Medicare coverage outside the United States is limited and depends on where you are and what kind of care you need

Original Medicare (Part A and Part B) does not cover medical care in most foreign countries. If you are traveling abroad or living overseas, you will likely pay out of pocket for any doctor visits, hospital stays, or prescriptions you need. The only exception is when you are in transit between two U.S. locations and need emergency care in Canada or Mexico — Original Medicare will cover that emergency care.

Medicare Advantage plans (Part C) vary widely. Some plans cover emergency care abroad; others cover nothing. You must check your specific plan's coverage document or call the plan directly to know what applies to you. Even plans that cover emergency care usually do not cover routine visits or prescriptions outside the U.S.

Prescription drug coverage (Part D) does not work overseas. You cannot fill prescriptions at foreign pharmacies using your Part D plan, and you cannot mail-order prescriptions from outside the U.S. back to yourself.

Key Takeaways

  • Original Medicare covers almost no care outside the U.S., except emergency care while traveling between U.S. locations through Canada or Mexico.
  • Medicare Advantage plans have different rules — some cover emergency care abroad and some do not, so you must check your plan documents or call your plan.
  • Part D prescription drug coverage does not work outside the U.S., and you cannot use it to fill prescriptions at foreign pharmacies.
  • If you plan to live abroad long-term, you may need to buy private travel insurance or local health insurance in your destination country.
  • You keep your Medicare enrollment even while living overseas, but you must continue to pay your premiums.

What Original Medicare covers abroad

Original Medicare covers emergency care in only one narrow situation: when you are traveling directly between two U.S. locations and need emergency care in Canada or Mexico. This means you are on your way from one U.S. state to another and become ill or injured in Canada or Mexico during that trip. Original Medicare will cover the emergency care you receive there.

All other care outside the U.S. is your responsibility. This includes routine doctor visits, hospital stays, lab work, imaging, surgery, and mental health care. It does not matter whether you are traveling for vacation, visiting family, or living abroad permanently — Original Medicare will not pay.

If you receive care outside the U.S. and Original Medicare does not cover it, you will receive a bill from the provider. You are responsible for paying it in full, often in the local currency. Some providers may not accept U.S. insurance at all and will ask for payment upfront.

What Medicare Advantage plans cover abroad

Medicare Advantage plans are run by private insurance companies, not by Medicare itself. Each company sets its own rules about overseas coverage. Some plans cover emergency care when you are traveling outside the U.S.; others cover nothing at all. A few plans may cover routine care if you are living in a specific country, but this is rare.

You must read your plan's coverage document — called the "Evidence of Coverage" or EOC — to know what your plan covers abroad. This document is sent to you each year and is also available on your plan's website. Look for sections titled "Emergency Care Outside the U.S." or "International Coverage." If you cannot find the information, call the customer service number on your insurance card and ask directly: "Does my plan cover emergency care outside the United States?"

Even if your Medicare Advantage plan covers emergency care abroad, the coverage is usually limited. It may only pay for truly life-threatening emergencies, not for urgent care or routine problems. You will likely have to pay upfront and then submit a claim for reimbursement after you return home.

Prescription drug coverage outside the U.S.

Part D prescription drug plans do not work outside the United States. You cannot walk into a pharmacy in another country and use your Part D card to fill a prescription. You also cannot mail-order prescriptions from a foreign pharmacy and have them shipped to you — U.S. Customs will not allow most foreign medications to enter the country, even with a valid U.S. prescription.

If you need medications while traveling or living abroad, you have two options. First, you can ask your U.S. doctor for a paper prescription before you leave and carry enough medication with you for your trip. U.S. Customs allows you to bring a 90-day supply of medication for personal use. Second, you can see a local doctor in the country where you are and pay out of pocket for local prescriptions.

Some countries have much lower medication prices than the U.S. If you are living abroad long-term, local prescriptions may be affordable even without insurance. However, you should verify that the medication you need is available in that country and that it is approved by that country's health authority.

Travel insurance and other options

If you are traveling outside the U.S. for a short trip, you may want to buy travel insurance that covers medical emergencies. Travel insurance is separate from Medicare and is sold by private companies. It typically covers emergency medical care, emergency dental care, and emergency evacuation if you need to be flown to a hospital. Travel insurance is usually inexpensive for trips under two weeks but becomes more costly for longer trips.

If you are planning to live abroad for an extended period, you have several options. You can buy private travel insurance that covers longer stays, though the cost increases significantly. You can also buy local health insurance in your destination country — many countries require this or make it available to residents. Some countries have reciprocal agreements with the U.S. that cover Medicare beneficiaries, though these are rare and limited.

Before you move abroad, contact your local Social Security office or visit ssa.gov to learn whether your destination country has any agreement with the U.S. regarding health coverage. You should also research what health insurance options are available in your destination country and what they cost.

Keeping your Medicare enrollment while living overseas

You can keep your Medicare coverage even if you move abroad permanently. You do not lose your Medicare benefits, and you do not have to disenroll. However, you must continue to pay your Medicare premiums — Part B premiums, Part D premiums, and any Medicare Advantage plan premiums — even though you are not using the coverage.

If you are receiving Social Security benefits, your Medicare premiums are usually deducted automatically from your Social Security check. If you are not yet receiving Social Security, you will need to pay your premiums directly to Medicare. You can set up automatic payments online at cms.gov or by calling 1-800-MEDICARE.

If you stop paying your premiums while living abroad, you may lose your coverage and face penalties if you return to the U.S. and try to re-enroll. It is important to keep your premiums current, even if you are not using Medicare.

What to do before you travel or move abroad

If you are planning to leave the U.S., take these steps before you go. First, call your Medicare plan — either Original Medicare (1-800-MEDICARE) or your Medicare Advantage plan — and ask what coverage you have outside the U.S. Get the answer in writing if possible. Second, ask your doctor for copies of your medical records and a list of your current medications and dosages. Third, research health care options in your destination country and find out what health insurance is available.

Fourth, consider buying travel insurance or international health insurance before you leave. Insurance companies often will not sell you coverage after you have already left the U.S. or after you have already become ill. Fifth, make sure you have enough medication to last your entire trip, plus extra in case you cannot refill it abroad. Sixth, get copies of your prescriptions from your doctor — not just the medications themselves, but the actual prescription paperwork, which may help you fill them in another country.

Finally, keep your Medicare enrollment active by paying your premiums on time, even if you are living abroad and not using Medicare. This protects your coverage if you return to the U.S. later.

Frequently Asked Questions

Can I use my Medicare card at a hospital in another country?

Most hospitals outside the U.S. will not accept Medicare. They may not recognize it as valid insurance. You will likely have to pay out of pocket and then submit a claim to Medicare or your Medicare Advantage plan for reimbursement — though reimbursement is not may provide if your plan does not cover care in that country.

What happens if I have a medical emergency while traveling abroad?

Call emergency services in that country (similar to calling 911 in the U.S.). Receive the care you need. Then contact your insurance company to report the claim. If Original Medicare covers it (emergency care while in transit through Canada or Mexico), Medicare will pay. If not, you will receive a bill. Travel insurance, if you have it, may cover the cost.

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

No. You keep your Medicare enrollment and your benefits. However, you must continue to pay your premiums. If you stop paying, you may lose coverage and face penalties if you return to the U.S. and want to re-enroll.

Can I get my prescriptions filled at a pharmacy in Canada or Mexico?

You can buy medications at a pharmacy in Canada or Mexico and pay out of pocket, but your Part D plan will not cover the cost. You can bring back a 90-day supply of medication for personal use through U.S. Customs. However, some medications available in other countries are not approved by the U.S. FDA and cannot be brought into the U.S., so check before you buy.

What should I do if I am living abroad and need to see a doctor?

See a local doctor in your destination country and pay out of pocket. Keep your receipts and medical records. If your Medicare Advantage plan covers care in that country, you may be able to submit a claim for reimbursement. Ask your plan in advance what documentation they need.