Take the AARP Smart Driver course and you could save on auto insurance! Sign up today.
by Patricia Barry, AARP Bulletin, February 26, 2009
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.
Please leave your comment below.
You must be logged in to leave a comment.
Members save 15% on medical alert service.
This tool helps you identify your pills by color, shape and markings.
Members can take a free confidential hearing test by phone.
AARP members receive exclusive member benefits & affect social change.
You are leaving AARP.org and going to the website of our trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits.
Your email address is now confirmed.
Manage your email preferences and tell us which topics interest you so that we can prioritize the information you receive.
Explore all that AARP has to offer.
In the next 24 hours, you will receive an email to confirm your subscription to receive emails
related to AARP volunteering. Once you confirm that subscription, you will regularly
receive communications related to AARP volunteering. In the meantime, please feel free
to search for ways to make a difference in your community at