Many Americans choose to retire overseas — for the warmer weather, the lower cost of living or the new cultural experience. If that describes you, you might be wondering how living overseas affects your Medicare coverage, especially if you intend to move back to the United States at some point.
In this guide, we’ll explain how living overseas might affect your Medicare coverage and enrollment and the best ways to make sure you’re covered.
[READ: How Do I Know When I’m Eligible for Medicare?]
Do I Have to Sign Up for Medicare If I’m Living Abroad?
No, you do not have to sign up for Medicare if you live abroad. Medicare typically does not cover medical care rendered outside the country, says Whitney Stidom, vice president of consumer enablement with eHealth Inc., a health insurance broker and online resource provider headquartered in Santa Clara, California.
“Most advanced countries already offer citizens, regardless of income, universal and affordable health insurance,” adds Jack Glasker, designated partner at Affordable Health Care Solutions, a father-son health insurance brokerage firm based in Westfield, New Jersey.
If you plan to return to the U.S., though, you should consider enrolling in Medicare to avoid coverage gaps or late enrollment penalties that may outweigh the cost of care or insurance overseas.
What does “living abroad” mean for Medicare?
“Abroad,” according to Medicare.gov, means outside of:
— The 50 states
— The District of Columbia
— Puerto Rico
— The Virgin Islands
— Guam
— American Samoa
— The Northern Mariana Islands.
The Social Security Administration defines “living” overseas as living outside the U.S. for at least 30 consecutive days. Once you’re back on U.S. soil for 30 consecutive days, you are no longer considered to be living abroad.
[READ: Will Medicare Cover Care If You’re Traveling?]
When Should I Sign Up for Medicare Coverage Abroad?
You should sign up for Medicare during the seven-month initial enrollment period, which starts three months before you turn 65 and lasts for three months after you turn 65.
You can delay signing up for Medicare if you meet any of the following criteria:
— You’re still working, and you have creditable health insurance coverage through your employer.
— You’re covered under the national health system of the country in which you’re residing.
— Your spouse works for an employer that provides creditable health insurance coverage for you, or they’re covered under the national health system of the country where you live and that provides coverage for you as well.
— Your reason for living abroad, such as volunteering with the Peace Corps or another approved organization, provides creditable health coverage.
U.S. citizens who are living abroad should receive a notice from the Social Security Administration (SSA) about signing up for Medicare as they approach their 65th birthday, Stidom says. You can also request enrollment forms from the U.S. embassy in the country where you’re living.
If you don’t sign up for Medicare during the initial enrollment period, you can sign up for Medicare during the general enrollment period between January 1 and March 31 each year. However, this could mean you’ll be without health insurance for several months while also potentially incurring a penalty.
You may also qualify for a special enrollment period in some situations, such as retiring from a job that provided creditable health insurance.
[READ: Navigating Medicare Deductibles and Premiums in 2026]
Should I Sign Up for Medicare Coverage Abroad When I Turn 65?
Whether you should sign up for Medicare (Part A and Part B) coverage when you become eligible if you’re living abroad depends on your specific situation and budget.
| Medicare Part | Monthly Premium Cost | Notes | Should You Enroll |
| Part A (hospital insurance) |
— $0 (for beneficiaries who paid into the system via Medicare taxes for 10 years — or 40 work credits — or more) — $311 (for beneficiaries with 30-39 work credits) — $565 (for beneficiaries with fewer than 30 work credits) |
If you don’t qualify for a $0 Part A premium, you will have a three-month window after moving back to the U.S. to enroll without penalty. | If you qualify for a $0 premium, yes. |
| Part B (medical insurance) | $202.90 | If you are not enrolled in Part B and move back to the U.S., you’ll have to pay a late enrollment fee unless you were actively working abroad or qualify for a special enrollment period. | If you’re planning to move back to the U.S., you should consider enrolling. Part B also provides coverage when you travel to the U.S., even if you’re not living here full-time. |
If you’re planning to enroll in Medicare after returning to the U.S., you should hold onto the following items as proof of having lived overseas:
— Pay stubs
— Tax returns
— Medical statements
— Insurance benefit statements
— Records of doctor’s bills and any payments you made
It’s also worth noting that Medicare Advantage plans and Medicare Part D plans cover services only within a specific geographical area. If you’ve already signed up for either of these programs prior to moving abroad, you should unenroll to stop paying the premiums on those plans.
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Do I Have to Sign Up for Medicare If I Live Overseas? originally appeared on usnews.com
Update 01/22/26: This story was published at an earlier date and has been updated with new information.
