Does Medicare Provide Out Of State Coverage?



As a federal program, Medicare provides coverage wherever federal law is in force.

If I Am Visiting Another State, Does Medicare Provide Out Of State Coverage?

Medicare provides coverage in all fifty states, the District of Columbia, and US territories. Qualified beneficiaries will receive coverage for any medical care they receive within federal boundaries. Any health care provider or institution operating under US jurisdiction is required to adhere to the provisions of the Medicare program. The providers may or may not be enrolled in the Medicare program but they are obligated to accept the Medicare fee schedule for reimbursement of medically necessary services.

If I Am Visiting Another Country, Does Medicare Provide Out Of State Coverage?

Medicare patients on US territory are eligible to receive their mandated Medicare benefits. This includes Puerto Rico, the US Virgin Islands, the Federated States of Micronesia, American Samoa, the Marshall Islands, the Northern Mariana Islands, Palau, and the US Minor Outlying Islands. These locations may be out of state but they are not out of country. Medicare regulations are enforced and claims are processed as they would be within the continental US, Alaska or Hawaii.

Does Medicare Provide Out Of State Coverage Differently Than In My State?

As a federal program, Medicare administers a uniform set of regulations across American territory. Wherever Medicare patients receive care in US territory, they enjoy the full benefits of Medicare coverage. Different fees may apply to different regions of the country and in different regions of any state but the program’s fundamentals remain the same. Claims are processed by local Medicare agents headquartered in the state where services are provided. Necessary medical care is covered whether the patient receives it around the corner, in Idaho, or in Massachusetts.



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