Original Medicare and Medicare Advantage do not travel the same way. Original Medicare: any doctor or hospital that takes Medicare, anywhere in the United States as Medicare defines it. Advantage: network and service area, except emergency, out-of-area urgent care, and (for many plan types) out-of-area dialysis. Foreign travel is generally not covered. Some Medigap letters cover 80% of certain foreign-travel emergencies up to plan limits, from the live chart and publication 11037.
This page does not invent a "snowbird plan" ranking. It does not name carriers.
I have spent 18 years inside consumer marketing and lead generation in insurance and health, the same markets behind Medicare Advantage, drug plans, and final-expense offers. That is operator experience, not a counseling credential and not a license.
What "the United States" means
Publication 11037 (*Medicare Coverage Outside the United States*): "outside the U.S." means anywhere other than the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
12026's Original vs Advantage table uses the same list for Original Medicare doctor and hospital choice: you can use any doctor or hospital that takes Medicare, anywhere in the U.S., including those territories.
If you are in Puerto Rico or another listed territory, you are not "abroad" for this definition. If you are in Canada, Mexico, or Europe, you are outside the U.S. unless one of the narrow foreign-hospital exceptions below applies.
Original Medicare inside the U.S.
Medicare.gov compare page and 12026: with Original Medicare you can use any doctor or hospital that takes Medicare, anywhere in the U.S. In most cases you do not need a referral to see a specialist. You still pay Part A and Part B cost sharing, 2026 Part A inpatient deductible $1,736 per benefit period; Part B deductible $283, then usually 20% if the provider accepts assignment. There is no yearly out-of-pocket max on Original Medicare alone.
Snowbirds who split the year between two states can use Original Medicare in both, as long as providers take Medicare. That is the federal rule. It is not a special snowbird product.
Part D is different. Drug plans have pharmacy networks and service areas. "Creditable coverage" and the 63-day rule still apply if you drop drug coverage while traveling. Extra Help has its own pharmacy copays; see Extra Help.
Dialysis while traveling *inside* the U.S.: Medicare.gov ESRD page: you can travel within the United States if you need dialysis. Your facility can help plan treatment along the route. You may need to pay the copay when you get dialysis. Check with the social worker at your facility. 11037: Medicare does not pay for dialysis outside the U.S. unless you get it during an inpatient hospital stay under one of the three foreign-hospital situations.
Advantage: network and service area, with emergency exceptions
12026: you may need to use doctors and other providers in the plan's network and service area for non-emergency care. Some plans offer non-emergency coverage out of network, usually at a higher cost.
HMO (12026): generally you must get care from network providers except emergency care, out-of-area urgent care, or temporary out-of-area dialysis. HMO-POS plans may allow some out-of-network services at a higher cost.
PPO: you can use out-of-network providers for covered services, usually for a higher cost, if the provider agrees to treat you and has not opted out of Medicare.
SNP and other Advantage types follow their plan type. SNPs that are HMOs generally have the same emergency / out-of-area urgent / out-of-area dialysis exceptions.
If you spend months outside the plan's service area, you can lose eligibility to stay in that Advantage plan. Confirm with the plan's Evidence of Coverage before you assume a winter address is fine. This page will not rank "snowbird" Advantage plans.
Foreign travel on Advantage (12026): plans generally don't cover medical care outside the U.S. Some plans *may* offer an extra benefit that covers emergency and urgently needed services when traveling outside the U.S. Check with the plan before you go. 11037: Medicare Advantage Plans and other Medicare health plans must follow Medicare's rules, including for coverage outside the U.S., but a plan may cover additional foreign care. Ask.
Foreign hospitals: three Original Medicare exceptions
11037: in most situations Medicare will not pay for health care or supplies you get outside the U.S. There are three situations when Medicare may pay for certain services in a foreign hospital:
- You are in the U.S. when you have a medical emergency, and the foreign hospital is closer than the nearest U.S. hospital that can treat you.
- You are traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat you. Medicare decides "without unreasonable delay" case by case.
- You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat you, whether or not it is an emergency.
What Medicare pays in those situations: Part A covers inpatient hospital care if you are formally admitted. Part B covers emergency and non-emergency ambulance and doctor services immediately before and during that covered foreign inpatient stay. If Medicare does not cover the hospital stay, or you get ambulance and doctor services outside the hospital after the stay ends, Medicare generally will not pay, including return ambulance trips home and doctor services in the foreign country after the stay.
You still pay deductibles and coinsurance. Foreign hospitals are not required to file Medicare claims. If they do not, you pay in full and submit a claim to Medicare for reimbursement (form CMS-1490S). Visit Medicare.gov claims or call 1-800-MEDICARE.
Drugs outside the U.S.: No. Medicare plans cannot cover drugs you buy outside the U.S.
Cruise ships: Medicare does not cover care when the ship is more than 6 hours away from a U.S. port. It may cover medically necessary care on a cruise ship if the doctor is allowed to provide medical services on the ship, and the ship is in a U.S. port or no more than 6 hours away, whether or not it is an emergency. The doctor must submit the claim; you may also file.
Travel insurance: 11037 says you can choose to buy travel insurance because Medicare's foreign coverage is limited. Travel insurance does not necessarily include health coverage. Read the conditions. This page does not rank travel policies.
Medigap foreign-travel emergency: 80% after $250, first 60 days, $50,000 lifetime
Live Medicare.gov compare-plan-benefits chart: Plans C, D, F, G, M, and N show 80% for foreign travel emergency (up to plan limits). Plans A, B, K, and L show no.
11037: most Medigap plans that include this benefit (C, D, E, F, G, H, I, J, M, and N) provide foreign travel emergency health care with a lifetime limit of $50,000. They pay 80% of billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year. They cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare does not otherwise cover the care. Plans E, H, I, and J are no longer sold; if you bought one before June 1, 2010, you may keep it.
You must have Original Medicare and a Medigap policy. You cannot use Medigap to pay Advantage copays, and you cannot generally have Medigap while in Advantage. See Medigap vs Advantage and Plan G vs Plan N. Both G and N include the 80% foreign-travel row. That is not a reason this page will call either letter better.
Massachusetts, Minnesota, and Wisconsin standardize Medigap differently; Minnesota's chart in 02110 also shows 80% foreign travel emergency on listed plans. Confirm in those states.
Confirm with 11037, the live chart, and your plan
- 11037 PDF
- Compare Medigap benefits
- Original vs Advantage
- Advantage EOC for service-area and foreign extras
- SHIP: shiphelp.org
Ask whether your destination is inside Medicare's U.S. definition, whether your Advantage plan covers out-of-area urgent care, and whether any Medigap letter you have includes foreign-travel emergency. Do not use a "snowbird" ad as a CMS figure.
This is education, not advice
Original Medicare travels across the 50 states and listed territories with any Medicare-taking provider. Advantage travels with the network, plus emergency/urgent/dialysis exceptions. Foreign care is generally yours unless a narrow exception, a Medigap foreign-travel benefit, or a plan extra applies. Confirm before you go. Rules can change after they are printed.
Labeled marketplace placements, when they exist, sit after the last decision section and before FAQ. Until a licensed partner link is live, that slot stays empty. This page will not rank carriers or treat a marketplace quote as a CMS or SSA figure.
Vaccines before you travel, and what Part D will not do abroad
11037: Part D covers vaccines the Advisory Committee on Immunization Practices (ACIP) recommends, including certain vaccines you might need before traveling outside the U.S. (yellow fever, chikungunya, Japanese encephalitis). Your Part D plan will not charge a copayment or apply a deductible for ACIP-recommended vaccines. Get those shots *before* you leave. The plan will not cover drugs you buy outside the U.S.
Urgent care in another U.S. state on Advantage is not the same as foreign emergency. Out-of-area urgent care is an HMO exception *inside* Medicare's U.S. definition. Cancun is not out-of-area urgent care; it is foreign, unless a plan extra or Medigap foreign-travel benefit says otherwise.
If you have Original Medicare plus Medigap G or N, both letters include the 80% foreign-travel row. You still need the $250 Medigap foreign deductible, the 60-day-from-start-of-trip rule, and the $50,000 lifetime cap. Keep receipts. Ask the Medigap company how to file. Foreign hospitals may demand payment up front.
TRICARE For Life and VA have their own foreign and travel rules. They are not this article. CHAMPVA and TRICARE often require Part A and Part B at 65. Confirm with those programs, not with a snowbird brochure.
Filing a foreign claim, and what you pay if you guess wrong
If a foreign hospital will not submit Medicare claims, you pay and file CMS-1490S for the narrow situations 11037 allows. If your trip does not match those three situations, you pay the full cost. Medigap foreign-travel emergency, if you have a letter that includes it, is billed to the Medigap company under that policy's rules, 80%, $250 yearly deductible, first 60 days, $50,000 lifetime, not as a Medicare Part A inpatient claim.
Cruise-ship care more than 6 hours from a U.S. port is not covered. Inside 6 hours, the doctor must be allowed to treat you on the ship and should submit the claim. Do not assume a ship's infirmary "takes Medicare" the way a U.S. hospital does.
This page will not rank travel insurance, air-ambulance memberships, or snowbird Advantage plans. 11037 says travel insurance is optional because Medicare's foreign coverage is limited. Read whether that policy includes health coverage.
FAQ
Does Original Medicare cover me in another state?
Yes, if the provider takes Medicare. The U.S. includes the 50 states, D.C., and the listed territories.
Does Medicare Advantage cover me in another state?
For non-emergency care, usually only in network / service area. Emergency, out-of-area urgent care, and often out-of-area dialysis are the exceptions. Check the plan. Spending months outside the service area can affect eligibility.
Does Medicare cover care in Canada or Mexico?
Generally no. 11037's three foreign-hospital exceptions are narrow (closer foreign hospital in an emergency from the U.S.; Alaska-Canada corridor; foreign hospital closer to your U.S. home). Medigap letters C, D, F, G, M, N include 80% foreign-travel emergency up to plan limits.
What does Medigap pay abroad?
11037: 80% after a $250 yearly deductible, first 60 days of the trip, $50,000 lifetime, if Medicare does not otherwise cover the care. Not all letters include it.
Will Part D pay for drugs I buy overseas?
No. Medicare plans cannot cover drugs bought outside the U.S.
11037, 12026, and the live Medigap chart are the records. Confirm the current text with them.
Is Puerto Rico "foreign travel"?
No. 11037 includes Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands in the United States for this purpose. Extra Help, however, is not available in those territories; that is a different program.
11037, 12026, and the live Medigap chart are the records. Confirm the current text with them.
About the author
Keith Guirao is founder and editor of Savvy Senior Central (Maven Media). He has spent about 18 years in consumer marketing and lead generation across insurance and health. That is operator experience, not a license to sell insurance, counsel Medicare, practice medicine, or give financial advice. Contact and bio: About · LinkedIn · Contact.
Disclaimer
Savvy Senior Central is not a licensed insurance agency. This article is for general educational purposes only and is not insurance, Medicare, legal, clinical, or financial advice. Confirm the current rule with the official sources linked below, 1-800-MEDICARE, SSA, your plan's Evidence of Coverage if you have Advantage, your state regulator, or SHIP. Costs and rules can change after agencies print them.
Sources
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Every figure traces to a government record. Figures last verified September 27, 2026 (Europe/Berlin).
- CMS: Medicare Coverage Outside the United States (11037)
- CMS: Understanding Medicare Advantage Plans (12026)
- Medicare.gov Medigap compare chart (foreign-travel emergency row)
- *Medicare & You 2026*
- Medicare.gov plan compare / Evidence of Coverage instructions
- SHIP: shiphelp.org
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