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I'm an American Citizen Living Overseas, What Should I Do About Medicare?

Q. I’m an American citizen living overseas and plan to continue working outside of the United States for a few more years. But I’ll be 65 soon, so what should I do about Medicare?

A. As long as you’re eligible for Medicare (having earned enough work credits), you can enroll in the program by going to the U.S. embassy or consulate of the nation where you’re living. (In the Philippines, contact the regional office of the U.S. Veterans Affairs agency.) But keep the following in mind:

Part A (hospital insurance): You can sign up for Part A during the seven-month enrollment period around your 65th birthday. You won’t be able to use Part A’s services outside of the United States, but it doesn’t cost you anything to enroll and there are no premiums to pay.

Part B (doctors and outpatient services): Here are the rules:

* If you have health coverage from your employer that is primary to Medicare, you need not enroll in Part B at this time.

* If you are volunteering abroad and have health coverage from your sponsoring organization, you will not need to enroll in Part B at this time. You are entitled to a special enrollment period to sign up for Part B on your return to the United States.

* If you don’t have coverage from an employer or voluntary service sponsor—or rely on the national health service of the country you’re living in—you have to decide between two options. You can sign up for Part B around the time you turn 65 and pay the required premiums, even though you will not be able to use its medical benefits outside of the United States. Or, you can delay joining Part B until you return to live in the United States and then pay a late penalty in the form of permanently higher premiums.

Part D (prescription drugs): You do not need to join Part D at this time. When you return to live permanently in the United States, you will not incur a late penalty as long as you begin receiving Part D drug coverage within 63 days of the date of your return. (Medicare policies for Part B and Part D differ on this point.)

Patricia Barry is a senior editor at the AARP Bulletin.

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