Which Countries Accept U.S. Medicare for Seniors? A Complete Guide

Quick Takeaways

• Medicare generally does not cover routine care outside the U.S., but it does pay for emergency services in many foreign hospitals.
• Only a handful of countries have agreements that allow seniors to receive Medicare‑covered treatment without paying out‑of‑pocket.
• Key steps: carry the correct Medicare card, verify hospital participation, and file a claim within 60 days.
• Common exclusions include elective procedures, long‑term care, and most outpatient services.
• Plan ahead: get travel insurance that fills gaps, understand local billing, and keep all receipts.

When traveling abroad, Medicare is the U.S. federal health insurance program for people 65 and older, plus certain younger people with disabilities. Knowing which countries accept U.S. Medicare can turn a stressful medical emergency into a manageable expense. This guide walks you through the current list of participating nations, the rules that apply, and practical tips to make sure your coverage works when you need it most.

How Medicare Works Outside the United States

Medicare consists of four parts:

1. Part A - Hospital Insurance (covers inpatient stays, skilled nursing facility care, hospice, and some home health services).
2. Part B - Medical Insurance (covers doctor visits, outpatient care, preventive services, and some medical equipment).
3. Part C - Medicare Advantage (private‑plan alternatives that must include Part A and B benefits).
4. Part D - Prescription Drug Coverage.

Only Parts A and B have any overseas reach. Part C may provide additional coverage if your private plan explicitly includes foreign services, and Part D generally does not apply abroad unless you have a specific plan that covers international prescriptions.

Two scenarios trigger Medicare payment abroad:

• Emergency care: If you’re in a medical emergency while traveling, Medicare will pay for the services that would be covered if you were in the U.S., provided the hospital is in a country that has a Medicare participation agreement.
• Medical repatriation: Some Medicare Advantage plans cover transport back to the United States for further treatment.

Current List of Countries That Accept Medicare

The Centers for Medicare & Medicaid Services (CMS) maintains a list of foreign hospitals that have signed a “Limited Service Agreement” with Medicare. As of October2025, the following countries contain at least one participating facility:

Step‑by‑Step: Using Medicare Abroad

1. Confirm participation: Call the hospital’s billing department or check the CMS list before you travel.
2. Carry the right card: You need the original red, white, and blue Medicare card (or a Medicare Advantage card with the same number). A copy won’t work for emergency billing.
3. Inform the provider: When you arrive at the ER or admit department, tell them you have Medicare and present your card.
4. Get a claim form: The hospital will give you a CMS-1450 (UB‑04) claim form. Fill it out accurately-your name, Medicare number, dates of service, and diagnosis codes.
5. Submit promptly: Mail the claim to the Medicare claims address (or upload via the MyMedicare portal) within 60 days of discharge.
6. Track the payment: Use the “Claims and Appeals” section of your online Medicare account to see status. Expect a 20‑30% patient responsibility for foreign hospital fees.

If you have a Medicare Advantage plan, call your private insurer first; many of them have their own foreign‑service networks and may even reimburse you directly.

Common Limitations & Pitfalls

• Elective procedures are out: Knee replacements, cosmetic surgery, or planned cardiac procedures are not covered.
• Out‑of‑network charges: Some hospitals work with a “billing agent” that adds extra fees not covered by Medicare.
• Prescription drugs: Part D generally does not reimburse overseas prescriptions; bring a sufficient supply or use travel‑specific pharmacy services.
• Long‑term care: Rehabilitation stays longer than 30 days or nursing home care are excluded.
• Currency conversion: Medicare reimburses based on the U.S. dollar conversion rate at the service date; fluctuating rates can affect your out‑of‑pocket cost.

Practical Tips for Seniors Planning Medical Travel

• Buy supplemental travel insurance that covers the gaps (e.g., ambulance transport back to the U.S., outpatient visits, and prescription drugs).
• Carry a summary of your medical history in both English and the local language; it speeds up the admission process.
• Know the emergency number of the destination country (e.g., 112 in Europe, 911 in Canada).
• Check visa requirements-some countries require proof of health coverage for long stays.
• Stay in a hotel near the participating hospital to reduce transport time in an emergency.

What to Do If Medicare Denies Your Claim

A denial can happen if the hospital wasn’t on the approved list or the services were deemed non‑emergency. Here’s how to fight it:

1. Request a detailed denial letter.
2. Gather supporting documents: medical records, doctor’s notes, and the hospital’s participation certificate.
3. File an appeal within 60 days using CMS-103 (if you have Part A/B) or the insurer’s internal appeal form for Medicare Advantage.
4. If the appeal fails, consider a private arbitration or contact a senior‑focused legal aid service.

Most denials are resolved on appeal when you provide clear evidence that the care was an emergency and the hospital was on the official list.