When planning to live abroad, American expatriates often face numerous questions regarding healthcare. One of the most common queries is whether they can use Medicare, the federal health insurance program primarily for people aged 65 and older, outside of the United States. Understanding the intricacies of Medicare and its applicability for expats is crucial for ensuring proper healthcare coverage while living abroad.

Understanding Medicare

Medicare is a U.S. federal health insurance program divided into several parts:

  • Part A: Covers hospital insurance, including inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B: Covers medical insurance, including certain doctors’ services, outpatient care, medical supplies, and preventive services.
  • Part C (Medicare Advantage): Offers an alternative way to receive your Medicare benefits through private insurance companies approved by Medicare.
  • Part D: Covers prescription drugs.

Medicare Coverage Outside the U.S.

One of the key limitations of Medicare is its geographic restriction. Generally, Medicare does not provide coverage for medical care received outside of the United States. This means that if you are an expat living abroad, Medicare will not cover your healthcare expenses, except in very limited circumstances such as:

  1. Emergency Situations: If an emergency occurs and a foreign hospital is closer than the nearest U.S. hospital.
  2. Traveling Through Canada: If you are traveling through Canada on a direct route between Alaska and another U.S. state, and a Canadian hospital is closer than the nearest U.S. hospital.
  3. U.S. Territories: Medicare may cover you if you are in a U.S. territory, such as Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

Alternatives for Expats

Given the limitations of Medicare for those living outside the U.S., expats need to explore alternative healthcare coverage options:

  1. International Health Insurance: Many insurance companies offer plans specifically designed for expatriates, covering medical expenses worldwide. These plans often include comprehensive coverage for inpatient and outpatient care, emergency evacuation, and repatriation.
  2. Local Health Insurance: Depending on the country you move to, you may be able to join the local healthcare system. Many countries offer high-quality public healthcare services at a fraction of the cost of private insurance in the U.S.
  3. Medicare Supplement Plans: Some expats choose to maintain a U.S. address and return to the U.S. for medical treatment, using their Medicare benefits. In this case, supplemental plans (Medigap) can help cover the costs that Medicare does not, such as deductibles and co-insurance.

Maintaining Medicare Coverage

Some expats choose to keep their Medicare coverage active for several reasons:

  • Future Use: If you plan to return to the U.S. eventually, maintaining your Medicare Part A (which is usually premium-free) and Part B can be beneficial. However, if you drop Part B, you might face a penalty if you decide to re-enroll later.
  • Continuous Coverage: Maintaining coverage ensures there are no gaps if you frequently travel between the U.S. and other countries.


While Medicare does not typically cover healthcare costs outside the U.S., there are various strategies expats can use to ensure they have adequate coverage while living abroad. Whether through international health insurance, local healthcare systems, or maintaining some form of Medicare, planning is essential to avoid unexpected medical expenses.

Need help navigating your health insurance options as an expat? Agora Expat is here to guide you through the process. Visit Agora Expat today to explore your options and find the best healthcare plan for your needs. Make your move abroad with confidence, knowing you’re covered no matter where you go!