What Happens to Your Medicare When You Move Abroad?
You've spent decades earning these benefits. But Medicare was built for the US — and almost none of it follows you abroad. Here's what that means for your health coverage, your wallet, and the decisions you need to make before you go.
Figures on this page reflect 2026 Medicare rates published by CMS. Premiums and deductibles change annually — verify current amounts at medicare.gov before making decisions.
First: The Four Parts of Medicare
Hospital Insurance
Covers inpatient hospital stays, skilled nursing, hospice, and some home health care.
Free for most people (if you paid into Social Security for 10+ years). Keep it — always.
Medical Insurance
Covers doctor visits, outpatient care, lab work, and preventive services. Costs $202.90/month in 2026 at standard income — higher earners pay more.
This is the decision. Whether to keep it depends on how permanently you're moving.
Medicare Advantage
A private insurance plan that replaces Parts A and B, usually bundling drug coverage and extras like dental and vision.
Largely incompatible with living abroad. See the Advantage Trap below.
Prescription Drug Coverage
Covers prescription medications in the US. As of 2026, includes an annual out-of-pocket cap.
Covers nothing outside the US. You'll pay 100% out of pocket for medications abroad.
The Part B Decision
You're paying $202.90/month for coverage that doesn't work outside the US. Whether to keep it depends entirely on your situation.
Fully relocating — no plans to return
Drop Part BYou're done with the US. Selling up and moving permanently.
Paying $202.90/month for coverage that won't work abroad is money you don't need to spend. If you stay away for 5 years and return, you'd have paid $12,174 for nothing — plus the permanent 50% penalty on top.
Document your time abroad carefully — you'll need proof to avoid the penalty if you ever return.
Splitting time — 6+ months abroad, some US visits
Keep Part BYou'll be back regularly — family, doctors, seasonal.
At $202.90/month, Part B costs about $2,435/year. A single specialist visit in the US without it could cost $300–500 out of pocket. The math favors keeping it, and the penalty risk makes dropping it a bad bet.
The penalty risk alone makes dropping it a bad bet.
Trial run — 1 to 2 years, likely returning
Keep Part BYou're testing the lifestyle before committing.
Dropping Part B for 2 years saves $4,870 — but locks in a permanent 20% premium increase if you return. That break-even takes years to recover and isn't worth it on a trial.
Don't risk a permanent penalty for a trial period.
Already on Medicare, moving now
Check firstYou've been enrolled for years and are relocating abroad.
Your plan type changes everything here. Advantage and Original Medicare require completely different actions before you leave.
Read the Advantage Trap section below before doing anything else.
The Part B Penalty — It's Permanent
Drop Part B and later return to the US? You'll pay more for Medicare every single month — forever. The penalty is 10% of your premium for every 12-month period you went without it. Think of it as a permanent surcharge: one decision you made years ago, quietly adding to your bill for the rest of your life. Figures below use the 2026 standard premium of $202.90/month — higher earners pay more.
There is one exception
If you were living abroad when you turned 65 and weren't yet receiving Social Security, you qualify for a penalty-free enrollment window when you return to the US and establish residency — but it's only 3 months, and you'll need documentation proving you lived outside the US during that time. Don't count on this; plan as if the penalty applies.
The Medicare Advantage Trap
More than half of all Medicare enrollees are on a Part C Advantage plan. If that's you, there's a rule buried in the fine print that could blindside you — and most people don't find out about it until it's already happened.
The 6-month rule
If you stay outside the US for more than 6 months, your Medicare Advantage plan can automatically disenroll you and move you back to Original Medicare — on their timeline, not yours.
Advantage plans cover emergency care only abroad — not routine care
The extras you're paying for — dental, vision, gym memberships — are useless abroad
Your in-network providers are in the US — the network means nothing internationally
Getting auto-disenrolled mid-year complicates your Medigap options
Your move: switch before you go
If you're on Advantage, switch to Original Medicare (Parts A + B) before you leave, during Open Enrollment (October 15 – December 7). Don't wait to get auto-disenrolled mid-year — that happens on the plan's timeline, not yours. Once you're on Original Medicare, consider adding a Medigap supplement to cover the gaps.
What is Medigap?
Original Medicare has real gaps — deductibles, copays, and coinsurance that add up fast. Medigap (also called Medicare Supplement Insurance) is a private policy you layer on top to cover those costs. Plans are standardized A through N, meaning the benefits are identical regardless of which insurer sells it. You're shopping on price and reputation, not coverage details.
Plan G Most popular
~$120–180/month at 65Covers nearly everything Original Medicare doesn't — Part A deductible ($1,676 in 2026), coinsurance, and excess charges. Also includes 80% foreign travel emergency coverage up to $50,000 lifetime.
Worth considering if: you're splitting time and want maximum US coverage with some international safety net.
Plan N Lower cost option
~$90–140/month at 65Similar to Plan G but you pay up to $20 copay per doctor visit and $50 per emergency room visit. Also includes 80% foreign travel emergency coverage up to $50,000 lifetime.
Worth considering if: you're healthy, want lower premiums, and don't mind small copays.
Important: Medigap foreign coverage is a safety net, not a plan
The $50,000 lifetime foreign emergency limit sounds like a lot — but a serious illness or surgery abroad can exceed that quickly. Medigap foreign coverage is designed for unexpected emergencies, not as your primary international coverage. You'll still need a separate international health insurance plan.
Don't miss your guaranteed issue window
When you first enroll in Part B at 65, every Medigap insurer must sell you a plan at standard rates — no health questions, no rejections. That window doesn't last. Miss it, and most states allow insurers to turn you down or charge more based on your medical history. If you're approaching 65 and thinking about moving abroad, make your Medigap decision before you go — ideally before you leave the country.
Your Complete Coverage Stack Abroad
Here's the coverage picture for a well-prepared US retiree living abroad. Think of it as four layers — each one handling a different piece of the risk.
Keep it — it's free
Hospital coverage for when you're back in the US
Keep if splitting time or unsure — drop only if fully relocating permanently
$202.90/month in 2026
Plan G recommended — covers US gaps and includes some foreign emergency coverage
~$100–200/month at 65
Your primary coverage abroad — fills everything Medicare won't touch
~$150–300/month depending on age, country, and plan
Keep if you have regular prescriptions — drop only with caution
Covers nothing abroad, but dropping triggers a separate late enrollment penalty
Now that you know what Medicare won't cover abroad —
See insurance plans →What You're Actually Exposed to Without International Insurance
Medicare covers almost nothing abroad. Without international insurance, every medical bill is yours — in full, up front. Here's the real cost of going uninsured:
International health insurance for a 65-year-old typically runs $150–300/month. Against a $100,000+ exposure, that's not a premium — it's the price of not gambling with your financial security.
Next: Find the right international plan for your destination
You know what Medicare won't cover. Now let's make sure something else will. See which international plans work well for US retirees — by country, age, and coverage level.
Compare International Insurance Plans