For Americans: US Social Security and Medicare when you retire abroad

Yes, for US citizens, in all 20 countries we cover. Social Security says that a US citizen "may continue to receive payments while outside the U.S." as long as you remain eligible and live in a country where it can send payments ¹.

• Countries where payments are blocked: the US Treasury prohibits payments to people living in Cuba and North Korea; a US citizen gets the withheld payments back after moving elsewhere. Social Security also generally cannot send payments to Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan, with exceptions on request ¹. None of our destinations is concerned.
• Benefits stay in US dollars. They are not raised or lowered when exchange rates move: if the dollar falls against your new currency, your budget shrinks ¹.
• Not a US citizen? Payments generally stop after six full calendar months outside the US, unless an exception applies: for example citizens of countries such as Portugal, Spain, France, Italy, Greece, Ireland and Uruguay (list 1), or of Mexico, Colombia, Costa Rica, Ecuador, Croatia, Cyprus, Malta and the Philippines when the benefits are on your own work record (list 2), or residents of a country with a US social security agreement. Check your case with the Payments Abroad Screening Tool ^1,2.

• Direct deposit to a local bank: Social Security can pay into a bank in any country that has an international direct deposit agreement with the US. All 20 of our destinations are on the list ³. It avoids the delays of paper checks and can avoid check-cashing and conversion fees ¹.
• Or keep a US bank account: Social Security can deposit into a US account wherever you live (unless a restriction applies). Many retirees keep one and transfer money with a low-fee service. ¹
• Direct Express card: a prepaid debit card for federal benefits, with an international customer line ¹.
• Paper checks still exist but are slow abroad and hard to replace if lost ¹.
• Whatever the method, Social Security must have your home address abroad, not only your bank details ¹.

• Report changes promptly: a new address, marriage, divorce, a death in the family, and work if you are under full retirement age. Not reporting can lead to overpayments that Social Security takes back, or to the payments being stopped ¹.
• Working abroad before full retirement age: under the "foreign work test", benefits are withheld for every month you work more than 45 hours outside the US in a job not subject to US Social Security tax. After full retirement age (67 for people born in 1960 or later), work no longer affects benefits ¹.
• Answer the questionnaire. Social Security mails a questionnaire to beneficiaries abroad every year or every two years, depending on your age, the type of benefit and the country (in May or June). Return it signed: if you do not, your payments stop ¹.
• Who to contact: from abroad, the Federal Benefits Unit (FBU) that covers your country, listed at ssa.gov/foreign; a my Social Security account also works from abroad ¹.

Supplemental Security Income (SSI) is not Social Security: you are not eligible for any full month spent outside the US, or after 30 days in a row abroad, and you must be back for 30 days in a row to qualify again ⁴. If you receive SSI, moving abroad means losing it.

The US has social security agreements with about 30 countries. They matter if you worked in that country: they avoid paying into both systems at once and let you combine work credits from both countries to qualify for a pension ⁵.

Among our destinations, the countries with an agreement in force are Italy (1978), Spain (1988), France (1988), Portugal (1989), Ireland (1993), Greece (1994) and Uruguay (2018) ⁵. For a retiree who never worked there, the agreement changes little; it is not a tax treaty (see section 6).

The US keeps taxing its citizens wherever they live: up to 85% of your benefits can be taxable, depending on your "combined income" (for a single return, 50% above $25,000 and up to 85% above $34,000; for a joint return, $32,000 and $44,000) ¹. Your new country may tax them too; a tax treaty, or the country's own rules, decide who has the right. Our country pages give the detail and the sources:

Tax rules change and depend on your whole situation: use this table to ask the right question, then check with an adviser who knows both countries.

Medicare usually does not pay for care outside the US. The exceptions are narrow: a cruise ship within six hours of a US port, a foreign hospital that is closer than the nearest US hospital during an emergency in the US, or travel through Canada between Alaska and another state ⁶. Medicare drug plans do not cover medicines bought abroad ⁶. In practice, you need health cover in your new country: its public system where residents can join, or private insurance (see the healthcare section of each country page).

Part A: keep it, it is usually free

Most people pay no Part A premium (they or a spouse paid Medicare taxes long enough, generally 10 years) ⁷. Part A cannot be used abroad, but it "becomes available to you if you return" ¹. There is nothing to cancel.

Part B: the real decision

Part B costs $202.90 a month in 2026 (more on higher incomes), usually taken from your Social Security payment ^7,1. Living abroad, you pay it for coverage you can only use on visits to the US. Dropping it (or not signing up at 65) saves the premium, but:

• A penalty for life: if you sign up later, the premium is raised by 10% for each full 12-month period you could have had Part B but did not, for as long as you have Part B. Social Security warns retirees abroad about exactly this ^8,1.
• A narrow door back: without a Special Enrollment Period, you can only sign up from January 1 to March 31, and coverage starts the month after ⁹. Someone who comes back in May may wait until the next January to sign up.
• An example in 2026 terms: two full years without Part B mean a 20% penalty, $243.50 a month instead of $202.90 ⁸. Ten years abroad would roughly double the premium, for life.

How people decide: those who are sure to stay abroad often drop Part B; those who expect to come back for treatment or for good, or who spend long periods in the US, often keep it. It is a bet on your future, and it is worth deciding before you turn 65 or before you move.

Part D, Medicare Advantage and Medigap

• Drug plans (Part D) and Medicare Advantage only serve people living in their US service area. When you move back, you have two full months after the month you return to join one ¹⁰. Joining within that window avoids a late enrollment penalty for the time abroad ¹¹.
• Medigap (supplement) plans C, D, F, G, M and N pay 80% of emergency care abroad, up to the plan limits: useful for trips, not a substitute for health cover where you live ¹².

1. Run the Social Security Payments Abroad Screening Tool if you are not a US citizen or receive benefits as a spouse or survivor ².
2. Choose how you will be paid: local direct deposit (all 20 destinations qualify) or a US account plus a low-fee transfer ³.
3. Give Social Security your new address abroad; note the FBU for your country ¹.
4. Decide about Part B before you leave, knowing the penalty and the January–March window ^8,9.
5. Arrange health cover in your new country from day one: Medicare will not pay there ⁶.
6. Ask a cross-border tax adviser how your new country taxes Social Security and your other pensions (section 6).
7. Watch your mail for the questionnaire every year or two, and answer it ¹.