Travel Outside of the United States
Coverage under Medicare The Original Medicare Plan generally does not cover care outside the United States. Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands are considered part of the United States. There are some exceptions.
In rare cases, Medicare can pay for inpatient hospital services that you get in Canada or Mexico. Medicare can pay only if:
You are in the United States when a medical emergency occurs and the Canadian or Mexican hospital is closer than the nearest U.S. hospital that can treat the emergency.
You are traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs and the Canadian hospital is closer than the nearest United States hospital that can treat the emergency.
You live in the United States and the Canadian or Mexican hospital is closer to your home than the nearest United States hospital that can treat your medical condition, regardless of whether an emergency exists.
Medicare also pays for doctor and ambulance services furnished in Canada or Mexico in connection with a covered inpatient hospital stay.
The amount you need to pay Health care services and supplies are Not covered outside the United States except under limited circumstances.
You pay the part of the charge that you would normally pay for covered services.
The part of Medicare that pays for this service or supply Part A Benefit
Medicare Contact for additional information State of New Jersey Fiscal Intermediary: 1-800-633-4227
1-800-MEDICARE
Important notes You must pay an annual $124 (in 2006) deductible for Part B services and supplies before Medicare begins to pay its share.
Actual amounts you must pay may be higher if a doctor, health care provider, or supplier does not accept assignment.
Additional Information There are no Local Medical Review Policies (LMRPs) or National Coverage Determinations (NCDs) currently associated with this coverage topic.