Medicare generally doesn’t cover health-care services if you move to another country even if you’re still enrolled in Medicare. If you’re a Medicare beneficiary moving outside the United States, plan ahead and make sure you have health-care coverage (other than Medicare) in that country.

For coverage purposes Medicare considers the U.S. to include the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa in addition to the 50 states. You’re considered to be living outside the country when you’ve been outside the U.S. for at least 30 consecutive days. You are no longer considered to be living outside the country once you’ve returned to the U.S. for at least 30 consecutive days.

Keeping your Medicare coverage while living abroad

You may want to retain your Medicare coverage while you are living abroad, especially if you think you may return to live permanently in the U.S. sometime in the future. Retaining your Medicare coverage may be particularly attractive if you are one of the many Medicare beneficiaries who receives  premium-free Medicare Part A (part of Original Medicare). Even though you can’t generally use your Medicare coverage while living abroad, it costs nothing to maintain premium-free Medicare Part A. In contrast, if you retain Medicare Part B, you continue to pay the Part B premium for coverage that is inaccessible to you while abroad. If you drop Medicare Part B, you can sign up later when and if you return to the U.S. Be sure to keep your address up to date with the Social Security Administration (SSA).

Signing up for Medicare coverage while living abroad

If you live outside the U.S. and are eligible for Medicare, you can apply for Original Medicare (Part A and Part B) during the General Enrollment Period, from January 1 to March 31 each year. Coverage will start July 1. You may have to pay higher premiums if you don’t sign up for Original Medicare when you are first eligible to receive Medicare benefits.

 Medicare coverage when you move back to the United States

If you’re still enrolled in Medicare when you move back to the U.S., make sure you notify the SSA that you’ve returned. If you’re no longer enrolled in Medicare:

  • You can re-apply for Medicare Part A.
  • You can re-apply for Medicare Part B, but your premium might be higher. It could go up 10% for every 12-month period that you were eligible for coverage, but didn’t sign up for it.
  • To apply or re-apply for Medicare when you move back to the U.S., contact the Social Security Administration (SSA) in any of the following ways.
    • Visit the Social Security website.
    • Call the SSA at 1-800-772-1213 (TTY users call 1-800-325-0778). To reach a representative, call between 7AM and 7PM Monday through Friday.
    • Go to your local Social Security office. For the location of the office nearest you, visit the Social Security Office Locator page or call the SSA at the telephone number listed above.

If you’re a U.S. citizen living outside the U.S. when you turn 65, and you’re not eligible for Social Security benefits, a special rule may apply to you: You must live in the U.S. to sign up for Medicare Part B, but you might not have to pay a higher premium if you sign up within 3 months of your return to this country.

If you’re not a U.S. citizen but you qualified for Medicare and were enrolled before you moved out of the U.S., re-enrollment rules may be different. Call the SSA to discuss your situation (contact information above).