Does Medicare Work in France? Part A, Part B and the Penalty for Americans (2026)

Medicare does not work in France: it pays for care given in the United States, and living abroad is not one of the three narrow situations in which it pays a foreign hospital. You keep your Medicare rights while you live in France, but they can only be used on US soil, and Part B, with its monthly premium, is a decision to make with the figures in front of you. This guide takes Medicare part by part for an American resident of France: what each part does from here, what it costs in 2026, how the late enrollment penalty works, how to enroll or cancel from France, what coming back involves, and how France covers you meanwhile. This article is for informational purposes only and does not constitute legal advice. Rules change, and your situation may differ: always verify current requirements with the relevant French authorities or a licensed professional. It is not insurance or medical advice either.

Does Medicare Pay for Care in France?

No. Medicare usually does not cover health care outside the US, which for Medicare means the 50 states, the District of Columbia, Puerto Rico, the US Virgin Islands, Guam, American Samoa and the Northern Mariana Islands. France, the rest of Europe and every other country are treated alike: there is no list of foreign countries where Medicare is accepted.

The fact sheet Medicare Coverage Outside the United States (April 2026) lists three situations in which Medicare may pay a foreign hospital:

• You are in the US when a medical emergency occurs, and the foreign hospital is closer than the nearest US hospital that can treat you.
• You are traveling through Canada without unreasonable delay, by the most direct route between Alaska and another state, when the emergency occurs, and the Canadian hospital is closer.
• You live in the US and the foreign hospital is closer to your home than the nearest US hospital that can treat you.

All three concern people who are in the US or live there, next to a border. None is “living abroad”, and in every other case you pay the full cost to the provider.

Medicare does not meet the insurance requirement of a French long-stay visa either: see which policies the consulate accepts before CPAM.

Medicare Part by Part: What Each Part Does for You in France

From France, Part A is free to keep and usable only on US soil, Part B is the one recurring cost, and the other parts either end or cannot serve a resident abroad. The figures are those of 2026.

What Staying Enrolled Costs in 2026: Part A and Part B

Keeping Part A costs nothing if you have it premium-free, the case of about 99% of beneficiaries. Keeping Part B costs $202.90 a month in 2026 at the standard rate, more on higher incomes.

Part A

About 99% of beneficiaries have no Part A premium, because they have at least 40 quarters of Medicare-covered employment. For them, staying enrolled from France is free, and dropping Part A is generally not possible. People who buy Part A pay $311 or $565 a month in 2026, and years worked in France do not help reach the 40 quarters, since the US-France Social Security agreement does not apply to Medicare benefits.

For a resident of France, Part A is hospital coverage during time spent in the US, with an inpatient deductible of $1,736 in 2026. On its own it covers inpatient hospital care only.

Part B

The standard Part B premium is $202.90 a month in 2026, about $2,435 a year, with a $283 annual deductible, after which you usually pay 20% of the Medicare-approved amount. Above $109,000 of modified adjusted gross income on an individual return ($218,000 on a joint one), the monthly total runs from $284.10 to $689.90. Look for the 2027 amounts on cms.gov before you budget.

From France, the premium buys care from doctors during stays in the US, a premium without penalty on the day you move back, and the right to hold a Medigap policy or a Medicare Advantage plan, both of which require Part B. Military retirees have one more reason: TRICARE For Life requires Part A and Part B and pays first where Medicare does not cover.

If you turn 65 abroad, Part B is not automatic: you get Part A automatically and must sign up for Part B if you want it, and Social Security’s operations manual asks for a special effort so that nobody outside the United States enrolls by mistake. Part B that you already have when you move continues, premium included, until you ask to end it.

What Dropping Part B Means and How the Penalty Is Computed

You can drop Part B at any time. The cost comes when you want it back: the premium is then 10% higher for each full 12 months you could have had Part B and did not, for as long as you have Part B, and you can sign up again only in an enrollment period.

Dropping Part B takes a signed written request to Social Security, on form CMS-1763. Coverage ends on the last day of the month after the month you file: a request made on April 5 ends it on May 31. The official pages know no “suspension” of Part B, only ending the coverage and signing up again.

The late enrollment penalty is added to the monthly premium and is not a one-time fee. Medicare’s own example: after 2 full years without Part B you pay 20% on top of the standard premium, or $243.50 a month in 2026 instead of $202.90. Social Security counts the months from the end of your coverage to the end of the month in which you sign up again, and only full 12-month blocks count.

For a five-year stay in France, the guide to preparing your US finances before the move works the case at the 2026 rate: about $12,174 saved, then a premium near $304 a month, and roughly ten years of that surcharge to cancel the saving.

The second cost is time: you may have to wait for the next General Enrollment Period to sign up.

Is There a Special Enrollment Period for Americans Who Lived Abroad?

Not for Part B. The Special Enrollment Periods medicare.gov lists cover job-based coverage, volunteering in a foreign country, TRICARE, the loss of Medicaid, a disaster, misleading information, release from incarceration, and other exceptional conditions that you must ask Social Security for. Having lived or retired abroad is not on the list. The one period written for people who move back is for Medicare Advantage and drug plans.

The clock starts at 65 in France as it does in Ohio: a foreign resident’s initial period is set by the month that person could have been entitled to Part A, application or not. The example in Social Security’s manual is an American living in France who turned 65, did not sign up, and enrolled in a later General Enrollment Period: 17 months had passed, and his premium was raised by 10%.

Work is the exception. The manual counts national health plans in foreign countries among group health plans and says that neither the employer nor the job has to be in the United States. You must show evidence of the employment and of the coverage under the national plan, and some countries’ plans, it warns, cover only their own citizens. If you are employed in France at 65, or covered through a working spouse, put the question to Social Security in writing before the initial period ends. A retiree’s French coverage rests on residence, not on employment.

Part D and Medicare Advantage When You Live Outside the Plan’s Service Area

Neither can follow you to France. To join a Medicare Advantage or drug plan you must live in its service area, and CMS’s 2026 enrollment guidance states that living abroad is not permanent residence.

A Medicare Advantage plan must end the membership of someone who permanently moves out of its area, or whose absence exceeds six consecutive months, and you are then in Original Medicare. A drug plan follows the same rule, with 12 consecutive months for an absence, and does not cover drugs bought outside the US anyway. For your treatment in France, see how French pharmacies and prescriptions work and what you may bring from the US.

The good news is the Part D late penalty, 1% of the national base beneficiary premium ($38.99 in 2026) for each full month without Part D or creditable drug coverage once the gap reaches 63 days in a row. CMS’s 2026 penalty guidance tells plans not to count the days a person lived in a foreign country. When you move back, you have 2 full months after the month of your return to join a plan. If the plan sees a gap in your coverage, it sends you a form: state there that you lived abroad, and return it by its deadline.

Medigap Foreign Travel Emergency Coverage: For Trips, Not for Residents

A Medigap policy with the foreign travel benefit pays 80% of the billed charges for emergency care abroad after a $250 deductible for the year, within a lifetime limit of $50,000, and only if the care begins during the first 60 days of a trip. It is written for a vacation, not for a life in France.

According to the Medicare fact sheet, plans C, D, F, G, M and N carry this benefit, as do E, H, I and J, which are no longer sold. It applies to certain medically necessary emergency care, not to routine care, and the certificate does not satisfy the consulate’s insurance requirement.

Keeping the policy means keeping Part B and paying both premiums. Giving it up has a cost too: the Medigap Open Enrollment Period lasts 6 months from the first month you have Part B at 65 or older, and it happens once. After it, an insurer may refuse you or charge more, although your state may add rights.

How to Enroll, Pay Premiums or Cancel From France

Everything goes through Social Security. It has no offices outside the United States, and for France the office that handles Social Security and Medicare questions is the Federal Benefits Unit at the US Embassy in Paris. Start from the SSA’s contact page for people outside the United States.

Enrolling at 65. If you already draw Social Security, Part A is set up for you and, according to Social Security’s manual, CMS mails beneficiaries abroad a package in the months before they turn 65, with form CMS-40B and a return envelope addressed to Social Security’s Division of International Operations. Return the form during your initial period if you want Part B. If you do not draw Social Security yet, do not wait for that package: the form says to contact Social Security to apply for Medicare for the first time.

Enrolling later. The same form serves in the General Enrollment Period or a special period. It names the local Social Security office as its destination, so from France confirm the address with the Federal Benefits Unit. The guide to US Social Security payments in France covers your other dealings with that office.

Paying. Most people have the premium deducted from their Social Security benefit. Without a benefit, Medicare bills you: you can pay through your online Medicare account, by automatic deduction from a bank account (Medicare Easy Pay), through your bank’s online bill payment or by mail. An unpaid delinquent bill ends the coverage.

Canceling. The signed request described above.

How You Are Actually Covered in France

By France. An American resident starts on private insurance, joins the public system, the Protection Universelle Maladie (PUMa), after three months of stable residence when not working, and adds a mutuelle (private complementary insurance).

Before PUMa you rely on the private policy that the long-stay visa requires, until the CPAM (Caisse Primaire d’Assurance Maladie, your local health insurance office) confirms your rights in writing. For a retiree that commonly takes six to nine months from arrival: see the comparison of international health plans for Americans.

PUMa has no age condition and no link with Medicare: it covers anyone who works or resides in France in a stable and regular manner. For someone without a job, service-public.gouv.fr (verified May 13, 2026) states that you wait 3 months in France before your rights open. The CPAM registration guide lists the documents, and the healthcare setup guide covers the Carte Vitale.

PUMa reimburses approximately 70% of most medical acts, and a mutuelle covers most of the rest, much as a Medigap policy sits on top of Medicare. None of it is free: see who owes the 2026 healthcare contribution and what French healthcare really costs.

If you divide the year between the two countries, note that the Assurance Maladie checks residence: you must be able to prove 6 months of residence in France over the last 12 months.

Coming Back to the US: What Restarts and When

Part A is there the day you land. Part B works at once only if you kept it: otherwise you sign up between January 1 and March 31, coverage starts the month after, and the penalty applies. Medicare Advantage and drug plans open for 2 full months after the month you move back.

• Part A. If you never applied, you can still sign up after 65, and coverage goes back up to 6 months.
• Part B, dropped or never taken. Unless Social Security grants a special period, someone who lands in April cannot sign up before the following January.
• Medicare Advantage and Part D. An Advantage plan requires Part A and Part B, a drug plan Part A or Part B. After the 2 months, the next chance is the Open Enrollment Period, October 15 to December 7, for coverage on January 1.
• Medigap. If you take Part B for the first time on your return, the 6-month open enrollment starts with it. Otherwise a new policy depends on the insurer and on your state’s rules.
• The French side. The Assurance Maladie asks you to declare your departure to your CPAM, on its form for a transfer of residence out of France.

Keep or Drop Part B: The Trade-Off by Profile

The official pages give no general answer, because the result depends on whether and when you return, on the care you seek in the US and on your income. They give the price of each choice: $202.90 a month in 2026 to keep Part B, or 10% per full year without it, plus a wait, to get it back.

The Retiree Who May Return

Keeping Part B is a known cost for coverage you cannot use in France. Dropping it is a saving that becomes a surcharge for as long as you have Part B after your return, with a wait for the January window. The longer you live in the US afterward, the more the surcharge costs, and the longer you stay in France, the more premiums you pay without using them. Neither length is known on the day you choose.

The Retiree Settled for Good

If you never again live in the US or seek care there, the penalty is never charged, and each year without Part B is a year of premiums not paid. You give up the ability to change course cheaply if your health or your family situation changes, and a Medigap policy if you hold one. Part A remains.

The Frequent Traveler to the US

With Part B, care from doctors during your visits is covered under the usual rules. Without it, Medicare covers only an inpatient hospital stay, and the rest falls on you or on a private policy that includes the US. A French mutuelle does not cover those trips, and US coverage is the main price lever of an international plan: compare on real quotes, and count your months, because of the French residence rule.

Not Yet 65

Nothing has to be decided before the seven months around your 65th birthday, but they run in France as they would in the US, and not claiming Social Security does not stop them. If you will be working in France at 65, settle the job-based special period with Social Security. If you will be retired and covered by PUMa as a resident, expect none. The retirement guide places that decision in the rest of the move.

Common Mistakes to Avoid

Counting on Medicare, or on a Medigap card, in France. Neither pays a French doctor or hospital, and neither is accepted as visa insurance.

Dropping Part B in the belief that returning Americans get a special period. The Part B list has none for residence abroad. The period that exists after a return is for Advantage and drug plans.

Thinking the clock waits for you. The initial period runs at 65 in France, even if you have not claimed Social Security.

Letting a Part B bill go unpaid. A delinquent bill ends the coverage, and getting it back means an enrollment period and possibly a penalty.

Practical Checklist

• Buy the private policy the visa requires. Medicare and Medigap do not count.
• Decide about Part B with the current premium, the 10% rule and the January 1 to March 31 window in front of you.
• Tell your Advantage or Part D plan the date you move, and ask your Medigap insurer what happens to the policy abroad.
• Give Social Security your French address, and keep a US bank account if you pay Part B by bill: the pre-departure checklist covers both.
• If you turn 65 in France and want Part B, return form CMS-40B within the initial period.
• In France, file with your CPAM after three months, and keep the private policy until your rights are confirmed in writing.
• Before moving back, note the two windows (Part B, then plans) and declare your departure to your CPAM.

When to Get Help

Enrollment, penalties and special periods are decided by Social Security, so a question about your own record goes to the Federal Benefits Unit, in writing. When Medicare is one piece of a larger plan that also holds the visa, French health coverage and the date of the move, a Consulting Call puts those pieces in order for your case.

FAQ

Does Medicare cover you in Europe, or in any other country overseas?

No. Medicare treats every foreign country alike: outside the US and its territories, it pays only in three narrow situations that involve a hospital close to a US border or a trip between Alaska and another state.

Can I apply for Medicare while living abroad?

Yes, if you are eligible for premium-free Part A: Social Security’s manual lets a person who resides outside the US enroll in Part B only on that condition. Part B is requested with form CMS-40B during an enrollment period.

Do I have to pay for Medicare if I live abroad?

Not for Part A when you have it premium-free. You pay for Part B only while you are enrolled, and you can end it at any time, with the consequences described above.

Can I use Medicare on a trip back to the US while living in France?

Yes. Medicare pays by where the care is given, not by where you live. Part A covers an inpatient hospital stay in the US, and Part B, if you kept it, covers doctors and outpatient care there.

Is there Medicare in France?

No. Medicare is a US program and has no French branch. France’s public health insurance, the Assurance Maladie, is not tied to age: through PUMa it covers anyone who works or resides in France in a stable and regular manner, and it is not free.

Conclusion

Medicare stays yours when you move to France, and it stays in the United States. Part A costs nothing and waits. Medicare Advantage and Part D end with your US residence and reopen for 2 full months when you return. Medigap’s travel benefit covers the start of a trip, not a life here. That leaves Part B: $202.90 a month in 2026 to keep it, or 10% per full year without it and a wait for the January to March window to get it back. Make that choice before you leave, on the official figures of the year.