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If you are traveling across the border, you might wonder, “Does Medicare Cover You in Canada?”
Over the past 50 years, the United States of America and Canada have each established unique versions of the Medicare program.
While there are some parallels between the two programs, their structures are very distinct from each another.
If you move to Canada, will you be able to keep your Medicare coverage from the United States? In this article, we answer your question in clear, plain English.
Does Medicare Cover You In Canada?
The short answer is maybe; Medicare may cover the cost of your medical expenses while you are in Canada. But this is not guaranteed, nor is it the case 100% of the time.
As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your medical emergencies in Canada.
Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your medical expenses in Canada.
Original Medicare Coverage in Canada
Original Medicare may provide coverage for your medical expenses in Canada if the following conditions apply:
- You travel through Canada by the most direct route between Alaska and another state when a medical emergency occurs.
- You require immediate medical attention and,
- A Canadian hospital is much closer to you than a U.S. hospital.
Other times Original Medicare may also provide coverage for your medical expenses in Canada if you have a medical emergency that specifically requires medical care in Canada.
So why is this care so limited? This plan does not usually cover U.S. citizens living abroad.
However, there is a chance that Original Medicare Part A will provide coverage for your medical expenses if you are a U.S. citizen living abroad.
Is Medicare in Canada Provided by Part A or Part B?
If Medicare provides coverage for your medical expenses abroad, Part A will provide coverage for hospital care.
Medicare Part B provides emergency and non-emergency ambulance and doctor services that you get immediately before and during your hospital stay in a foreign country.
However, Medicare Part B will not provide coverage for any said services if Medicare does not cover your hospital stay. They will also not provide coverage for ambulance and doctor’s services after your covered hospital stay has ended.
Once covered, you will pay for the coinsurance that you normally pay.
Medicare Advantage Coverage in Canada
On the other hand, some Medicare Advantage plans (Medicare Part C) provide coverage for your medical expenses in Canada.
The Advantage plans cover everything Original Medicare covers and some additional benefits. However, coverage and out-of-pocket costs will vary depending on the plan providers provide.
Medigap (Medicare Supplement) policies from C to G, M, and N cover 80% of emergency care costs abroad.
If you still have a Medigap Plan E, H, I, or J, you may still have emergency care coverage abroad. However, these plans are no longer sold.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always be sure to double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series, including: Does Medicare cover Naltrexone?