Question
I am planning on moving to Spain next year, and I am not old enough for Medicare yet. I will be in 2 years. When the time comes, do you just pay for the cheapest policies you can find, or do you let it go? What do you do when visiting the US? What if something happens and you have to return to the US to live?
Answers
These are the answers of Spainguru’s Facebook group members:
“I have La Caixa insurance, and I am covered worldwide. The social security lady told me to go to Madrid and disenroll when I am of age.”
“I have Adeslas. I believe I am covered anywhere for 90 days in the event of an emergency. When traveling to the USA, it’s a good idea to purchase travel insurance in addition to your private policy.”
“If you are collecting Social Security, you will automatically be enrolled in Medicare Part A and B when you turn 65. Part A is free, but Part B will cost $185 per month in 2025. You can opt out of Part B, but re-enrolling later will incur a 10% penalty for each 12-month period you were not enrolled. It’s wise to keep Part B if you might return to the US in the future.”
“Part A is free, so keep it. Part B costs money and doesn’t work in Spain. If you are sure you’ll never move back to the US, cancel Part B.”
“Medicare doesn’t cover healthcare abroad, but I kept Part B for peace of mind in case I need to return to the US for medical reasons. I also purchase travel insurance with high coverage limits for emergencies during visits to the US.”
“If you drop Part B, you face permanent penalties if you decide to re-enroll later. A 10% penalty applies for each year you are not enrolled. For example, being unenrolled for 10 years would double your premiums.”
“Spanish private insurance policies often include limited travel coverage (e.g., €15,000–€30,000). For serious emergencies in the US, this won’t go far. You might want to buy separate travel insurance with higher limits.”
“Medicare Advantage plans might kick back part of your premium, but most have service area restrictions. If you’re out of the US for more than six months, they can cancel your coverage.”
“If you have a qualifying health insurance plan abroad, you might avoid penalties when re-enrolling in Medicare upon returning to the US. However, Spanish private plans might not meet these requirements due to exclusions for pre-existing conditions.”
“Consider keeping Part B if you have any uncertainty about returning to the US. It’s better to have it and not need it than to need it and not have it.”
Conclusion
The decision on how to handle Medicare while living in Spain depends on your long-term plans and financial situation.
Keeping Medicare Part A is a straightforward decision, as it comes at no cost and provides valuable hospital coverage in case you ever return to the U.S.
Part B, however, involves a monthly cost and doesn’t cover healthcare outside the US. If you are certain you’ll never move back, it might make sense to drop Part B and rely on Spanish private insurance and travel coverage for US visits.
However, re-enrolling in Part B later incurs permanent penalties and potential delays in coverage. Read “Should You Cancel Medicare Part B after Moving to Spain?“
Many group members recommend keeping Part B for peace of mind and purchasing travel insurance for emergencies in the US.
Others suggest saving the money you’d spend on premiums in case you decide to re-enroll in the future. Ultimately, the choice is personal, and thorough planning is essential.
