Medicare coverage stops at the U.S. border

Medicare does not pay for medical care outside the United States, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, or the Northern Mariana Islands. If you receive care in any other country, Medicare will not reimburse you, even if you have a valid Medicare card. This applies to all parts of Medicare — Part A (hospital), Part B (medical), Part D (prescription drugs), and Medigap policies sold by private insurers.

The only exception is dialysis care: if you have end-stage renal disease and need dialysis while traveling, Medicare may cover it in certain circumstances, but you must contact Medicare in advance to arrange it. For all other medical needs abroad, you pay out of pocket.

This rule affects people who travel for extended periods, winter in another country, or move overseas permanently. It also affects U.S. citizens living abroad who are enrolled in Medicare.

Key Takeaways

  • Medicare does not cover medical care in any country outside the United States and its territories, regardless of how long you have been enrolled.
  • You remain enrolled in Medicare while abroad, but you cannot use your Medicare benefits until you return to the U.S. or its covered territories.
  • Travel insurance and expat health plans are separate products that cover medical care overseas and are not connected to Medicare.
  • If you plan to live outside the U.S. permanently, you should understand how leaving affects your Medicare enrollment and when you can re-enroll if you return.
  • Prescription medications filled abroad are not covered by Medicare Part D, though you may be able to fill prescriptions through other means depending on where you are.

What happens to your Medicare enrollment when you travel

Your Medicare enrollment does not end when you leave the United States. You remain enrolled in whatever parts of Medicare you signed up for — Part A, Part B, Part D, or Medigap — and you continue to pay your premiums. If you have Part B or Part D, your premiums are still deducted from your Social Security check or billed to you directly, depending on how you set up payment.

However, your benefits do not follow you. You cannot use your Medicare card to see a doctor, fill a prescription, or pay for a hospital stay in another country. When you return to the U.S., your coverage resumes when ready.

If you are traveling for a few weeks or months, this arrangement works fine — you keep your coverage active and resume using it when you get home. If you are moving abroad permanently or staying for years, you may want to reconsider whether keeping Medicare makes financial sense, since you will be paying premiums for coverage you cannot use.

Travel insurance versus Medicare: what you need to know

Travel insurance is a separate product from Medicare. It is sold by private insurance companies and covers medical emergencies while you are outside your home country. Travel insurance typically covers urgent care, emergency hospital stays, and medical evacuation — not routine checkups or ongoing treatment. Policies usually last from a few weeks to a year and cost anywhere from a few dollars per day to several hundred dollars for longer trips, depending on your age and the coverage level.

Travel insurance does not replace Medicare. Instead, it fills the gap that Medicare leaves when you are abroad. You buy it separately, and it is entirely independent of your Medicare enrollment. Some travel policies exclude people over a certain age (often 75 or 80) or charge much higher premiums for older travelers, so read the policy details carefully.

If you travel frequently or spend several months abroad each year, you might also look into expat health insurance, which is designed for people who live outside their home country for extended periods. Expat plans typically offer broader coverage than travel insurance and may include routine care, not just emergencies. These plans are also sold by private insurers and are not connected to Medicare.

Prescription medications and Medicare Part D overseas

Medicare Part D does not cover prescriptions filled outside the United States. If you need medications while abroad, you will need to pay for them out of pocket or find another way to obtain them.

Before you travel, talk to your doctor about how long your trip will be and whether you can bring enough medication with you. In most countries, you can carry a personal supply of prescription medications for your own use, but the rules vary by destination. Some countries have strict limits on how much you can bring, and some medications that are legal in the U.S. are restricted or banned elsewhere.

If you are moving abroad permanently, you may be able to fill prescriptions through a local doctor and pharmacy in your new country. Many countries have lower drug prices than the U.S., but you will need to work with a local healthcare provider to get prescriptions written in that country's format. This is a practical matter, not a Medicare matter — Medicare straightforward will not pay for it.

Medigap and other supplemental coverage abroad

Medigap policies (supplemental insurance sold by private companies) follow the same rule as Medicare itself: they do not cover care outside the U.S. and its territories. If you have a Medigap plan, your premiums continue while you are abroad, but your benefits do not work overseas.

Some Medigap plans offer a small benefit for emergency care during travel outside the U.S., but the coverage is limited — usually capping out at $250 per day for a maximum of 14 days per trip. This is not enough to cover a serious illness or injury. Check your Medigap policy documents to see whether your plan includes any overseas emergency coverage, and if it does, understand the limits.

If you have a Medicare Advantage plan (Part C) instead of Original Medicare plus Medigap, the same rule applies: coverage stops at the border. Medicare Advantage plans are required to cover emergency care in the U.S. and its territories, but not abroad.

Staying enrolled in Medicare while living overseas

You can stay enrolled in Medicare while living outside the United States. Your enrollment does not automatically end, and you do not have to do anything special to keep your coverage active. You will continue to pay premiums, and you remain may be able to access to re-enroll in any part of Medicare you dropped, as long as you follow the rules about enrollment periods.

However, if you move abroad and want to drop your Medicare coverage to stop paying premiums, you can do that. You will need to contact Social Security or Medicare directly to request disenrollment. Be aware that if you drop Part B or Part D, you may face a penalty if you re-enroll later — the penalty is a permanent increase to your premium. The penalty does not explore to Part A if you have worked long enough to may have access to for it without paying premiums.

If you are a U.S. citizen or permanent resident living abroad and you want to re-enroll in Medicare after dropping it, you can do so during the General Enrollment Period (January 1 to March 31 each year), though the penalty will explore to Part B and Part D. There is no special enrollment period for people moving back to the U.S. from abroad, so plan your re-enrollment timing carefully if you know you will be returning.

What to do before you travel or move abroad

Before you leave the United States, take these steps to protect yourself and understand your coverage situation.

First, get copies of your Medicare card and any other insurance documents you have. Keep them in a safe place, both physical and digital. You will need them if you return to the U.S. and need to use Medicare, or if you need to contact Medicare from abroad.

Second, talk to your doctor about your travel plans. Ask whether you can get a supply of any medications you take regularly, and ask for copies of your medical records or a summary of your current diagnoses and treatments. This information will be useful if you need to see a doctor in another country and want to provide your medical history.

Third, research travel insurance or expat health insurance options for your destination and the length of your stay. Get quotes from multiple insurers and read the policy details carefully, including what is covered, what is excluded, and whether there are age limits or higher premiums for older travelers.

Fourth, contact Medicare or Social Security if you have questions about how your enrollment will be affected by your travel or move. You can reach Medicare at 1-800-MEDICARE (1-800-633-4227) or visit Medicare.gov. If you are moving abroad permanently and want to drop your coverage, do this before you leave so there is no confusion about your enrollment status.

Frequently Asked Questions

Can I use my Medicare card at a hospital in Canada or Mexico?

No. Medicare does not cover care in any country outside the U.S. and its territories, including Canada and Mexico. You will need to pay out of pocket or have separate travel insurance. Some people who live near the border travel to Canada or Mexico for care because it is cheaper, but they do so knowing Medicare will not reimburse them.

What if I have a medical emergency while traveling abroad?

Medicare will not pay for emergency care outside the U.S., but travel insurance will if you have it. If you do not have travel insurance, you will pay out of pocket and may be able to seek reimbursement from your travel insurance provider or credit card company if you used a card that offers travel protections. After you return to the U.S., you can submit the bills to Medicare to ask whether any portion is covered, though the answer is almost always no.

Do I lose my Medicare if I move to another country permanently?

No, your Medicare enrollment does not end automatically. You remain enrolled and continue to pay premiums unless you contact Social Security or Medicare to request disenrollment. However, you cannot use your benefits while abroad. If you move back to the U.S., your coverage is still active and you can use it when ready.

Can I get Medicare to pay for care I received abroad if I was a U.S. citizen at the time?

No. Medicare does not cover care outside the U.S. and its territories under any circumstances, regardless of your citizenship status. The only exception is dialysis for people with end-stage renal disease who arrange it in advance with Medicare.

What happens to my Part D prescription coverage if I live overseas?

Part D does not cover prescriptions filled outside the U.S. You will need to pay for medications out of pocket or work with a local doctor and pharmacy in your new country. Some countries have much lower drug prices than the U.S., but you will be paying directly, not through Medicare.