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, with very limited exceptions. If you need a doctor, hospital, or emergency care while traveling abroad, you will pay the full cost out of your own pocket. Medicare will not reimburse you later, even if the care was medically necessary.
The exceptions are narrow: Medicare may cover care in Canada or Mexico if you are in the U.S. and the foreign hospital is closer than the nearest U.S. hospital, or if you are traveling directly between two parts of the U.S. and the foreign country is on your direct route. In practice, this means a hospital visit in Tijuana while you live in San Diego, or care in a Canadian border town while traveling through the northern U.S. Even then, Medicare covers only the care itself, not travel to get there.
Medicare Advantage plans (Part C) and prescription drug plans (Part D) vary by plan. Some offer limited coverage abroad, but most do not. You must check your specific plan's coverage rules before you travel.
Key Takeaways
- Original Medicare does not cover medical care outside the United States except in rare cases involving Canada or Mexico when a foreign hospital is closer than any U.S. option.
- You are responsible for the full cost of any care received abroad, and Medicare will not reimburse you after the fact.
- Medicare Advantage and prescription drug plans have different rules — some offer limited international coverage and some offer none, so you must contact your plan before traveling.
- Travel insurance that covers medical emergencies is the main way to protect yourself financially while outside the U.S.
- If you plan to live abroad for more than a few months, you may lose your Medicare coverage and need to understand the rules for returning.
What happens if you need emergency care while traveling
If you have a medical emergency abroad — a heart attack, serious accident, or sudden illness — seek care when ready. Do not delay treatment to worry about cost. Get to the nearest hospital or clinic and tell them you have Medicare. They will treat you, but they will bill you directly because Medicare will not pay.
After you return to the U.S., you can submit the bills to Medicare with documentation (receipts, medical records, proof of payment). Medicare will review the claim, but will almost certainly deny it because the care was outside the U.S. You will not be reimbursed. This is why travel insurance is critical for anyone leaving the country.
Some credit card companies offer emergency medical coverage as a cardholder benefit, particularly cards marketed to travelers. Check your card's terms before you leave, as coverage limits and what counts as an emergency vary widely.
Travel insurance as your main protection abroad
Travel insurance is a separate policy you buy before you leave the U.S., and it covers medical emergencies while you are outside the country. Costs range widely depending on your age, how long you are traveling, and what level of coverage you choose. A two-week trip for someone in their 70s might cost $50 to $200; a three-month trip could cost $300 to $800 or more.
Travel insurance typically covers emergency medical care, emergency dental care, and emergency evacuation if you need to be flown to a hospital that can treat you. It does not cover routine care, pre-existing conditions (unless you buy a waiver), or care you could have delayed until returning home. Read the policy carefully to understand what "emergency" means under that specific plan.
You can buy travel insurance from travel agencies, insurance brokers, or directly from insurers. Some policies are sold through credit card companies or travel booking sites. Compare a few options before you buy, because coverage and price vary significantly. Buy the policy before you leave — you cannot buy it after an emergency happens.
Medicare Advantage and Part D coverage abroad
Medicare Advantage plans are run by private insurance companies, and each plan sets its own rules about international coverage. Some plans offer limited coverage in certain countries; most offer none. A few plans marketed to people who travel frequently may cover emergency care abroad, but this is uncommon.
Prescription drug plans (Part D) also vary by plan. Most do not cover prescriptions filled outside the U.S. If you take regular medications and will be abroad for more than a few weeks, you have two options: fill a 90-day supply before you leave (some pharmacies will do this if you ask), or research pharmacies in the country where you are going and plan to fill prescriptions there. Costs for the same medication can be very different in other countries.
Contact your plan directly before you travel. Ask whether your plan covers any care or prescriptions abroad, in what countries, and what you need to do to file a claim. Get the answer in writing if possible, because plan rules change and phone representatives sometimes give incorrect information.
Planning a longer trip or move abroad
If you plan to be outside the U.S. for more than six months, you may lose your Medicare coverage. The rules depend on whether you are a U.S. citizen, a permanent resident, or in the country on a visa. U.S. citizens can keep Medicare while living abroad, but permanent residents and visa holders may not be able to.
If you are moving abroad permanently or for an extended period, contact Medicare directly at 1-800-MEDICARE before you leave. Ask about your specific situation — your citizenship status, how long you will be gone, and whether you can keep your coverage. If you lose coverage and later return to the U.S., you may have to re-enroll, and you could face late-enrollment penalties if you wait too long.
Some people who spend winters abroad or travel for several months at a time keep a U.S. address (sometimes a family member's home or a mail forwarding service) to maintain their Medicare coverage. This is legal as long as you are a U.S. citizen and you do not claim residency in another country for tax purposes.
What to do before you leave the country
Before any trip outside the U.S., take these steps. First, get copies of your Medicare card, insurance cards for any Advantage or supplemental plans, and a list of your current medications with their doses. Keep these in a separate bag from your wallet.
Second, research hospitals and clinics in the places you are visiting. Write down the addresses and phone numbers of major hospitals in each city. Many countries have English-speaking medical staff in major hospitals, but not all clinics do.
Third, buy travel insurance that covers medical emergencies. Do this at least a week before you leave, so you have time to read the policy and ask questions if something is unclear.
Fourth, tell your doctor you are traveling and ask whether there are any health precautions specific to the countries you are visiting. Some regions have diseases or health risks that are uncommon in the U.S. Your doctor may recommend vaccines or medications to take with you.
Finally, check the U.S. State Department website for travel advisories for each country on your itinerary. Health emergencies sometimes happen in places with limited medical infrastructure or political instability that affects hospitals.
Frequently Asked Questions
Can I use my Medicare card at a hospital in another country?
No. Your Medicare card is not recognized outside the U.S., and hospitals abroad will not accept it as payment. You will need to pay out of pocket and keep all receipts and medical records. Travel insurance, not Medicare, is what will cover the cost if you have it.
What if I am a U.S. citizen living permanently in another country?
U.S. citizens can keep Medicare even if they live abroad permanently. However, you must maintain a U.S. address for Medicare's records, and you cannot claim residency in another country for tax purposes. Contact Medicare before you move to confirm your coverage will continue.
Does travel insurance cover pre-existing conditions?
Most travel insurance policies exclude pre-existing conditions — illnesses or injuries you had before you bought the policy. Some insurers sell a waiver that covers pre-existing conditions if you buy the policy within a certain number of days of your first trip payment. Read the policy details carefully, because this varies by insurer.
Can I buy travel insurance after I have already left the U.S.?
No. Travel insurance must be purchased before you leave the country. Once you are abroad, no insurer will sell you a new policy. If you are already traveling and did not buy insurance, you have no financial protection if a medical emergency happens.
What should I do if I get sick while traveling and do not have travel insurance?
Seek medical care when ready — do not delay because of cost. Get treatment, keep all receipts and medical records, and pay what you can. After you return home, contact your travel credit card company (if you used one to book the trip) to see whether their cardholder benefits cover any of the cost. You can also submit the bills to Medicare, though they will likely deny the claim.