You booked the cruise. You packed the sunscreen. But before the ship leaves the dock, there is one piece of fine print every senior should understand: Medicare's so-called 6-hour rule.
Here is how it works. Original Medicare may pay for medically necessary care from the ship's doctor only while the vessel is in a U.S. port or within six hours of one. The moment your ship is more than six hours from a U.S. port, Medicare stops paying, even for a heart attack, a broken hip, or anything else.
Six hours sounds like a quick afternoon outing. In cruising terms, it is almost the whole ship. A Caribbean sailing out of Miami, an Alaska run through international waters, a Mediterranean tour, almost all of it happens outside that six-hour bubble.
Part D drug plans do not pay for prescriptions filled on board or in foreign ports. Bring enough medication, plus a few extra days' worth in case of delays.
Ship medical centers expect payment upfront, often by credit card. You file for reimbursement later, and most of the time, you will not get much back.
Medicare Advantage plans must meet the same minimum rules, but some include extra emergency or urgent care benefits abroad. Check your plan before you sail.
Most Medigap supplement plans (C, D, F, G, M, and N) offer foreign travel emergency coverage. They pay 80 percent of approved emergency care during the first 60 days of a trip, after a $250 deductible, with a $50,000 lifetime cap.
That $50,000 sounds generous until you price a medical evacuation by helicopter at sea. For real protection, most experts recommend a separate travel medical policy that includes evacuation.