Does Medicare cover you abroad? Mostly no.

The general rule

Original Medicare (Parts A and B) provides almost no coverage for health care services received outside the United States. "United States" for Medicare purposes means the 50 states, D.C., Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

If you're in any other country and you have a heart attack, break a leg, or need ongoing care for a chronic condition, Medicare pays nothing. You pay cash, file with travel insurance if you have it, or rely on local public healthcare in countries that allow non-residents to access it.

The four narrow exceptions

Original Medicare covers limited services outside the U.S. in these specific scenarios:

1. Emergency in the U.S. but the closest hospital is foreign. If you have a medical emergency in the U.S. but the nearest hospital that can treat your condition is across the border (typically a Canadian hospital from northern border states or a Mexican hospital from southern ones), Medicare may cover it.
2. Travel between Alaska and another U.S. state through Canada. If you're driving from Alaska to the Lower 48 (or back), and you have an emergency while in Canada, Medicare may cover the Canadian hospital treatment.
3. Foreign hospital nearer to your U.S. home. If a foreign hospital is closer to your U.S. home than the nearest U.S. hospital that can treat your medical condition, Medicare may cover services received there.
4. Medical care on a ship in U.S. territorial waters. Medicare may cover services on a cruise ship within six hours of a U.S. port. Outside that, no coverage.

Outside these four narrow scenarios, Original Medicare pays zero. That's the rule.

Medigap's foreign travel emergency rider

Medigap plans C, D, F, G, M, and N include a Foreign Travel Emergency benefit that pays 80% of medically necessary emergency care during the first 60 days of a trip outside the U.S. — after a $250 deductible per year, with a $50,000 lifetime maximum.

That's helpful for travelers who experience a one-time emergency abroad. It's not coverage for living abroad. The $50,000 lifetime cap is enough for one moderately serious emergency or two minor ones — after that, you pay everything yourself.

Plans K and L don't include the foreign travel benefit. Plan A doesn't either. Plans B and L are inconsistent. If overseas travel matters to you and you're picking a Medigap plan, this is a reason to favor G or N over cheaper letters. Our comparison tool shows which carriers in your state offer G and N.

Medicare Advantage abroad — even more restrictive

Medicare Advantage plans are typically worse than Original Medicare for international travel. The plan's network is geographically bounded — outside the service area, you may have no coverage at all (HMOs) or very limited out-of-network coverage at higher cost (PPOs).

Some MA plans market a "worldwide emergency" benefit. Read the fine print: typically capped at $25,000-$50,000 lifetime, only for true emergencies (not pre-existing condition flares), and requires you to pay up front and seek reimbursement after returning to the U.S.

If you're going to be a snowbird or expat, Original Medicare + Medigap G/N is structurally better for international travel than MA. (See our MA vs Medigap guide.)

What expat retirees actually pay for healthcare abroad

The flip side: in many countries, healthcare is dramatically cheaper than U.S. costs even without any insurance, and quality is often comparable or better than U.S. care for routine and even some complex services. Approximate 2026 figures:

• Portugal — Private health insurance from a major insurer (Fidelidade, Médis): ~$150-$280/mo for comprehensive coverage including hospitalization, specialist visits, and prescription support. The public SNS system also accepts residents at minimal cost.
• Mexico — Private hospitals (Hospital Ángeles, Sanatorio San Juan, etc.) accept cash or insurance. Comprehensive private insurance: ~$120-$220/mo. IMSS public system: ~$700/year flat fee for full coverage, with waiting periods for pre-existing conditions.
• Costa Rica — CAJA public system: 7-11% of declared monthly income, capped low. INS private supplement: ~$80-$150/mo. Cash prices for procedures are 50-80% below U.S. costs at private clinics.
• Spain — "Convenio Especial" for residents not eligible for the standard public system: ~$70-$220/mo depending on age, with comprehensive coverage. Private insurance from $80-$200/mo.
• Panama — Pensionado visa includes 25% off medical services nationwide. Private insurance ~$60-$200/mo. Costs at the Hospital Punta Pacifica (a Johns Hopkins affiliate) are roughly 1/3 of U.S. equivalents.
• Thailand — Private hospitals like Bumrungrad offer U.S.-quality care at 20-40% of U.S. costs cash-pay. Comprehensive private insurance ~$100-$300/mo for retirees.

For comprehensive country-by-country breakdowns including residency requirements, tax treatment, and lifestyle costs, see our Living Abroad hub.

The real decision: how to plan for healthcare as an expat

If you're seriously planning to live outside the U.S. for a meaningful portion of your retirement, the framework breaks into four scenarios:

1. Travel only — short trips multiple times a year. Keep Original Medicare + Medigap G or N (with foreign travel rider). Rely on the rider for emergencies. Buy supplemental travel medical insurance for trips longer than 60 days. Total cost: ~$2,000-$3,000/yr Medicare side; $50-$200/trip travel insurance.
2. Snowbird — 4-6 months abroad annually. Original Medicare + Medigap stays (still your primary). Buy expat-specific health insurance like Cigna Global, GeoBlue, or IMG Global for the months abroad. Common cost: ~$200-$500/mo for comprehensive expat coverage. Total: Medicare baseline + $1,200-$3,000/yr travel policy.
3. Permanent expat — full residency abroad. Decision: keep paying Part B (~$203/mo + IRMAA if applicable, $2,400+/yr) for the future-return option, or drop it and rely on local. The math depends on age, health, and likelihood of returning. See our "Should I keep Part B abroad?" guide.
4. Returning to the U.S. eventually. Keep Part B no matter what. The 10%/year lifetime late-enrollment penalty for letting Part B lapse and re-enrolling later is brutal — at typical retirement durations, the penalty exceeds the premium savings within 3-5 years.

The two-pillar planning question

Most senior planning sites cover Medicare or expat life — not both. The question that matters when you bridge the two: what's the total cost of your healthcare strategy across both possibilities?

• Path A: Original Medicare + Plan G + Part D + cash-pay short trips. Approx 2026 cost in California: $4,000-$5,500/yr depending on Plan G carrier and Part D plan. (Run our comparison tool for your actual numbers.)
• Path B: Skip the U.S. system entirely, retire to Portugal or Costa Rica. Total healthcare cost: $1,500-$3,000/yr for comprehensive private insurance. Caveat: you've also moved.
• Path C: Hybrid. 8 months in Portugal + 4 in the U.S. Keep Part B as insurance against return. ~$5,500 Medicare side + ~$1,500 private expat policy. Total: ~$7,000.

The right answer is personal. But if you have any chance of moving abroad in retirement, the standard "just pay for Medicare and don't think about it" framing leaves real money on the table.