I plan to move abroad permanently when I retire next year. How will living outside of the U.S. affect my Medicare coverage?
-Walter (Eugene, OR)
If you move outside the United States permanently, you should decide whether to keep Medicare Parts A and B. It is important to remember that you can have Medicare while you live abroad, but it will usually not cover the care you receive.
Since most people pay no premium for Part A coverage, it is usually best to keep Part A, even if you are moving abroad, because it is free. If you are enrolled in premium-free Part A, you cannot disenroll without having to pay all benefits you’ve received back to the Social Security Administration (SSA), including Social Security monthly retirement or disability payments and claims paid by Medicare Part A. If you must pay a premium for Part A, be aware of the high monthly cost for maintaining Part A coverage.
To have Part B coverage, you must pay the monthly Part B premium. You may want to keep Part B if you plan to move back to the U.S. in the future or visit frequently. This is because paying the premium to keep Part B when abroad will ensure that Medicare will cover your care whenever you travel to the U.S., and that you will not face premium penalties or gaps in coverage. If you fail to pay for Part B while abroad, when you move back to the U.S. you may go months without health coverage. This is because you may have to wait until the General Enrollment Period (GEP), which runs January 1 through March 31 each year, with coverage starting July 1.
Keeping Part B may not be worth the cost if you plan to live abroad permanently and do not take frequent trips to the U.S. To stay enrolled in Part B, you must continue to pay monthly Part B premiums even though Medicare will not cover your care. If you plan to move back to the U.S. or travel back frequently, you might still consider dropping Part B only if:
You or your spouse currently work outside the U.S. for a company that provides you with health insurance, or you or your spouse work in a country with a national health system. You will qualify for a Special Enrollment Period to enroll in Part B without penalty. This SEP begins at any time while you (or your spouse) are still working and for up to eight months after you lose your health coverage or stop working.
You volunteer internationally for at least 12 months for a tax-exempt non-profit organization and have health insurance during that time. You will have a six-month Special Enrollment Period to enroll in Medicare without gaps or penalties. This SEP begins once your volunteer work stops or your health insurance outside of the U.S. ends, whichever is earlier.
Before you move abroad, make sure to explore your options for health coverage in whichever country you may reside. Once you are a resident of certain foreign countries, you may qualify for national health insurance, or you may be able to buy private health insurance. Get specifics about this coverage to ensure that coverage will be adequate and affordable now and in the future.
Best of luck on your big move!