US Issues

Johanna Dishongh


Johanna Dishongh
US Liaison


If you are an American living overseas you may have many questions about your rights and responsibilities. FAWCO is the oldest and largest non-partisan organization representing private sector Americans abroad. FAWCO works to keep the public up to date on issues important to Americans living and working overseas, including citizenship, voting, taxation, and banking concerns.

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Is It Time for Medicare?

Dates often slip by for those who live outside the US. However, if you are approaching your 65th birthday, it’s the time to consider signing up for Medicare.  Although Medicare does not typically cover medical costs incurred while living abroad, there are several things to consider:  whether you plan to return to the US, whether you (or your spouse) are working outside of the US and provided health insurance by an employer, and the potential costs of premium penalties for late enrollment.    

The sign-up period is no sooner than three months prior to your 65th birthday and the three months after your 65th birthday; in other words you have about a six-month window.  For example, if your birthday is May 20, the original enrollment period would be February 20 through August 19. It takes 4 to 6 weeks to process the enrollment application. 

If you miss the enrollment period, then you would need to enroll in the General Enrollment Period (GEP) of October 15 - December 7, 2019, with coverage becoming effective on January 1, 2020. This includes Parts A, B, C and D.  Some people will be able to enroll at the end of their previous insurance coverage right away, but they need to check with Medicare. Always remember that it will take several weeks minimum to process an application once it is received by Medicare. There may be exceptions in individual cases, but again, check with Medicare directly, so there are no lapses in insurance coverage.

Normally, you can sign up online through the Social Security Administration website,, but if you reside overseas, you should phone your closest overseas SSA office and you can be enrolled over the phone. Not all Consular posts have SSA offices. For example, I live in the United Arab Emirates and was registered by phone from a representative in Rome.

For those who have already registered for Social Security benefits, you may have been registered for Medicare Part A benefits. There is no charge for Part A, if you have paid into social security a minimum of 40 quarters.

Part B and other sections of Medicare will likely charge a fee; currently the minimum fee for Part B is $135/month. You may want to have Part B if you ever plan to move back to the US or frequently visit.  If you fail to register on time for Part B, you may incur premium penalties and gaps in coverage when you move back to the U.S and apply at a later date.  

Please refer to and for information and instructions.

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