Medicare for Overseas Americans
- Published: 24 June 2014
Americans who travel or live abroad cannot have medical treatment received outside the United States covered by Medicare, even though they have fully contributed to the program. Medicare recognizes no providers outside of the USA and has not implemented a method for reimbursement, despite ample evidence that qualified care is available abroad, usually at lower cost. Medicare-enrolled Americans must travel to the USA, often in poor health or suffering an acute condition, to receive the covered care for which they have paid.
Unlike most seniors, retired military veterans and their families living abroad do have access to covered care under the Tricare Overseas Program-Tricare For Life (TOP TFL). By statute, these military beneficiaries must be enrolled in Medicare Parts A and B, but since Medicare does not cover them abroad, TOP TFL serves as the primary coverage, reimbursing for reasonable, scheduled medical expenses incurred at host nation providers (local, private providers that have been approved by Tricare). Upon submission of proper claims, reimbursement amounts to 75% of expenses incurred.
The military’s Tricare coverage is evidence that administration of cross-border healthcare coverage is practicable and thus that Medicare could function abroad. Tricare’s program as administered by the Wisconsin Physicians Service is not only effective – it has encouraged the adoption of medical standards recognized as meeting Medicare criteria in Mexico.