Retiring or living abroad after age 65 can offer an exciting new chapter, but healthcare planning becomes especially important. For Americans over 65, choosing international health insurance is different from choosing coverage at a younger age because Medicare, age-related underwriting, pre-existing conditions, and the cost of international medical care can all affect your options.
There is no single international health insurance plan that is best for every American over 65. The right policy depends on where you live, how often you return to the United States, your medical history, the level of coverage you want, and your budget.
This guide explains what Americans over 65 should consider when comparing international health insurance in 2026.
Does Medicare Cover Americans Living Abroad?
One of the most important things to understand is that Medicare generally does not pay for healthcare received outside the United States.
According to Medicare, coverage outside the U.S. is limited to specific situations. For example, Medicare may cover certain emergency treatment in a foreign hospital when the foreign hospital is closer than the nearest U.S. hospital under specific circumstances. These exceptions are narrow and should not be treated as comprehensive international health coverage.
Original Medicare generally does not provide routine healthcare coverage while you are living overseas. Medicare Advantage plans also generally do not cover healthcare outside the U.S., although some plans may provide limited emergency or urgently needed coverage when traveling.
This is why Americans moving abroad should look carefully at international health insurance rather than assuming Medicare will cover their healthcare overseas.
Should You Keep Medicare If You Move Abroad?
This is an important decision and depends on your circumstances.
Some Americans living abroad choose to maintain Medicare Part A and Part B because they expect to return to the United States for medical care. Medicare itself notes that people living outside the U.S. may want Part B if they plan to return to the United States for healthcare services. Medicare
There can also be consequences to delaying Part B. Medicare states that people who don’t enroll when first eligible may have to wait for a later enrollment period and may face a late enrollment penalty. Medicare+1
Because Medicare decisions can affect your future access and costs, Americans moving overseas should consider their long-term plans before dropping or delaying coverage.
What Should International Health Insurance Cover After Age 65?
For Americans over 65, price should not be the only consideration. A comprehensive international medical plan may offer benefits such as:
- Inpatient and outpatient medical treatment
- Emergency treatment
- Specialist consultations
- Diagnostic testing
- Prescription medication benefits
- Hospitalization
- Emergency medical evacuation
- Treatment in multiple countries
- Worldwide coverage options
- Optional or included coverage in the United States, depending on the plan
The exact benefits, exclusions, limits, deductibles, and eligibility rules vary by insurance provider and policy.
For someone with an ongoing medical condition, understanding the policy’s rules concerning pre-existing conditions is particularly important.
USA Coverage Can Make a Major Difference
One of the biggest decisions for an American over 65 is whether international coverage should include the United States.
If you plan to live overseas permanently and rarely return to the U.S. for treatment, you may prefer a plan focused primarily on international healthcare.
However, someone who spends part of the year in the United States may want a policy that includes U.S. coverage.
Adding the United States can affect eligibility and premium costs, so it should be evaluated based on your actual travel and healthcare plans rather than automatically included.
What About Medigap?
Medigap is designed to help cover certain out-of-pocket costs associated with Original Medicare. Some Medigap policies also provide foreign travel emergency benefits.
Medicare’s current comparison information shows that certain Medigap plans include foreign travel emergency benefits, subject to plan limits. Medicare+1
However, Medigap foreign travel benefits should not be confused with comprehensive international health insurance.
A Medigap policy’s foreign emergency benefit is not necessarily designed to provide the ongoing outpatient, hospital, specialist, and routine healthcare coverage an American living overseas may need.
If you are moving abroad permanently, compare the two types of coverage carefully.
How Age Affects International Health Insurance
Age can have a significant impact on international health insurance eligibility and pricing.
Applicants over 65 may encounter different age limits, premiums, medical underwriting requirements, benefit restrictions, or plan availability depending on the insurer.
This means that waiting until after you relocate—or until you develop a new medical condition—can potentially reduce your available choices.
It is generally sensible to investigate coverage before moving and compare multiple plans rather than assuming that every international insurer will offer the same terms.
Pre-Existing Conditions Matter
Pre-existing medical conditions are another major consideration for Americans over 65.
Insurance providers can have different definitions, underwriting procedures, exclusions, waiting periods, and coverage rules relating to pre-existing conditions.
For example, one plan may offer terms that are different from another plan for a particular medical history.
Never assume that a condition will automatically be covered—or automatically excluded. Read the policy wording and ask the insurer or broker how the condition is treated before purchasing.
How Much Does International Health Insurance Cost for Americans Over 65?
There is no reliable single price for international health insurance at age 65 or older.
Premiums can depend on factors such as:
- Age
- Country of residence
- Geographic area of coverage
- Whether the USA is included
- Deductible
- Benefit limits
- Medical history
- Coverage level
- Optional benefits
A lower premium may come with a higher deductible, narrower geographic coverage, or other limitations. Comparing the overall policy—not simply the monthly price—is therefore important.
How to Choose the Best Plan
For Americans over 65, start by identifying your actual healthcare needs.
Ask yourself:
- Where will I live most of the year?
- Will I return to the United States regularly?
- Do I need U.S. coverage?
- Do I have pre-existing medical conditions?
- Do I want private hospitals?
- How much deductible can I comfortably afford?
- Do I need medical evacuation?
- Will I need coverage in multiple countries?
Once you know the answers, compare policies from multiple providers.
Final Thoughts
The best international health insurance for Americans over 65 is not necessarily the cheapest plan or the policy with the longest list of benefits. It is the plan that fits your destination, medical needs, travel patterns, budget, and long-term retirement plans.
Medicare generally provides limited coverage outside the United States, making international health insurance an important consideration for Americans who plan to live overseas. Medicare+1
At Expat Global Medical, we help Americans living, retiring, and traveling abroad compare international health insurance options from multiple providers. We can help you review available options based on your age, destination, coverage requirements, and individual circumstances.
If you’re over 65 and planning to retire or live abroad, start comparing your international health insurance options before you move.
Request a free, no-obligation international health insurance quote from Expat Global Medical today.
