Alert
Close

Think you know AARP? What you don't know about us may surprise you. Discover all the 'Real Possibilities'

HIGHLIGHTS

Open

REAL POSSIBILITIES

AARP Real Possibilities

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Dream Vacation Sweepstakes

10 weeks. 10 amazing trips. Seize your chance to win!
See official rules. 

CHECK OUT OUR
NEW IPAD APP!

ATM Mobile App for iPhone and Ipad

Enjoy the best of AARP’s award-winning publications

on the go with the new

AARP ePubs iPad App

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP Books

Medicare for Dummies book cover

Get the answers you need, from Patricia Barry, AARP's Ask Ms. Medicare

Most Popular

Viewed

share your Thoughts

Reader stories help us fine-tune our education efforts and strengthen our calls for action on issues that matter most to you. We read and learn from every story and may use yours (with permission) to brief legislators, inspire other readers and more. Please share your story with us. Do

Ask Ms. Medicare

Medicare Coverage Abroad When Treatment Isn’t Available in the United States

Q. I need a treatment that I can get in another country (Switzerland or Argentina) but isn’t yet available in the United States. Will Medicare cover my costs abroad in these circumstances?

A. Medicare doesn’t usually cover treatment abroad, as explained here.

One of the few exceptions allowed, according to Medicare regulations, is for “inpatient hospital services at a foreign hospital that is closer to, or more accessible from, the individual’s residence within the United States than the nearest U.S. hospital that is adequately equipped and available to treat the individual’s condition, whether or not an emergency exists.” In other words, the rule allows beneficiaries living close to U.S. borders to be treated at hospitals in Canada or Mexico that are nearer than an American hospital.

However, the rule doesn’t specifically address a situation where the treatment in question is not offered in any U.S. hospital. Asked to clarify this point, Medicare officials say: “If the service is so experimental that no hospital in the U.S. furnishes it, then it is very unlikely that Medicare would pay for the service.”

They say that in this situation, you “could always attempt to appeal Medicare’s denial [of payment].” First you’d have to undergo treatment, pay for it out of pocket and then put in a claim to Medicare. But, the officials say, “We believe that Medicare would ultimately deny a claim for services furnished in [foreign countries such as Switzerland or Argentina].”

If your claim is denied, you have the right to go through several levels of appeal. Since this kind of case would involve challenging Medicare regulations, you’d probably need a lawyer experienced in Medicare law to argue it for you. To find such help, consult the Eldercare Locator or your state health insurance assistance program, both of which can direct you to appropriate legal services.

Patricia Barry is a senior editor at the AARP Bulletin.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Medicare & Medicaid News

Discounts & Benefits

bring health To Life-Visual MD

AARP Bookstore

AARP Bookstore - woman reaches for book on bookshelf

VISIT THE HEALTH SECTION

Find titles on brain health, drug alternatives and losing weight. Do