Will Original Medicare pay for an emergency room visit in Spain?

No. Original Medicare (Part A and Part B) does not pay for healthcare outside the United States, including emergency room visits. The four narrow exceptions involve cross-border emergencies (Canada or Mexico hospitals closer than US ones) and cruise ships within 6 hours of a US port. If you have a Medigap policy with plan letter C, D, F, G, M, or N, you get 80% of billed charges back after a $250 deductible, capped at a $50,000 lifetime maximum, during the first 60 days of a trip. Medicare Advantage coverage varies by plan. For everyday care in Spain, expats typically carry separate international insurance through Cigna Global, GeoBlue, Allianz, or IMG.

Can I pay my Part B premium while living overseas?

Yes, but you call Social Security, not Medicare. SSA owns enrollment and premium collection; Medicare owns claims and coverage. The line is SSA International Operations at +1 (410) 965-0160, Monday through Friday, 8 to 11 AM Eastern only. That's a 3-hour window, which converts to 2 to 5 PM in Berlin or Madrid, 6:30 to 9:30 PM in Mumbai, and the middle of the night in Sydney. SSA also accepts Easy Pay debit from a US bank account, which avoids the call entirely. Calling 1-800-MEDICARE about a premium just earns a referral to SSA and a wasted morning on hold.

Can SSA mail a replacement Medicare card to my foreign address?

Generally no. SSA and Medicare require a US mailing address on file for most account actions, including replacement card shipments. The workarounds: order the replacement at MyMedicare.gov and have it shipped to a US relative or a mail-forwarding service like USGlobalMail or Earth Class Mail, then reship internationally. Most expats keep their card with family in the US and carry a photo of both sides on their phone. The Medicare Beneficiary Identifier (MBI) replaced the SSN-based HICN in 2018-2019, so the number itself is meaningful even without the physical card when you call CMS Baltimore at +1 (410) 786-3000.

What if I get fraud calls claiming to be Medicare while I'm overseas?

Medicare never cold-calls beneficiaries asking for your MBI, Social Security number, or bank details. Real Medicare contact starts with mail, not phone. If a caller claiming to be Medicare reaches you abroad, hang up and report it to 1-800-HHS-TIPS (1-800-447-8477) or through the fraud form at OIG.HHS.gov. The fraud hotline runs Monday through Friday, 8 AM to 5:30 PM Eastern, and is US toll-free, so use a browser dialer or call CMS Baltimore at +1 (410) 786-3000 to be transferred. Common scams target retirees abroad with fake MBI verification requests during Open Enrollment (October 15 through December 7).

How long are Medicare holds during Open Enrollment?

Expect 30 to 60 minutes or longer during US Medicare Open Enrollment (October 15 through December 7) and the General Enrollment Period (January 1 through March 31). Off-peak, holds typically run 10 to 30 minutes. A 45-minute hold is normal. The cost depends entirely on routing: US carrier roaming on a TravelPass-style plan can cost $90 to $180, foreign carrier direct-dial runs $14 to $45, and a browser-based service like WorldDialer costs $1.80 at $0.04 per minute. If the call drops mid-conversation, write down the agent ID at the start so you can resume the same case file when you call back.

Call Medicare from Abroad: The Line That Actually Connects

To call Medicare from outside the United States, dial +1 (410) 786-3000 — CMS headquarters in Baltimore. It connects from any foreign carrier and any browser dialer. The 1-800-MEDICARE number printed on every Medicare card is US toll-free, which means it often won't connect from your foreign SIM at all.

For Medicare enrollment, Part B premium questions, or a replacement card, you actually need Social Security, not Medicare. The SSA Office of International Operations is +1 (410) 965-0160, Monday through Friday, 8-11 AM Eastern only.

This guide sorts every Medicare contact line by what it handles, explains why your 1-800 calls keep failing, maps which agency owns your question, gives the honest answer on what Medicare covers abroad, and shows how to sit on a 45-minute hold for less than a dollar.

The Numbers That Actually Connect from Abroad

From outside the US, the working numbers are CMS Baltimore at +1 (410) 786-3000 for general Medicare questions and claims, and SSA International at +1 (410) 965-0160 for anything enrollment- or premium-related. For Medicare Advantage, Part D, or Medigap, the number on your member card is the one that matters.

Line | Number | What It Handles | Hours (US Eastern)

CMS Baltimore HQ | +1 (410) 786-3000 | General Medicare, claims, escalations | Mon-Fri 8:30 AM - 5 PM

1-800-MEDICARE | 1-800-633-4227 | Beneficiary services, plan info, claims | 24/7 (US toll-free — see §2)

Medicare TTY | 1-877-486-2048 | Hearing-impaired | 24/7 (US toll-free)

Medicare Fraud Hotline | 1-800-447-8477 | Report suspected fraud | Mon-Fri 8 AM - 5:30 PM (US toll-free)

SSA International Operations | +1 (410) 965-0160 | Part A/B enrollment, premiums, ID cards | Mon-Fri 8-11 AM (narrow window)

SSA main line | 1-800-772-1213 | General SSA (US toll-free) | Mon-Fri 8 AM - 7 PM

Medicare plan member services | On member card | Plan-specific questions | Plan-specific

Flip your Medicare Advantage or Part D card over before you call. The member services line on the back is almost always toll-free, and the same routing issues apply. Most plans publish an alternative direct-dial number on their website for international members.

Why 1-800-MEDICARE Often Fails from Outside the US

US toll-free numbers don't reliably connect from foreign carriers. 1-800-MEDICARE, 1-800-HHS-TIPS, and the Medicare TTY line will either fail with a "call cannot be completed" message, ring without answering, or get billed by your foreign carrier at premium per-minute rates.

The structural reason: US toll-free numbers (1-800, 1-888, 1-877, 1-866, 1-855, 1-844, 1-833) are funded by the called party paying a per-minute origination fee inside the US tariff. International origination sits outside that tariff. Most foreign carriers refuse to route the call. Some route it but bill you $1-3 a minute for the privilege.

Behavior shifts by region:

Mexico (Telcel, Movistar, Bait, Virgin Mobile MX) — generally fails. Some AT&T Mexico postpaid plans connect. If you're calling from Mexico full-time, the call-medicare-from-mexico guide covers Mexican carrier specifics and the 880-series workaround.
Canada — often connects on the 1-800-MEDICARE line specifically; rates vary.
UK and Europe — usually fails or premium-billed.
Asia (Japan, Philippines, India, Indonesia) — usually fails.
Middle East (UAE, Saudi Arabia, Israel) — usually fails.
Australia and New Zealand — usually fails or carrier-billed.

A handful of countries publish "international 800" conversion codes (the ITU E.169 standard) that re-route US toll-free numbers as paid international calls. Mexico's 880-series is the most consistent. Other countries' implementations are patchy. Either way, the converted call is no longer free — you pay your carrier's international rate.

The cleanest workaround is to skip 1-800-MEDICARE entirely and call the CMS HQ direct line at +1 (410) 786-3000, which routes as a regular international call from any carrier. The deeper version of why toll-free is broken internationally is in calling 1-800 numbers from abroad.

SSA vs. CMS: Which Agency Owns Your Question

Most callers from abroad reach the wrong agency first. Medicare and Social Security split responsibilities in a way that's not obvious from outside the system. The rule of thumb: anything about enrolling or paying is SSA. Anything about claims, plans, or coverage rules is CMS or the plan.

Your Question | Who To Call

Initial Enrollment Period (around your 65th birthday) | SSA — +1 (410) 965-0160

General Enrollment Period (Jan 1 - Mar 31, if you missed Initial) | SSA — +1 (410) 965-0160

Special Enrollment Period (after losing employer coverage abroad) | SSA — +1 (410) 965-0160

Late Enrollment Penalty appeal | SSA — +1 (410) 965-0160

Part B premium payment while abroad | SSA — +1 (410) 965-0160

Part B premium amount or IRMAA question | SSA — +1 (410) 965-0160

Replacement Medicare card | SSA — +1 (410) 965-0160 (or order at MyMedicare.gov)

Claim status for a specific service | CMS — +1 (410) 786-3000, or the plan

Plan information (Advantage, Part D coverage details) | The plan — number on member card

Coverage question for a specific service or drug | 1-800-MEDICARE or the plan

Medigap foreign-travel emergency claim | Medigap insurer — number on member card

Medicare Savings Programs (low-income subsidies) | SSA + your state Medicaid office

Suspected Medicare fraud | 1-800-HHS-TIPS (1-800-447-8477)

The single most common mistake from abroad: calling 1-800-MEDICARE about a Part B premium payment. That's an SSA question. The Medicare line will tell you to call Social Security, and then you've spent your morning on hold for nothing. For more on the SSA side of the wall, see calling SSA from abroad.

Does Medicare Cover Healthcare Abroad? The Honest Answer

Original Medicare (Part A and Part B) does not pay for healthcare outside the United States. That's the rule. The exceptions are narrow enough that most beneficiaries will never qualify for one.

The four documented exceptions:

You're in the US, but the closest hospital that can treat your emergency is across the border in Canada or Mexico.
You're traveling between Alaska and the lower 48 through Canada by the most direct route and have a medical emergency.
A foreign hospital is closer to your home than the nearest US hospital that can treat your emergency or illness — even if you're not crossing a border.
You're on a cruise ship within 6 hours of a US port and have a medical emergency.

That's it. Living in Mexico, getting sick in Spain, breaking a hip in the Philippines — Original Medicare pays zero.

Medigap (Medicare Supplement) is where original Medicare beneficiaries get any foreign coverage. Medigap Plans C, D, F, G, M, and N include foreign-travel emergency coverage: 80% of billed charges after a $250 deductible, with a $50,000 lifetime maximum, on emergencies during the first 60 days of a trip. Plans A, B, K, and L don't include it. If you have Medigap and don't know your plan letter, the letter is in the upper-right of your Medigap card.

Medicare Advantage is plan-specific. Some plans (especially those marketed to people who travel) include emergency and urgent care abroad. Coverage varies wildly. You call your plan, not Medicare, to find out.

The practical reality for most expats: keep Part B active so you have it when you're back in the US, and carry separate international or expat health insurance for everyday care abroad. Cigna Global, GeoBlue, Allianz, and IMG are the major providers in this segment.

Calling from Your Time Zone (the SSA 8-11 AM ET Trap)

SSA International Operations runs Monday through Friday, 8-11 AM Eastern only. That's a 3-hour window. From most of Europe, Asia, or the Middle East, hitting it means either an afternoon call (Europe), an evening call (Asia), or a middle-of-the-night call (Pacific). CMS HQ is more forgiving — 8:30 AM to 5 PM Eastern. 1-800-MEDICARE runs 24/7 (when it connects at all).

Standard-time conversions for the SSA 8-11 AM ET window:

Region | Local Zone | SSA Window (Local, Winter)

Mexico City, Mérida, Lake Chapala | CST (UTC-6) | 7-10 AM

Toronto | EST (UTC-5) | 8-11 AM

London | GMT (UTC+0) | 1-4 PM

Berlin, Paris, Madrid | CET (UTC+1) | 2-5 PM

Tel Aviv | IST (UTC+2) | 3-6 PM

Dubai | GST (UTC+4) | 5-8 PM

Mumbai | IST (UTC+5:30) | 6:30-9:30 PM

Manila | PHT (UTC+8) | 9 PM - midnight

Tokyo | JST (UTC+9) | 10 PM - 1 AM (next day)

Sydney | AEDT (UTC+11) | midnight - 3 AM

During US daylight saving (mid-March through early November), shift each window one hour earlier in local time. Several countries don't observe DST at all — Mexico (except Baja border zone), Japan, India, most of Asia, the UAE. Others (UK, EU, Israel) do but with different start dates.

Sydney callers: easiest pattern is to call at 1-3 AM Tuesday local for 9-11 AM Monday Eastern. Most days don't matter for SSA, but if you have to call Monday for a deadline reason, that's the conversion.

What It Costs to Call Medicare from Abroad

A 45-minute Medicare hold is normal. Off-peak, expect 10-30 minutes. During US Medicare Open Enrollment (October 15 to December 7) and the General Enrollment Period (January 1 to March 31), expect 30-60 minutes or longer.

How you route the call determines whether that hold costs a dollar or two hundred dollars:

Routing | Per-Minute Cost | 45-Minute Hold

US mobile carrier roaming abroad (Verizon TravelPass, AT&T International Day Pass, T-Mobile Magenta) | $2-$4/min | $90-$180

Foreign carrier international dial | $0.30-$1+/min | $14-$45+

World Dialer (browser) | $0.04/min | $1.80

US carrier roaming charges are the worst case. International Day Pass plans bill a flat fee per day you make a call, then absorb the minutes — but those plans assume you're a tourist for a week, not a retiree in Portugal calling Medicare three times a year. Foreign carrier rates vary widely. Telcel prepaid in Mexico runs $0.20-$0.40 per minute. UK mobile to US runs $0.50-$1.20. UAE postpaid runs $0.40-$0.80.

World Dialer routes any US number — including 1-800-MEDICARE — through a browser tab at $0.04 a minute. A 45-minute hold costs $1.80. No app to install, no subscription required, no minimums. The math gets worse the longer the hold runs, and Medicare holds are not short.

Before You Call: What to Have Ready

Have your Medicare number from your red, white, and blue card, your Social Security number, your date of birth, and the US address SSA and Medicare have on file. The agent will authenticate before discussing anything. Authentication failure ends the call, and the next call queues you back behind the same 30-60-minute wall.

Bring to the call:

Medicare number — printed on your red, white, and blue Medicare card (the MBI, replaced the SSN-based HICN in 2018-2019)
Social Security Number
Date of birth
US mailing address on file — Medicare doesn't accept foreign addresses for most account purposes; if your address has changed, the agent will ask
The letter or notice — if you're calling about something specific (denial of claim, premium notice, IRMAA letter), have the actual paper or PDF in front of you with the reference number visible
Plan member ID — if you're calling Advantage, Part D, or Medigap
A US relative's mailing address — for any document or card the agency needs to mail; foreign addresses are slow or refused

Write down the agent's ID number at the start of the call. If the call drops mid-conversation, that's what gets you back to the same case file.

Make the Call

You have the line that connects, the agency map, the coverage reality, and a way to sit on hold for less than a dollar. Time to dial.

The Medicare line from abroad is +1 (410) 786-3000, Monday through Friday, 8:30 AM to 5 PM Eastern. For enrollment and premium questions, +1 (410) 965-0160, Monday through Friday, 8-11 AM Eastern.

World Dialer routes that call from anywhere in the world for $0.04 a minute. Browser-based, no app to install, no subscription required. A 45-minute Medicare hold costs $1.80.

We'll be here when the line you actually need is the +1 line. See also calling US government from abroad for the broader institutional context.

→ Try World Dialer

---