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My husband and I are finally taking a trip we’ve talked about for years, a Caribbean cruise. There will be port calls in the Bahamas, the Virgin Islands, St. Vincent, St. Lucia, and Trinidad and Tobago. How does Medicare work if we have an emergency at sea or in a foreign country?

P.S. We are celebrating our 41st wedding anniversary!

Jeanine and Tom

Hey Jeanine and Tom!

Congratulations on 41 years together, and on taking a well-deserved vacation. I hope you will have time to reflect on all you’ve built together, make some new memories, and dream big for your future! You’ve asked a great question that will benefit a lot of our readers during the summer travel season, so let’s get right to it.

Traveling in the U.S. with Medicare

I know most of your trip will be at sea or on foreign soil, but you’ll be traveling in the U.S. to reach your cruise departure port, so let’s talk about how Medicare has you covered for that portion of your trip.

Medicare Parts A and B, also known as “original Medicare,” covers you anywhere in the United States and its territories. You didn’t mention whether you’ll be visiting the U.S. Virgin Islands or the British Virgin Islands, but if you’re on St. Croix, St. John, or St. Thomas, you’ll be covered.

If you have a Medicare Advantage Plan, each plan is a little different and may or may not provide coverage outside their service area. Some plans require prior authorization for medical care, or they may impose higher copayments or coinsurance charges for going to an out-of-network provider. They are required to provide emergency and urgent care anywhere within American territory without these extra costs, though. You’ll need to check with your provider for specifics on your plan’s coverage while you travel.

Traveling Outside the U.S. with Medicare

Outside the U.S., Original Medicare and Medicare Advantage are required to cover you under these circumstances:

  • You get medical care on a cruise ship while it is in U.S. territorial waters. The ship must be within 6 hours of arrival or departure from a U.S. port. This could cover you, for example, on your way to and from the U.S. Virgin Islands portion of your trip.
  • You live near the Canadian or Mexican border and a foreign hospital is closer to you than the nearest U.S. hospital.
  • You’re traveling between Alaska and another U.S. state by way of Canada and have an emergency that causes you to go to a Canadian hospital.


Medigap plans C-G, M, and N cover 80% of the cost of emergency care overseas. Some Medicare Advantage plans also cover more than the minimum required emergency care overseas. If you have any of these plans, check with your provider to find out their policies and procedures for using their services outside the country.

Long-Term Travel with Medicare

Whether in the U.S. or abroad, if you travel outside the service area of your Medicare Advantage Plan for more than 6 months, most plans will drop you from their rolls. This could happen, for example, if you stayed for an extended period of time with a relative in another part of the country. There will be a Special Enrollment Period in which you can join a different plan; otherwise, you will be placed in Original Medicare.

However, some Medicare Advantage plans do have a travel benefit for up to 12 months that covers you within American territory. Check with your plan administrator if this scenario applies to you.

Another Option

As you can see from what I’ve shared, on Original Medicare you will not be covered if you have a medical emergency in international waters or in a foreign country during your trip. You might want to look into purchasing a travel insurance plan to make sure you’re covered in those parts of your journey. Your travel agent or insurance agent will be able to help you identify a suitable and affordable plan that meets your needs.

Bon Voyage!

I hope what I’ve shared has given you a clear answer to your question and pointed you where you need to go for more information and to get supplemental insurance coverage if necessary. Incidentally, it’s understandable that some people are concerned about seeking medical attention in other countries. But rest assured that the personnel on your cruise and the medical professionals in the highly-traveled countries you are visiting encounter these kinds of issues regularly and provide professional, knowledgeable service. If you have a serious issue, don’t hesitate to seek the medical attention you need.

And again, congratulations on the anniversary trip of a lifetime!



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Author Bio: Matt Feret is the author of the Prepare for Social Security -The Insider’s Guide and the Prepare for Medicare – The Insider’s Guide book series. He launched PrepareforSocialSecurity.com to help people get objective answers to questions about Social Security and Medicare. Matt is also the host of The Matt Feret Show. He has held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development, and strategy for over two decades.