When Medicare pays outside the United States, and when it doesn't

The narrow situations where Original Medicare pays for care abroad, cruise ship rules, U.S. territories, and how to plan coverage before you go.

The general rule is simple: Original Medicare does not pay for health care outside the United States. The exceptions are narrow but worth knowing.

What counts as the United States

The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa. Care in these places is covered like anywhere else in the U.S.

The exceptions

Medicare may pay for inpatient hospital care abroad in limited cases:

• You are in the U.S. when an emergency happens and a foreign hospital is closer than the nearest U.S. hospital.
• You are travelling through Canada without unreasonable delay by the most direct route between Alaska and another state, and an emergency occurs.
• You live in the U.S. and a foreign hospital is closer to your home than the nearest U.S. hospital that can treat you.

Cruise ships

Medicare may cover medically necessary care on a ship in U.S. waters, at a U.S. port, or within six hours of arriving or departing a U.S. port. Beyond that, coverage stops.

Planning before you travel

1. Check whether your Medigap plan includes the foreign travel emergency benefit (see how it works).
2. Price travel medical insurance with evacuation for longer trips.
3. Carry a list of medications and diagnoses.
4. Fill prescriptions before you go; Part D does not cover drugs bought abroad.

Moving abroad

If you move overseas, keeping Part B means paying premiums for coverage you cannot use abroad, but dropping it can trigger a late enrollment penalty if you return. This is a decision to make with full information; your State Health Insurance Assistance Program can help.

Questions people ask

Are U.S. territories covered by Medicare?

Yes. Puerto Rico, Guam, the U.S. Virgin Islands and others are treated as the U.S.

Does Medicare cover cruise ship care?

Only within six hours of a U.S. port or in U.S. waters, with conditions.

Does Part D cover drugs bought abroad?

No.

Should I drop Part B if I move abroad?

Consider the late enrollment penalty if you return before deciding.

Independent educational site. Not affiliated with or endorsed by the U.S. government, the federal Medicare program, or any insurance company. Figures are 2026 amounts published by CMS unless noted; check Medicare.gov for your situation.