If I Go Abroad, What Happens to My Medicare?

No matter what happens this November or in the four years that follow, one thing is for sure: your Medicare coverage won't be going with you should you decide to  retire overseas.

Luckily, though, there are many countries where, as a legal resident, you can qualify for a local health care plan that's often even more comprehensive and less costly than Medicare.

Here's what you need to know:"¨ Medicare doesn't normally cover health care costs outside the U.S. (And the government's definition of the U.S. includes the 50 states and the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Northern Mariana Islands - you can use your Medicare benefits in these countries.)

There are some small exceptions when you can use Medicare internationally. If you are traveling in the U.S. and have a medical emergency, but the nearest hospital is in Canada or Mexico, you can qualify for Medicare coverage at that hospital. Similarly, you can use your benefits if you are traveling to or from Alaska via Canada and the nearest hospital is in Canada.

If you are on a cruise...and you become ill or have an emergency, you must seek assistance from the doctor on that particular cruise ship. If the ship is no more than six hours from a U.S. port, you will be covered by Medicare. And if the doctor determines you require hospitalization...in a hospital in Mexico or Canada, for instance, Medicare will pay for services provided by hospital staff.

Importantly, though, the ship's doctor must have taken care of you while on board, and while the ship was within six hours of a U.S. port - and the doctor must send you to the hospital on the same day for the same medical condition.

How to be prepared: If you often travel internationally, consider one of the Medicare C through J supplement ( Medigap) plans sold by private companies that provide foreign coverage. And especially if you relocate overseas, consider an evacuation plan (many are available) that will cover the cost of your transportation back to the U.S. for treatment. One such company is Medical Air Services (MASA).

But here's the good news: You probably won't need or want Medicare if you retire overseas, as many countries offer residents a government-sponsored health insurance plan. (In Costa Rica, Ecuador, and Mexico, for instance, you'll pay about $50-$70 a month, depending on your age, for a full government health care plan that covers office visits, hospitalization, prescriptions, and more.)

And in most countries, such as Panama and Uruguay- which have excellent private health care systems -- you can also buy a private plan for far less than it might cost in the U.S. One expat I know in Atlantida, Uruguay, in his late-60s, pays $75 a month for a plan he calls "excellent -- it covers most everything." But be forewarned that some insurance companies have age limits on participation, so be sure to do your homework.

What other questions do you have about health care overseas?

Photo of Panama City by Laik LePera for International Living.