Does Medicare work in Mexico?

The general rule

Medicare is a U.S. program, and Mexico is treated like any other foreign country. Medicare.gov says Original Medicare generally doesn't cover health care outside the U.S., and Medicare drug plans don't cover prescriptions bought outside the U.S. A clinic, hospital or pharmacy in Ciudad Juárez, Nuevo Laredo, Piedras Negras, Reynosa or Matamoros can't bill Medicare, so you pay it directly.

When Medicare may pay for care in Mexico

Medicare.gov lists a few situations in which Medicare may pay for inpatient hospital care, doctor services and ambulance services in a foreign hospital:

• An emergency inside the U.S. You're in the U.S. when a medical emergency happens, and a hospital in Mexico is closer than the nearest U.S. hospital that can treat you.
• A foreign hospital closer to your U.S. home. You live in the U.S., and a hospital in Mexico is closer to your home than the nearest U.S. hospital that can treat your condition, emergency or not. This can matter in remote border areas.
• Travel through Canada between Alaska and another state, which doesn't apply in Texas.

Medicare may cover an ambulance to a foreign hospital only if you're admitted there for covered inpatient care, and it generally won't pay for the trip home. Your usual Medicare deductibles and coinsurance still apply.

Medigap foreign travel emergency coverage

If you have Original Medicare and cross the border often, a Medigap plan with foreign travel emergency coverage is the most common way to get some protection. Plans C, D, F, G, M and N include it: after a $250 yearly deductible, the plan pays 80% of the cost of emergency care that would be covered in the U.S., during the first 60 days of each trip, up to a $50,000 lifetime limit. It doesn't cover planned treatment, such as surgery you travel to Mexico for. See Medigap in Texas.

If you go to Mexico for care

• Get prices in writing and keep itemized receipts.
• Know where the nearest U.S. emergency room is on your side of the bridge.
• Consider travel medical insurance for longer stays in Mexico.
• For medicines, see can I use Medicare for prescriptions in Mexico.

Get help

A licensed insurance agent with Benefits Life can compare Medigap plans with foreign travel emergency coverage, and other plans, from the companies they work with, at no cost to you, at (512) 265-6565, TTY 711. See our guide to Medicare in Mexico and border communities.

Related questions

Sources

• Medicare.gov — Travel outside the U.S.
• Medicare.gov — What Medigap covers
• Medicare.gov — Dental services

Frequently asked questions

Will Medicare pay for dental work in Mexico?

No. Original Medicare doesn't cover routine dental care in the U.S. or abroad, and it pays for care in Mexico only in rare hospital cases. People who get dental work across the border usually pay the dentist directly.

Does a Medigap plan cover me in Mexico?

Medigap Plans C, D, F, G, M and N include foreign travel emergency coverage. After a $250 yearly deductible, they pay 80% of covered emergency care during the first 60 days of a trip, up to a $50,000 lifetime limit. It covers emergencies only, not planned care.

Does Medicare Advantage cover care in Mexico?

Medicare's rules for care outside the U.S. are written for Original Medicare. Whether a Medicare Advantage plan covers anything abroad depends on the plan, so check its Evidence of Coverage before you travel.

What counts as the United States for Medicare?

The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa. Mexico is outside the U.S. for Medicare.

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