Does Medicare Cover Me in Canada? | Medicare & Medicare Advantage Info, Help and Enrollment (2024)

Canada is one of the United States’ closest allies on the world stage, but it is also a very important trade partner. Additionally, many Americans work in Canada while living in the United States, and travel between the two countries is common for leisure and commerce. Both countries also share a common language and history as well as a uniquely western identity.

Although there are many similarities between Canada and the United States, there are many differences as well, including how each country handles healthcare and health insurance. In the United States, the federal government administers the Medicare benefits program, and this program provides access to affordable healthcare for older Americans and those with qualifying disabilities. In Canada, citizens take advantage of publicly subsidized healthcare for all Canadians. Because of these differences, and because many Americans find themselves on Canadian soil for travel and work, it’s important to know whether or not Medicare pays for healthcare needs for American citizens while traveling north of the border.

Will Medicare Cover Me for Medical Care in Canada?

In general, Medicare only covers recipients while in the United States. This means that if you have Medicare and you travel to Canada, your healthcare costs will not be covered, even if the services or medications provided would normally be covered in the United States. Part of the reason for this is that Canada has its own healthcare system for its citizens, but another element of the equation is that Medicare requires a contractual agreement between itself and participating healthcare providers in order to cover costs. This would require international contractual obligations between the United States government and the Canadian government and would likely become a complicated financial situation quickly, especially considering each provider would need to to receive payment upon the provision of healthcare services.

Are There Exceptions?

Although Medicare does not directly provide benefits to Americans in Canada, there are a few exceptions based on situational challenges. Most commonly, Medicare may cover healthcare costs in Canada for recipients who experience a medical emergency that necessitates care in Canada. Most often, this coverage is granted only if it would be detrimental to the recipient’s health to transport the recipient to an American healthcare facility.

Another situation where Medicare may cover healthcare provided in Canada would be when transport to an American healthcare provider would not be feasible. This might occur if an American Medicare recipient were in need of healthcare services in a remote part of Canada and transport would be more expensive than the cost of covering care expenses provided by a Canadian doctor or facility.

What About Travel Insurance?

Although there may be some exceptions, it is generally not a good idea to rely on the small possibility that you would be covered by Medicare benefits in Canada. If you receive Medicare and find yourself frequently traveling to Canada, you may want to consider purchasing travel insurance from a private provider in addition to carrying Medicare benefits. Medicare Supplement, or Medigap, policies help cover some of the costs that Original Medicare does not. Some policies will help cover medical expenses while you are traveling outside of the country. These policies are separate from Medicare, but they may be able to save you money if you experience a medical emergency and are facing 100% out-of-pocket medical expenses while outside of the United States.

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Does Medicare Cover Me in Canada? | Medicare & Medicare Advantage Info, Help and Enrollment (2024)

FAQs

Does Medicare Cover Me in Canada? | Medicare & Medicare Advantage Info, Help and Enrollment? ›

In general, Medicare only covers recipients while in the United States. This means that if you have Medicare and you travel to Canada, your healthcare costs will not be covered, even if the services or medications provided would normally be covered in the United States.

Does Medicare Advantage cover you in Canada? ›

Healthcare services received beyond U.S. borders are not covered. Medicare may cover inpatient hospital costs, ambulance services or dialysis for the following circ*mstances: You are in the U.S. when emergency treatment is needed and the closest hospital is in a foreign country (e.g., Canada or Mexico).

What happens to my Medicare if I move to Canada? ›

Medicare generally does not cover health services outside the United States. If you move outside the United States: Medicare Part A (hospital insurance), is available to you if you return. No monthly premium is withheld from your Social Security benefit payment for this protection.

Does the Medicare Advantage plan cover international travel? ›

Key Takeaways. In four situations, Original Medicare and Medicare Advantage plans will pay for Medicare-covered services internationally. Most Medicare Supplement Insurance plans provide coverage for emergency medical care while you're traveling abroad.

Why are people leaving Medicare Advantage plans? ›

Most individuals that dislike a Medicare Advantage plan usually have had a bad experience with in-network providers, plan authorizations for medical care, or having to wait a long time to have an appointment scheduled. Some of these concerns can be attributed to the healthcare provider.

Can a US citizen use Medicare in Canada? ›

Travel outside the U.S.

Medicare usually does not cover medical care you receive when traveling outside the U.S. and its territories.

What is not covered by Medicare in Canada? ›

What's not covered with your health card? Most notably, the public health system does not cover prescriptions, dental care and vision care.

What is the equivalent of Medicare in Canada? ›

Medicare is a term that refers to Canada's publicly funded health care system. Instead of having a single national plan, we have 13 provincial and territorial health care insurance plans.

Who pays for Medicare in Canada? ›

More than 70% of health care spending is publicly funded through general tax revenues. The provinces and territories generate 78% of the cost, with the federal government providing the rest through the Canada Health Transfer (CHT). This split has been the subject of debate since Medicare was first established.

Can Americans retire in Canada? ›

Yes, retired American citizens can move to Canada. They can apply for various immigration pathways, such as family sponsorship, investor programs, or temporary stays. Meeting eligibility criteria and legal requirements is essential for a successful move.

What countries accept US Medicare for seniors? ›

The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S. Anywhere else is considered outside the U.S. Medicare drug plans don't cover prescription drugs you buy outside the U.S.

Does UnitedHealthcare Medicare Advantage cover out of country? ›

Your Compass Rose Medicare Advantage Plan covers care even when you're traveling outside the United States just as if you were in the United States. UnitedHealthcare will reimburse you for any covered services or prescriptions you may need while traveling minus any copays that may apply.

What happens if you have a medical emergency abroad? ›

The nearest US embassy or consulate can help travelers locate medical services and notify your friends, family, or employer of an emergency. They are available for emergencies 24 hours a day, 7 days a week, overseas and in Washington, DC (888-407-4747 or 202-501-4444).

Why do doctors not like Medicare Advantage? ›

In some cases, your doctor may not agree with your insurance provider's decision to approve a less expensive treatment before paying for a more expensive one that your doctor may recommend. Providers in Medicare Advantage networks may also have to take time away from patients to spend it on pre-authorization paperwork.

Why do people say not to get a Medicare Advantage plan? ›

Restrictive networks

Medicare Advantage plans, however, have provider networks. In some cases, you'll have a higher share of costs when you see an out-of-network doctor. In other cases, you're not covered at all if you go out of network.

What is the downside of Medicare Advantage? ›

Potential risk in the long run: With MA, you can end up paying more — especially if you spend a lot of time in the hospital. Also, costs can escalate as you get older. Some MA plans also have an additional premium beyond what you pay for Medicare Part B.

How does the Medicare system work in Canada? ›

Under this system, all Canadian residents have reasonable access to medically necessary hospital and physician services without paying out-of-pocket. Roles and responsibilities for health care services are shared between provincial and territorial governments and the federal government.

Who qualifies for Medicare in Canada? ›

To be eligible for New Brunswick Medicare coverage you must be: a Canadian citizen or be legally entitled to remain in Canada and a resident who makes his/her permanent and principal home in New Brunswick; or. an international student who meets the eligibility criteria.

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