Quick answer
If you move abroad, your U.S. health plan and Medicare generally won’t cover you there, so most expats rely on an employer’s international plan, international private medical insurance, or their new country’s public or private system. For short stays, travel medical insurance can work; for a move of a year or more, look for a long-term expat plan with coverage where you live and medical evacuation.
Key takeaways
- Most U.S. plans cover little or nothing outside the country, and Original Medicare generally doesn’t cover care abroad.
- International health insurance for expats covers routine and major care, often worldwide.
- Travel medical insurance is for trips, not for living abroad.
- Medical evacuation coverage matters if you live where advanced care is far away.
- If you drop Medicare Part B while abroad, you may face a late penalty when you return.
On this page
Your options abroad
| Option | Best for | Good to know |
|---|---|---|
| Employer’s international plan | People sent abroad by their employer | Often the most complete coverage; ask HR before you move |
| International private medical insurance | Long-term expats, retirees abroad | Covers routine and major care; may include U.S. care for an extra cost |
| Your new country’s public system | Legal residents who qualify | Rules vary; some require residency or contributions |
| Travel medical insurance | Trips up to a few months | Emergencies only; not meant for living abroad |
What to look for in an expat plan
- Where you’re covered: your country of residence, worldwide, or worldwide including the U.S. (usually the most expensive).
- Pre-existing conditions: international plans may exclude them or apply waiting periods.
- Routine care: doctor visits, vaccinations, prescriptions and maternity care.
- Medical evacuation and repatriation: getting you to a hospital that can treat you, including by air ambulance. The State Department says air evacuation to the U.S. can cost $20,000 to $200,000.
- Direct billing: whether the insurer pays hospitals directly or you pay and claim back.
Medicare if you live abroad
Original Medicare generally doesn’t pay for care outside the U.S. You can keep premium-free Part A. If you keep Part B, you pay premiums while you can’t use it abroad; if you drop it, you may pay a late penalty when you re-enroll after moving back. Some retirees keep Part B to avoid that. A few Medigap plans cover some emergency care abroad.
ACA plans and moving back
Marketplace plans are tied to where you live in the U.S. When you move back, a permanent move from abroad qualifies you for a special enrollment period, so you can get a plan without waiting for open enrollment.
For short trips, see health insurance when traveling abroad and does Obamacare cover international travel.
Moving back to the U.S.? Compare plans by ZIP code.
Frequently asked questions
Does my U.S. health insurance work abroad?
Usually only for emergencies, if at all. Check your plan before you move.
Should I keep Medicare if I’m retiring abroad?
Many people keep Part A, which is usually free. Keeping Part B costs premiums but avoids a late penalty if you come back. It depends on your plans.
What’s the difference between travel insurance and expat insurance?
Travel insurance covers emergencies during a trip. Expat insurance is ongoing coverage for living abroad, including routine care.
Sources
This article is general information, not insurance advice. Last reviewed September 2026.