Medicare coverage stops at the U.S. border in most situations
Original Medicare (Parts A and B) does not cover medical care you receive outside the United States, except in very narrow circumstances. If you need a doctor, hospital, or prescription filled while traveling internationally, you will pay the full cost out of pocket — Medicare will not reimburse you later. This applies even if you are a U.S. citizen and even if the care is urgent.
The exceptions are small and specific. Medicare covers care in Canada or Mexico only if you are traveling directly between two parts of the continental United States and the foreign care is medically necessary and cannot wait until you return home. Medicare also covers dialysis in certain countries if you arrange it in advance through your dialysis provider. Beyond these rare cases, international medical care is your responsibility.
Medicare Advantage plans (Part C) may offer some international coverage, but the rules vary widely by plan. You need to check your specific plan's coverage document before you travel.
Key Takeaways
- Original Medicare does not pay for medical care received outside the United States except in rare cases involving travel between U.S. states through Canada or Mexico.
- Emergency care abroad is not covered, and you will owe the full bill to the foreign provider.
- Some Medicare Advantage plans offer limited international coverage, but you must review your plan documents to know what applies to you.
- Travel insurance that covers medical emergencies is widely available and inexpensive, and many travelers buy it specifically because Medicare does not cover international care.
The rare situations where Original Medicare does cover international care
Original Medicare covers emergency or urgent care in Canada or Mexico only if you are traveling directly between two parts of the continental United States and the care cannot wait until you return home. "Directly" means you are on a reasonably direct route — not taking a detour to vacation in Cancun. The care must be something that could not be postponed.
If you receive dialysis, Medicare may cover it in certain countries if your dialysis provider arranges it in advance. This requires coordination with your current dialysis center before you leave. Call your provider at least six weeks before your trip to ask whether they have a partner facility where you will be traveling.
These exceptions are genuinely narrow. A heart attack in London, a broken bone in Japan, or a dental infection in Australia will not be covered, even if it is an emergency. You will receive a bill from the foreign hospital or clinic, and Medicare will not reimburse any part of it.
Medicare Advantage plans and international coverage
Some Medicare Advantage plans (Part C) include limited international coverage, but the scope and rules differ by plan and by insurance company. A few plans cover emergency care in any country for a limited time. Others cover nothing outside the United States. You cannot assume your plan covers international care just because you have Medicare Advantage.
The only way to know what your plan covers is to read your plan's coverage document, called the Evidence of Coverage, or to call your plan's customer service number before you travel. Ask specifically: "Does my plan cover emergency medical care outside the United States?" and "If yes, what is covered and for how long?" Write down the answer and the date you called, in case you need to reference it later.
Even if your Medicare Advantage plan does cover some international care, the coverage is usually limited to emergencies and usually has a time limit — often 14 to 21 days. Routine care, follow-up visits, and prescription refills are typically not covered.
Travel insurance as an alternative to Medicare coverage
Travel insurance that covers medical emergencies is inexpensive and widely available from travel agencies, insurance brokers, and online retailers. A typical policy costs $10 to $30 per week for someone over 65 and covers emergency medical care, emergency dental care, and evacuation to a hospital in your home country if needed.
Travel insurance is not the same as travel medical insurance, though the terms are sometimes used interchangeably. Make sure the policy you buy specifically covers medical emergencies — some travel policies cover only trip cancellation or lost luggage. Read the fine print to understand what is covered, what is excluded, and how much you have to pay out of pocket before the insurance kicks in (the deductible).
Many travelers over 65 buy travel insurance as a matter of routine because they know Medicare will not cover them abroad. It is often cheaper to buy a week of travel insurance than to risk a $5,000 or $10,000 hospital bill in a foreign country.
What to do if you need care while traveling internationally
If you become ill or injured while traveling outside the United States, go to a hospital or clinic when ready if it is an emergency. Do not delay care because you are worried about cost. Once you are stable, contact your travel insurance company (if you have a policy) and your Medicare plan to report what happened.
Keep all receipts, bills, and medical records from any care you receive abroad. Even though Original Medicare will not reimburse you, you may be able to deduct the cost on your taxes, or your travel insurance may reimburse you if you file a claim. Some credit card companies also offer limited medical coverage for cardholders traveling abroad — check with your card issuer before you leave.
If you receive a bill from a foreign provider and you are unsure whether Medicare or your plan should cover it, contact your plan's customer service line with the bill and the dates of service. They can tell you definitively whether coverage applies.
Planning ahead for international travel
Before you book a trip outside the United States, take these steps: First, call your Medicare plan or read your Evidence of Coverage to understand what international care, if any, is covered. Second, decide whether to buy travel insurance based on where you are going, how long you will be gone, and your comfort level with medical risk. Third, make a list of any medications you take and bring copies of your prescriptions in case you need a refill abroad — foreign pharmacies may not recognize U.S. prescription bottles.
If you have a chronic condition that might need care while traveling, ask your doctor for a written summary of your condition and current treatment. Carry it with you. If you use medical equipment like a CPAP machine or insulin pump, bring extra supplies and a power adapter for the countries you are visiting.
Register with the U.S. State Department's Smart Traveler Enrollment Program (STEP) before you leave. It is free and allows the embassy to contact you in case of an emergency at home or to help you if you are in crisis abroad.
Frequently Asked Questions
Can I use my Medicare card at a hospital in Canada or Mexico?
Your Medicare card will not be accepted as payment at a Canadian or Mexican hospital. You will be asked to pay upfront or provide a credit card. Medicare will only reimburse you later if the care meets the narrow criteria (direct travel between U.S. states, medically necessary, could not wait). Most of the time, you will not meet those criteria and will not be reimbursed.
What if I am a U.S. citizen living abroad — does Medicare cover my care?
No. Medicare covers care only in the United States, regardless of your citizenship or where you live. If you live abroad permanently, you may not be able to keep Medicare Part B. Contact Social Security to discuss your situation.
Does travel insurance cost more if I am over 75?
Yes, travel insurance premiums increase with age. A 75-year-old typically pays more than a 65-year-old for the same coverage. Costs vary by insurer and by the length of your trip, but you can usually find a policy for $20 to $50 per week. Shop around and compare quotes from multiple insurers.
If I have a Medicare Advantage plan with international coverage, do I need travel insurance too?
It depends on what your plan covers. If your plan covers emergency care for the full length of your trip with no deductible, you may not need additional insurance. If your plan has a high deductible, a short coverage window, or excludes certain types of care, travel insurance can fill the gaps. Review both documents side by side before you decide.
What happens if I get sick and do not tell Medicare or my plan?
If you do not report the care to your plan, you will straightforward receive a bill from the foreign provider and will have to pay it yourself. Medicare will not know about it and will not reimburse you. There is no penalty for not reporting, but there is also no benefit — you will owe the full amount.