Do Medicare Insurance Policies Cover Emergency Services?
Medicare will pay for emergency room visits and the majority of individual emergency services within the U.S. Under some circumstances medical services outside the U.S. are also covered.
Medicare is a publicly funded health insurance program funded through the U.S. government. The program provides health insurance for people aged 65 and older, and those with certain disabilities and life threatening illnesses. Small co-payments are commonly required from the insured person to complete payment for emergency medical services in U.S. hospitals.
In an emergency situation Medicare insurance policies will cover the total cost of an emergency room visit, minus a minimal co-payment. Referrals are generally not required from a family doctor when a medical emergency arises; Medicare will cover the cost of an emergency room visit even when the situation is later deemed to not be an emergency. U.S. emergency rooms are classed as outpatient hospitals with emergency room visits covered under Medicare Part B insurance coverage.
The costs and services of emergency medical services are billed as individual services under Medicare insurance policies. The initial visit and checkup provided by a hospital or clinic emergency room is covered by Medicare Part B; other services, such as x-rays are billed separately, Medicare insurance policies cover around 80 percent of the cost of these services. The insured person must pay the remainder of the bill for services personally or through a Medicare supplemental insurance policy.
Outside the U.S.
Medicare insurance policies are generally only applicable to treatment offered by Medicare accepting medical institutions within the U.S. and its territories. There are a small number of exceptions to the requirement to be within the boundaries of the U.S. Individuals traveling to or from Alaska and the U.S. can receive emergency services in Canada under Medicare coverage. Emergency medical treatment onboard a cruise ship docked in a U.S. port, or no more than six hours from U.S. waters may also be covered by Medicare insurance policies.