Living overseas and health care


Q. I am in the GS, age 64. I hit seven years overseas and am on the Priority Placement Program to return to the U.S. Instead, I plan to stay overseas and marry a local national. My options are to retire at 13 years’ service or to resign and take a Non-Appropriated Fund job on base to continue earning FERS coverage. I understand that next year I must enroll in Medicare Part A, although I will be overseas and unable to use it. Is there any benefit to me also enrolling in Part B if I plan to retire overseas? I have the Foreign Service Benefit Plan.

It appears that I am going to be undercovered either way unless I am still able to work on base as NAF and access the U.S. hospital where Medicare coverage would be primary. Do you have any advice on how to retire overseas regarding health care benefits? It seems there is no good answer, and yet I know many people who are not military retirees making the decision to stay overseas after their tours end.

A. As a rule, Medicare doesn’t cover health care while you are outside the United States (including Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands). Therefore, if you need care covered by Medicare, you will have to return to the U.S. to have Medicare pay for those services.


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Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to


  1. Jerry Drawhorn on

    The response doesn’t really seem to answer the correspondents questions.

    Is there an advantage to paying for Medicare Part B if one lives abroad? The answer is it depends if one intends to move back to the US or seek hospital/medical coverage when one travels back to the US. Declining Medicare B generally makes one subject to a penalty of 10%/year (you didn’t pay your Medicare premiums) . Thus if you return after a 5 year period abroad without premium payments you will pay an additional 50% atop the current monthly premium rate. For 2018 that will be $134 + $67 per month…and this will continue in perpetuity.
    If one had paid for the premium for that 5 years (even though you cannot use Medicare services) you’d be paying $134/month. After 5 years that would be $8040 (assuming no premium increases). So how many years would you pay the penalty before it would be more than the amount you had paid for those 5 years??? That would be 120 months or ten years.
    If you stayed abroad for 10 years the penalty would double your monthly premium. If you didn’t pay premiums over that decade you’d save at least $16,080 (assuming no premium increases)….but you’d pay a minimum of $134+$134 monthly upon return. That too is 120 months (10 years) to reach the point where you’d “lose” money.
    I’d point out, however, that some state (and perhaps Federal) retirement systems subsidize the payment of Group B premiums for retirees (and that includes those who live overseas) in their retiree insurance plan coverage. If your system does this then it makes sense to Claim Medicare a and B. Also check to see whether your insurance plan has an affiliation with bcbs or the Geo-Blue program which provides remuneration for healthcare expenses for both travel and those that reside overseas.

    • Useful input that’s worth sharing with others. However, since this is a site for federal employees, retirees, and their survivors, it needs to be made clear that the the federal government does not subsidize the payment of their Part B premiums.

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