All American citizens over the age of 65 and those with certain disabilities qualify for Medicare coverage. However, since Medicare benefits are limited to healthcare services you receive within the U.S except in a few circumstances, it is important to understand how Medicare coverage for expatriates works.

How do American expatriates handle Medicare?

For expatriates, who are eligible for Medicare and either want to maintain their coverage for the first time, they must retain their U.S citizenship or legal status. Depending on the Medicare plan type, here is how you can enroll or maintain your plan as an expatriate.

Original Medicare

For Original Medicare, there is no requirement for residency to maintain your Part A and Part B benefits.

You can sign up for Medicare while living abroad through the closest U.S embassy or consulate. You can get the contact details for the U.S embassy in your country through the social security website.

Medicare Advantage

Expatriates can also enroll in Medicare Advantage plans if they live abroad part-time. However, unlike Original Medicare, you can only get a Medicare Advantage plan if you reside within the plan’s service area for at least 6 months per year.

Shopping Medicare in the digital age is as simple as you make it.

Medigap

If you plan to enroll in a Medigap plan to supplement your Original Medicare as an expatriate, you can do so. However, you need to be a resident of a U.S state at the time of enrollment and have active Medicare Part A and Part B.

Most Medigap plans offer coverage for medical emergencies during the first 60 days of your trip outside of the U.S.

Medicare Part D

Medicare Part D plans do not offer coverage outside of the U.S, so if you are already enrolled before moving abroad, you will not be able to keep paying your Part D premiums. Expatriates who move back to the U.S can re-enroll for Part D during the special enrollment period.

Medicare for expatriates who live abroad full-time

If you are an expatriate who is eligible for Medicare or already enrolled but live fully overseas, you can still maintain your Original Medicare coverage. This is because Original Medicare does not have a residency requirement, so you can maintain your benefits even if you have no immediate plans of returning to the U.S.

Most Medicare beneficiaries are not required to pay premiums for Medicare Part A, so there is usually no reason to drop this coverage. However, since Medicare Part B does attract premiums, you can opt to drop this part of your coverage if you live abroad full-time. You will need to notify Social Security Administration if you plan to drop your Part B coverage while living overseas.

Keep in mind that if you drop your Part B coverage, you will need to pay a late enrollment penalty to re-enroll if you move back to the U.S. Dropping your Part B coverage also means that when you return to the U.S, you will have a lapse in coverage since the open enrollment runs from January to March and your coverage will only begin in July. You may qualify for special enrollment in some circumstances.

Medicare coverage for expatriates who live abroad full-time can only be maintained for Original Medicare and Medigap plans. Medicare Advantage and Medicare Part D require residency in the plan’s service area, so you will be ineligible to apply if you do not reside within the U.S.

Medicare coverage for expatriates who live abroad full-time can only be maintained for Original Medicare and Medigap plans.

Medicare for part-time expatriates

If you are an expatriate who spends some time in the U.S or plan to return to the U.S at some point, it’s important to maintain your Medicare coverage. Part-time expatriates should maintain their Original Medicare coverage, including paying their Part B premiums. This will ensure that you do not end up paying a higher premium to enroll in Part B when you return to the U.S.

Part-time expatriates can also choose to enroll in a Medicare Advantage plan if they reside in the U.S for six months or more each year. Most Advantage plans offer coverage for medical emergencies abroad, so you will be able to benefit from your benefits in the event you have a medical emergency.

You can also maintain or enroll in a Medigap plan if you live abroad part-time. However, you will need to be a resident in the issuing state when enrolling. Medicare Part D does not allow you to continue coverage while outside the U.S, so you can drop this coverage while living abroad and re-enroll if you move back to the U.S.

Shopping Medicare in the digital age is as simple as you make it.

Reasons to maintain Medicare coverage as an expatriate

·         You will avoid penalties for late enrollment for Medicare Part A and B, which can be incurred if you do not enroll when you first become eligible;

·         Most Medicare beneficiaries do not incur premiums for Medicare Part A, so there is no reason to drop it while living abroad;

·         Most Medigap and Medicare Advantage plans will offer coverage for emergency healthcare while traveling, so they can help meet some of your medical expenses abroad;

·         You will avoid a lapse in coverage when you move back or visit the U.S.

Other health insurance options for expatriates

Maintaining your Medicare coverage, especially Medicare Part A and Part B, is recommended for all eligible expatriates. However, since Medicare does not cover your health care expenses outside the U.S, it is important to ensure you have suitable health insurance when living abroad.

Some health insurance options for U.S expatriates include:

·         International health insurance: Private insurance companies offer international health insurance that will offer you medical coverage regardless of where you reside. This is ideal for expatriates who travel widely.

·         National health insurance: if you work or fulfill residency requirements for the country you reside as an expatriate, you may qualify for coverage under your employer’s health insurance plan or a national health insurance program.

·         Travel health insurance: if you only live abroad for short periods, travel insurance can help your emergency medical expenses while traveling. Check with your provider for coverage benefits and limits before you travel.

Frequently Asked Questions

You can learn more about Medicare coverage for expatriates in the answers to frequently asked questions.

Do expatriates need to enroll in Medicare?

Expatriates who are eligible for Medicare are not required to enroll in Medicare, but it is recommended to enroll and maintain your Original Medicare coverage. This will ensure you do not incur late enrollment penalties when you move back to the U.S

How do expatriates contribute to social security and Medicare?

If you are a U.S expatriate working for a U.S company abroad, you and your employer are required to make Social Security contributions. Self-employed expatriates pay their own social security and Medicare premiums if they are enrolled for coverage.

Can expatriates drop Medicare Part B coverage?

Yes, if you live overseas, you can drop the Part B of Original Medicare if you no longer want to keep paying Part B premiums. You will have to re-enroll for Part B when you move back to the U.S, but you are not required to maintain Part B while living abroad. Late enrollment penalties may apply. 

•January 6, 2022