Medicare if you live outside the U.S.

Medicare generally doesn't pay for health care outside the U.S., which for Medicare includes the 50 states, DC, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa. See Medicare when you travel for the few exceptions.

Part A

If you qualify for premium-free Part A, it doesn't cost you anything to keep, and it covers you whenever you're back in the U.S.

Part B: the big decision

• If you live outside the U.S., you aren't enrolled in Part B automatically; you have to sign up for it.
• Part B has a monthly premium ($202.90 in 2026), even though it generally won't pay for care abroad.
• If you don't take Part B, or drop it, and want it later, you may have to wait for the General Enrollment Period (January 1 to March 31) and pay a late penalty of 10% for each full year you could have had it, for as long as you have Part B, unless you qualify for a Special Enrollment Period.

Weigh how long you'll be away and how often you'll come back. Ask Social Security how the rules apply to you before you decide, and get the answer in writing if you can.

Drug plans and Medicare Advantage

• Medicare drug plans don't cover drugs you buy outside the U.S.
• Medicare Advantage and drug plans serve specific areas in the U.S.; if you move out of your plan's area, you can switch, or you'll go back to Original Medicare.
• When you move back to the U.S., you have 2 full months after the month you return to join a Medicare Advantage or drug plan.

While you're abroad

You'll need other health coverage where you live, such as a local or international health plan. Medigap's foreign travel benefit covers only emergencies that start in the first 60 days of a trip, so it isn't a substitute for coverage where you live.