If you live outside the United States, you should understand how your Medicare is affected and should make decisions about your enrollment in Medicare. Living outside the United States means you do not live in the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

To qualify for Medicare, you must qualify to collect Social Security benefits. Alternatively, you must be a US citizen, or a legal permanent resident who has lived in the United States continuously for five years. If you qualify for Medicare, you can have Medicare Parts A and B, also known as Original Medicare, when you live abroad—whether you enroll before you leave the United States or after you move to a foreign country. However, Medicare does not typically cover medical care you receive outside of the United States.

To decide if you need your Medicare while living abroad, you need to consider costs, your individual circumstances, and future plans.

Most people pay no premium for Part A coverage for inpatient hospital services. It is usually best to keep Part A, even if you are moving abroad, since it will not cost you anything.

To have Part B coverage, you must pay the Part B premium. You may also need to keep Part B, especially if you plan to move back to the United States in the future or travel here frequently. Keeping Medicare when you live abroad will ensure that Medicare is ready to pay for your care when you return to the United States to live or travel.

If you fail to pay for Part B while overseas, you may go months without health coverage when you move back to the United States. You may have to wait until the General Enrollment Period (January 1 – March 31 of every year) to enroll and then wait until July 1 for your Part B coverage to start. Also, if you do not keep Part B while living overseas, upon your return, you may face lifelong premium penalties that will make your Medicare coverage more expensive.

If you have a Medicare Advantage or Medicare Part D plan before you move abroad, you should stop paying these premiums when you move.

Decisions about Medicare enrollment can be complicated if you live abroad. Have a plan if you live abroad and plan to return to the United States in the future. Know the key things to think about if you plan to settle in a foreign country permanently. Be prepared to enroll in Medicare if you first qualify when you live abroad.  Note this information only applies if you live in a foreign country, not if you simply take a trip abroad.

Finally, understand that these materials are intended as a general guide and will not address the particulars of every situation. Be sure to contact Social Security or the United States Consulate or Embassy in whichever country you reside before making any final decisions about Medicare enrollment.