Medicare Coverage While Traveling Overseas

Most people assume their Medicare coverage travels with them. It mostly doesn't. Original Medicare covers almost nothing outside the U.S. — and what fills that gap depends entirely on which additional coverage you have, if any.

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Original Medicare Alone

Parts A + B · no supplemental coverage

The short version

Original Medicare generally does not cover routine or emergency care once you leave the U.S. — with a few narrow, technical exceptions.

What "outside the U.S." means

The 50 states, D.C., Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa all count as "in the U.S."
Everywhere else — Canada, Mexico, Europe, anywhere — is "outside the U.S." for Medicare purposes, even if it's just across the border

The narrow exceptions where it does apply

You're on a cruise ship in a U.S. port, or within six hours of one
You're in the U.S. when an emergency happens, and the closest hospital that can treat you happens to be across the Canadian or Mexican border
You're traveling the most direct route between Alaska and another U.S. state through Canada, and a Canadian hospital is closer than the nearest U.S. one
Even then, your normal deductibles and coinsurance still apply — it's not free just because an exception kicked in

No Coverageoutside these specific, narrow situations

Original Medicare + Medigap

Plans C, D, F, G, M & N · standardized benefit

The short version

Six Medigap plan letters include a standardized Foreign Travel Emergency benefit — the same terms no matter which carrier you're with.

How the benefit actually works

Covers medically necessary emergency care that begins within the first 60 days of your trip
You pay a $250 annual deductible, then the plan covers 80% of the billed charges
There's a $50,000 lifetime maximum — not annual. Once you've used it, it's gone for good and never resets
Doesn't cover medical evacuation or repatriation back to the U.S.

Which plans include this

Plans C, D, F, G, M, and N all include it, on identical terms
Plans A, B, K, and L do not include this benefit at all
Plan F is closed to new enrollees since January 1, 2020 — only available if you were eligible for Medicare before that date

80% After $250up to a $50,000 lifetime cap — not a yearly one

Medicare Advantage

Part C · varies significantly by plan

The short version

Most Medicare Advantage plans don't extend coverage beyond Original Medicare's narrow exceptions — but some plans add limited travel benefits. It depends entirely on the specific plan.

What to actually check

There's no standardized foreign travel benefit for Medicare Advantage the way there is for Medigap — it's entirely plan-by-plan
A typical Medicare Advantage plan covers you the same narrow way Original Medicare does, and no further
Some plans add limited worldwide emergency coverage as an extra, plan-specific benefit — this varies a lot by carrier and plan
Your plan's Evidence of Coverage document is the only reliable way to know what your specific plan actually includes

One more thing worth knowing

Medigap and Medicare Advantage can't be combined — it's one or the other, so this isn't a choice you layer on top of a Medigap plan

Check Your Planno standardized benefit — verify with your specific plan's EOC

The Gap Almost Everyone Misses

Part D prescription drug coverage — whether standalone or bundled into a Medicare Advantage plan — does not cover medications purchased outside the U.S., at all, with no exceptions. If you fill a prescription at a foreign pharmacy, expect to pay 100% out of pocket. Before you travel, ask your plan about a "vacation supply" — an early refill of your maintenance medications, typically available once per calendar year — so you're not caught short.

Side by side

What's covered, option by option

Original Medicare

+ Medigap (6 plan letters)

🩺 Routine care abroad

● Not covered. A routine visit overseas is entirely out of pocket.

● Not covered either. The foreign travel benefit is for emergencies only, not routine care.

🚑 Emergency care abroad

● Not covered, except the narrow cruise-ship and border exceptions above.

● 80% covered after a $250 deductible, up to a $50,000 lifetime max, if the emergency starts within 60 days of departure.

💊 Prescriptions abroad

● Not covered under any circumstance. 100% out of pocket at a foreign pharmacy.

● Same — Medigap doesn't include drug coverage at all, foreign or domestic.

✈️ Medical evacuation

● Not covered.

● Not covered — the foreign travel benefit specifically excludes evacuation and repatriation.

📄 Filing a claim

● Foreign hospitals aren't required to bill Medicare directly — you may pay upfront and file Form CMS-1490S for reimbursement.

● Same process for the Original Medicare portion; check with your specific Medigap carrier for how they handle their share.

The honest bottom line

Even with a Medigap plan that includes the foreign travel benefit, you're still exposed on three fronts: routine care, any evacuation costs, and everything past the $50,000 lifetime cap. None of that resets, and none of it is covered by adding a Medicare Advantage plan instead — most don't go any further than Original Medicare already does. For anyone traveling internationally, especially more than once, a standalone travel medical policy is worth pricing out alongside whatever Medicare coverage you already have.

Before you leave

A short checklist worth going through

Check your Medigap plan letter, if you have one

Only Plans C, D, F, G, M, and N include the foreign travel emergency benefit. If you're not sure which letter you have, your carrier's member services line can confirm it in a couple of minutes.

Pull up your Medicare Advantage plan's Evidence of Coverage, if that's your plan

Search it for "worldwide," "foreign," or "outside the United States" — that's the only reliable way to know what, if anything, your specific plan adds.

Ask your pharmacy about a vacation supply before you leave

An early refill of your maintenance medications is often available once per calendar year — worth arranging a few weeks ahead, not the day before your flight.

Price out a standalone travel medical policy

Given the evacuation gap and the lifetime cap on Medigap's benefit, this is the piece most people are actually missing — especially for trips further than a short flight from home.

Not sure what your specific plan covers?

A PharmSurance advisor can walk through your actual Evidence of Coverage or Medigap policy with you — and flag the gaps before you travel, not after. At no cost to you.

PharmSurance.com

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048) to get information on all of your options. If you submit your information on this site, it will be provided to one or more licensed insurance agents, who may call, email, or text you about Medicare Advantage, Medicare Supplement, and Prescription Drug Plan options. This is a general educational overview only, not specific to any plan.