Question
For those of you 65 and over collecting US social security, are you paying for Medicare? Hubby and I won’t be 65 until 2026. We are moving in September and don’t intend on moving back to the US, but you never know. But having to pay $400/month for private insurance in Spain, then Medicare on top of that, it’s expensive! Thoughts??
Answers
“I’m living in Spain and keeping Medicare, you never know. Paying for it doesn’t affect my quality of life.”
“My wife and I have Medicare and private Spanish insurance with Sanitas. For us Medicare is free. So while in the USA we use it. In Spain, Sanitas. We are both over 65 and pay about $1500.00 a year for each of us.”
“Spain can care less about your SS in America. We are 64 so 400 euros is the ante plus the bank account and the paperwork. It’s the initiation to get in.”
“Set aside the 400 a month for a few years… If you go back, you’ll have a chunk of dough set aside. If you decide not to go back, use it on something fun.”
“We dropped ours – we are not going back.”
“Key Words – ‘don’t intend on moving back to the US, but you never know.’ Dropping Part B is not a decision to be taken lightly.”
“I’m dropping my Medicare Part B. We have no interest in moving back to the US once we move to Alicante next year.”
“How do you drop it? I tried calling Medicare before I left but they said I had to go through SS.”
“Do the math on the penalty for NOT enrolling at 65 if you do move back.”
“$400 a month for Spanish insurance is very high. Shop around.”
“Same for us. My wife opted out of Medicare. She is on my French state healthcare so only I pay and there was no surcharge.”
“I moved to Spain when I was 67, I already had Part B. I tried to cancel it but they make it practically impossible to do so.”
“Keep your Medicare plus private insurance. Never say never…”
“No.”
“No Medicare for us.”
“As I write, it seems the new administration is attempting to either eliminate or privatize SS. Verify new birthday eligibility tables. Maybe you do not have to make the decision now and will have time as the administration implements these changes.”
“My parents lived here for all of their retired life and never paid Part B. They had Sanitas which had them covered if they ever traveled back for a visit (90 days). They knew they were never going back as residents.”
“If you are NOT going to use your Medicare, you must suspend it with the Social Security office. It is easy to do and should you ever go back to the US and want to use it you will not have to pay a fine.”
“I canceled my Medicare coverage the day we left the U.S.”
“Medicare is only for use in the US. It can’t be used outside the US. I already went through that and contacted Social Security about it and they explained to me it’s useless outside the US.”
“If you start SS before Medicare, they will AUTOMATICALLY sign you up for Part B unless you sign off on NOT getting it. There can be added premiums IF you sign up for a Supplement or Advantage plan.”
“And you have to opt out before you turn 65. Four months before is recommended.”
“On a related topic, how do retirees in Spain plan for long-term care, assisted living, and nursing home costs when needed?” – “A private room is 3000–5000€ a month. In-home care: 5000–8000€/month. Spain also has ‘daycare’ services with pick-up and drop-off and daily activities.”
“Many expats skip Part B to avoid paying for something they can’t use. Just keep in mind that if you move back to the US later, you could face a late enrollment penalty.”
“I have only Part A.”
“We are on the same boat. I am 65 in June and planning to pay for Part B. At least for now.”
“Keep in mind that if you don’t enroll in Part B and want to later, there are specific times that you can enroll.”
“Medicare supplemental insurance is $170/month/person and that only makes it a slightly less crap system.”
“Private insurance is worth every penny here. Medicare Plan B is useless here and expensive. I kept it for years but dropped it when it got too expensive.”
“My husband is over 65. While in the U.S., he was on my employer’s policy, and therefore only enrolled in Part A. We plan to enroll in Spain’s Convenio Especial after a year.”
“You can get public healthcare in Spain after a year of residency. It costs about 60–160€ per month depending on age.”
“SS told me you can apply for an exemption from future penalties for not signing up for Part B if you can show you are on public healthcare in your country of residence.”
“That only applies if you were working and the insurance is employer-sponsored or through a volunteer organization.”
“I read on the SS website that you can call Social Security and tell them you will not be living in the US and be exempt from Medicare Part B.”
“If you drop out of Medicare you would lose Tricare automatically, not worth it.”
“My husband is Ret. USAF and dropped Part B. It took 9 months, endless calls, emails, etc., and finally got refunded for all the months SS took out.”
“I talked to Social Security – they told me you can apply for an exemption from possible future penalties if you have public insurance while working abroad.”
“It’s just sickening. People who will never have to depend on benefits making decisions for people who do.”
“Unless you are planning to move back to the US, you are just throwing your money away for anything beyond basic Medicare.”
“$400/month is really high for Spain.”
“I just double-checked and it’s $322/mo.”
“I’m in my 50s. Our policy fulfills the NLV requirements, no copay or deductible.”
“I pay for one person, 57 years old, 89€/month with Adeslas. Full coverage, no copay.”
“Depends on age.”
“Even if you do return to the U.S., who knows what Medicare Part B will cover in the future?”
“We chose qualifying private health insurance in Spain that also provides reimbursement coverage worldwide, including any future visits to the U.S.”
“You don’t have to take Part B. Refuse it upfront.”
“My husband signed up for Part A but not Part B. We have no plans of going back.”
“We signed up for SNS (Spanish national health system) after a year of residency via Convenio Especial: 60€/month pp under 65, 157€ pp 65+.”
“If you do decide you want Medicare in the future it’ll be a 10% penalty for each year AND you’ll need medical underwriting for Part G.”
“The 10% penalty is only on the Part B base premium ($185.00), so that equates to $18.50/month.”
“If you bring verification that you had coverage in Spain then there is no penalty to pay – but it must be employer-based.”
“You guys need to decide if you are moving permanently to Spain or going back and forth.”
“If you are firmly set on permanent relocation, then you don’t need Medicare. If you plan to return, you might.”
Conclusion
The discussion around Medicare for American retirees in Spain reveals a deeply personal decision, shaped by financial flexibility, future plans, and peace of mind. Some choose to keep Medicare Part B as a backup, accepting the monthly premium to avoid penalties later. Others, committed to staying in Spain, opt out entirely, especially considering the high quality and affordability of Spanish private health insurance.
While Medicare Part A is free and generally kept by all, Part B remains a gray area. Many weigh the 10% penalty per year for delayed re-enrollment against the savings of dropping it. Those leaning toward staying in Spain permanently find greater comfort in local systems like Convenio Especial after one year of residency, while others take a cautious approach, maintaining Medicare just in case.
Ultimately, when deciding what would be the best path, consider your long-term plans, current health, budget, and the complexity of re-enrollment if you return to the US.
