treatment may be covered by Medicare Part B. This also includes ports located in the five U.S. territories: 

  • American Samoa

  • Guam

  • The Northern Mariana Islands

  • Puerto Rico

  • The U.S. Virgin Islands

If the emergency cannot be resolved by on-ship medical staff, you’ll be stabilized and evacuated to the nearest appropriate medical facility. Suppose that facility is located in the U.S. or one of its territories. In that case, your transportation will be covered under Medicare Part B, and your hospitalization will be covered under Medicare Part A. However, there may be cases where a U.S. hospital isn’t the most efficient choice. For instance, you’re taking an Alaskan river cruise when an emergency strikes, but the nearest hospital is located in Canada. In cases where you are in U.S. territory, but the nearest hospital is in a foreign territory, Medicare will cover treatment in that foreign hospital.

But what if you’re not in U.S territory? What then?

Medicare Overseas

Because Medicare is an American program, it does not typically cover medical treatment rendered overseas. This is true for most health insurance. Medicare has a network of providers just like private insurers do. If you suffer a medical emergency under Original Medicare, you’ll likely have to pay out of pocket. Therefore, it’s best to prepare!

Some cruise lines allow you to purchase travel insurance as part of your booking. This will cover the cost of medical services rendered on the ship and things like lost luggage or trip cancellations. It may also cover medical evacuation and repatriation. However, these insurance packages need to be purchased for each voyage and only cover a limited number of things. 

In addition, travel insurance isn’t subject to the terms of the Affordable Care Act. This means you can be denied coverage for pre-existing conditions or refused certain essential services. If you’re traveling for more than a few weeks or have a health condition that may impact your travel, you’ll want a long-term solution.

Medigap

Medicare Supplemental Plans, also known as Medigap, are a type of private insurance plans that are meant to fill the ‘gaps’ in Original Medicare coverage. One of these gaps is Medicare foreign travel insurance. Under specific Medigap plans, you can get foreign travel emergency coverage for up to 60 days following your departure. It doesn’t matter how long your coverage lasts; as long as the emergency begins within the first 60 days, Medigap will cover 80 percent of all medically necessary services. However, there is a $250 deductible and a lifetime limit of $50,000. 

For most people, this will be more than sufficient. A medical emergency overseas is usually a once-in-a-lifetime experience, and most emergencies cost far less than $50,000. Combining this with short-term insurance will fit occasional travelers’ needs, but what about people on long-haul voyages? 

Medicare Advantage

Foreign travel insurance is one possible benefit offered by Medicare Advantage plans, though it’s a bit more complicated than bringing your ship’s doctor in-network. 

Most insurance providers do not have international networks, meaning you’ll need to file a claim with your insurance provider after receiving services. Other plans may provide payment on your behalf. Check your plan before you embark.

Be Aware: many Medicare Advantage plans have specific coverage areas, often limited to a single state or county. Most plans will accommodate up to six months of travel outside your coverage area but will disenroll you if you’re planning to go on a voyage lasting longer than six months.

Other Travel Considerations

Even if you can get Medicare coverage on cruise ships, that doesn’t mean you have access to the full suite of Medicare services. Ship doctors are not a substitute for primary care physicians. They can’t help you establish a plan of care, can’t do bloodwork or tests, and will only prescribe limited medication. In addition, ships do not typically have on-board pharmacies. Any required medications will need to be purchased in advance or picked up while in port. Bring your prescriptions in their original, labeled containers, and make sure you have a sufficient supply to cover your entire trip, plus extras. You may not be able to schedule mail delivery during your voyage.

 

You will also need to bring any specialty medical supplies, including durable medical equipment. While most cruise ships are equipped with wheelchairs, they may lack things like diabetes testing equipment or CPAP machines.

If you’re going on an ultra-long voyage or are becoming a permanent resident of a cruise ship, you’ll want to make a plan with your primary care physician. Consider setting up telehealth services for routine checkups.

Sailing can be a liberating experience, and the right Medicare Advantage plan can make sure your health is a top priority throughout your journey. Call us today at (800) 950-0608 to speak with a licensed insurance agent. 

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