Protect the trip and the traveler.

What Medicare and Medigap actually pay overseas

For Medicare clients I start with Medicare's own fact sheet (CMS Product No. 11037, April 2026), because it decides how much of the trip is uncovered.

• The three foreign-hospital exceptions are narrow. Medicare may pay a foreign hospital only when you are in the U.S. for a medical emergency and the foreign hospital is closer than the nearest U.S. hospital that can treat you, when you are driving through Canada without unreasonable delay by the most direct route between Alaska and another state, or when you live in the U.S. closer to a foreign hospital than to a U.S. one that can treat you.
• Even then, the ride home is yours. Medicare won't cover return ambulance trips home or doctor services abroad after a covered foreign hospital stay ends, and Medicare plans can't cover drugs you buy outside the U.S.
• Cruises have a six-hour line. Medicare may cover medically necessary care on board only when the doctor is allowed to treat on the ship and the ship is in a U.S. port or no more than 6 hours from one.

If you carry Medigap, note that most plans (C, D, E, F, G, H, I, J, M and N) pay 80% of the billed charges for certain medically necessary emergency care outside the U.S. after a $250 deductible for the year, with a $50,000 lifetime limit, and only if the care begins during the first 60 days of the trip and Medicare doesn't otherwise cover it. Medicare Advantage plans must follow Medicare's rules but may cover more abroad, so check with your plan before you go.

Foreign hospitals aren't required to file Medicare claims, so you may pay the full bill and file Form CMS-1490S yourself. A travel medical policy is designed to address gaps like these.

Cancel for any reason: what the option trades

Standard trip cancellation pays only for the reasons listed in the policy. Cancel for any reason, usually called CFAR, is an optional add-on that drops that test. The NAIC lists the trade-offs:

• The reason doesn't matter, but CFAR typically reimburses only a portion of your trip expenses, not the full amount.
• Timing is tight. It typically must be bought within a certain period after you book.
• All or nothing. You are generally required to insure all of your prepaid, nonrefundable trip costs to be eligible.
• There is a cancellation window. There is usually a set period for cancellations, so check how close to departure you can still cancel under the policy.

Because the purchase window starts at booking, the most useful thing you can tell me is the date you paid your first deposit. If that date is already past the window, I'll say so and we'll look at standard cancellation instead. Rules vary by state; your state insurance department can answer questions. How California regulates travel insurance sold here is covered in California travel insurance rules.

Visas for Europe: the Schengen insurance rule

Anyone joining your European trip on a passport that requires a Schengen short-stay visa, such as relatives you invite, must show travel medical insurance with the visa application. The European Commission lists medical insurance covering emergency medical care, hospitalisation and repatriation, including in the event of death, among the documents to apply.

Schengen consulates apply Article 15 of the EU Visa Code. As Latvia's Office of Citizenship and Migration Affairs summarizes it, the policy must meet these terms:

• A minimum insurance sum of EUR 30,000.
• Valid across the whole territory of the Schengen member states; for a visa limited to certain countries, at least in those countries.
• Covering the entire planned stay or transit.
• Covering emergency medical care, hospital treatment, and repatriation for medical reasons or in case of death.

An EU delegation checklist sent to insurers adds that all claims must be recoverable in a Schengen member state. Tell me each traveler's passport and dates in Europe, and I'll look for a policy whose certificate states those terms in writing, since a consulate reads the document, not the brochure. If the trip dates move, the certificate has to move with them so it still covers the entire stay.

Official sources

• Medicare.gov: Travel outside the U.S.
• Medicare fact sheet: Medicare Coverage Outside the United States (CMS Product No. 11037, April 2026)
• Federal Register: Refunds and Other Consumer Protections, 89 FR (April 26, 2024), 14 CFR Part 260
• eCFR: 14 CFR Part 260, Refunds for Airline Fare and Ancillary Service Fees
• CDC Yellow Book: Travel Insurance, Travel Health Insurance, and Medical Evacuation Insurance
• NAIC: Should I Get Travel Insurance? (June 16, 2026)
• NAIC Consumer Insight: Taking a Trip? Information About Travel Insurance
• European Commission, Migration and Home Affairs: Applying for a Schengen visa
• Latvia Office of Citizenship and Migration Affairs: Insurance policy (Schengen visa, Visa Code Art. 15)
• EU Delegation to Kenya (EEAS): International Medical Travel Insurance checklist per Art. 15 EU Visa Code