Here's the rule that surprises people: Original Medicare only covers you inside the United States. Cross into another country and, with a few narrow exceptions, your Medicare coverage essentially stays behind at the border. But "mostly no" isn't "always no" — and depending on whether you're traveling for a while or living abroad for good, the smart move looks very different. Let's take them one at a time, the SRIG way.
1
Where Medicare Actually Works
Good news first: your Original Medicare travels freely anywhere in the U.S. and its territories — all 50 states, plus Washington D.C., Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. No out-of-state restrictions, no extra approvals.
Outside those borders, Original Medicare generally pays nothing — even for an emergency. That's the gap this page is all about closing.
2
The Rare Foreign Exceptions
Medicare does cover foreign care in a few narrow situations. These are the exceptions, not the rule — but they're worth knowing:
- A foreign hospital is closer. If you have an emergency (or need care during a covered hospital stay) and a foreign hospital is nearer than the closest U.S. one that can treat you, Medicare may cover it.
- Traveling through Canada to Alaska. If you're taking the most direct route between Alaska and another state and an emergency happens, a Canadian hospital may be covered.
- On a cruise ship. Medicare may cover medically necessary care aboard a ship when it's in a U.S. port or within six hours of one.
The catch: even in these cases, Medicare only pays for services it would cover at home, and you're still responsible for your usual deductibles and coinsurance. Foreign hospitals also aren't required to bill Medicare, so you may pay up front and file for reimbursement later. Keep every itemized receipt.
For Travelers & Snowbirds
Taking a trip — a dream vacation, a visit to family, a few months as a snowbird? Here's where your coverage can actually come from, and it depends on which kind of Medicare you have.
Best for travel
Medigap Foreign Travel Benefit
If you have Original Medicare plus a Medigap plan lettered C, D, F, G, M, or N, you likely have a built-in foreign travel emergency benefit. This is where most travelers actually get their overseas coverage.
Varies by plan
Medicare Advantage
Many Advantage plans include worldwide emergency coverage as a perk — but the details differ by plan, so always check your Evidence of Coverage before you go.
How the Medigap travel benefit works
On the qualifying plans above, the foreign travel emergency benefit follows a standard formula:
$250
Annual deductible you pay first
80%
Of billed emergency charges after that
60 days
Must begin in first 60 days of the trip
$50k
Lifetime maximum benefit
Read those limits carefully. The benefit only covers emergencies (not routine care), only in the first 60 days of a trip, and stops forever once you've used $50,000. For a serious medical event abroad, that 20% you owe plus the lifetime cap can still leave a big bill — which is exactly why the next point matters.
Heads up on Medicare Advantage: because Advantage plans work on networks, staying outside your plan's service area for more than six months can get you disenrolled. Great for shorter trips; riskier for long stays abroad.
The smart add-on: for any real international trip, a dedicated travel medical insurance policy is often the smartest buy. It can cover what Medicare and Medigap miss — including things like medical evacuation back to the U.S. and emergency care beyond the $50,000 cap. We can point you in the right direction.
One clear rule with no exceptions: your Part D drug plan does not cover prescriptions purchased outside the U.S. Foreign pharmacies also won't honor a U.S. prescription. So plan ahead:
- Pack enough medication for your whole trip, plus a buffer, in your carry-on.
- Bring a written list of your medications and dosages in case luggage is lost.
- Don't count on refilling abroad — assume you'll pay 100% out of pocket if you do.
🏠
If You're Living Abroad (Expats)
Moving overseas for good — or most of the year — changes the question entirely. Since Medicare won't follow you, the real decision becomes: do you keep paying for Part B, or drop it to save the premium? This is the single biggest choice expats face, and it's a genuine trade-off.
Keep Part B
You Might Return to the U.S.
If there's any real chance you'll come back — to live, or even for major medical care — keeping Part B (about $202.90/month for most in 2026) preserves your coverage and avoids a lifetime penalty later. Think of it as insurance on your options.
Drop Part B
You're Committed to Staying
If you're confident you'll never need care in the U.S. again, dropping Part B saves that premium every month. Just go in with eyes open about the penalty if you ever change your mind.
The penalty trap: if you drop Part B and later re-enroll, you'll generally face a permanent late-enrollment penalty — roughly 10% added to your premium for each full 12-month period you could have had it — plus you may have to wait for the General Enrollment Period to get coverage. That penalty follows you for life. For many expats, the modest Part B premium is worth it just to keep the door open.
What about Part A? Since premium-free Part A costs most people nothing, there's usually little reason to drop it — it simply sits there in case you're ever hospitalized back in the States. The real money decision is almost always about Part B.
SRIG take: there's no one right answer here — it depends on your plans, your health, and how tied you still are to the U.S. What we can do is run the actual numbers with you: the premium you'd save, the penalty you'd risk, and what local or international health coverage you'll want in your new country. We'll help you make the call with clear eyes, not guesswork.
Heading abroad? Let's protect you first.
Book a free Blueprint call and we'll check your travel coverage, weigh the expat Part B decision, and close the gaps before you go.
Book Your Free Call →
Does Medicare cover me overseas?
Generally no. Original Medicare covers care only in the U.S. and its territories. There are a few rare foreign exceptions — like a closer foreign hospital in an emergency, travel through Canada to Alaska, or a cruise ship within six hours of a U.S. port — but you can't rely on them for planned care abroad.
Which Medicare plans cover foreign travel?
Medigap plans C, D, F, G, M, and N include a foreign travel emergency benefit: 80% of billed charges after a $250 annual deductible, during the first 60 days of a trip, up to a $50,000 lifetime limit. Many Medicare Advantage plans also offer worldwide emergency coverage, though details vary by plan.
Does my Part D drug plan work abroad?
No. Part D does not cover prescriptions purchased outside the U.S., and foreign pharmacies won't honor a U.S. prescription. Pack enough medication for your whole trip in your carry-on, plus a written list of your prescriptions.
Should expats keep or drop Part B?
It depends on whether you might return to the U.S. Keeping Part B preserves your coverage and avoids a lifetime penalty; dropping it saves the premium but means a permanent penalty if you re-enroll later. Since premium-free Part A usually costs nothing, most expats keep at least that.
Do I need travel insurance if I have Medicare?
For international trips, it's often the smartest add-on. Even with a Medigap foreign travel benefit, you face a 20% share and a $50,000 lifetime cap. A dedicated travel medical policy can cover the gaps, including medical evacuation back to the U.S.
Whether it's a trip or a permanent move, a little planning now saves a giant headache later:
- Watch the video above for a plain-English walkthrough.
- Check your plan's foreign coverage — your Medigap letter or your Advantage Evidence of Coverage.
- Book a Blueprint consultation — we'll close the gaps and weigh the expat Part B decision, free.
Your blueprint is waiting. Let's build it together.