Question
Curious if any Americans had to move back to the US from Spain and were able to appeal the Medicare Part B penalties? It’s my understanding that they increase 10% per year that you qualified and didn’t pay to keep Part B active.
Answers
These are the answers of Spainguru’s Facebook group members:
“I don’t think penalties are negotiable. When I was laid off from my work, my company covered COBRA for my husband too for a year. When we bought Medicare for him the following year, we had to pay penalties even though my company had paid for his insurance.
It’s ridiculous, but I guess it’s to deter people from not paying the extra money until they need it.”
“My mom returned after 25+ years and is still paying the penalty. We have gone to SSA, tried with an attorney to no avail. Over $350 in penalty a month.”
“There is no deviation from the law. Once you decline Part B and try to get it back, you get penalized for life, and it gets deducted every month from Social Security regardless of whatever coverage you have or had.”
“My understanding is that only applies if you are actively working and if the insurance is employer-sponsored or provided through a volunteer organization. A private insurance policy you buy for yourself doesn’t qualify.”
“There is a Facebook page called Medicare Family. The lady running it is very knowledgeable. More people could learn something there in case of what-if situations.”
“Part B is part of your Social Security pension, and you go through them for the info on Part B, which is who maintains the penalty deduction.”
“If you can prove you had credible coverage while off Medicare, you may avoid penalties. But if you simply declined Part B without alternate coverage that qualifies, you will face a lifetime penalty.”
“If you ever need skilled nursing care, Medicare will cover it all. You should consider signing up. If you don’t sign up now, you can enroll later, but it will be much more expensive, and you will not get the best plan.”
“As a vet with VA healthcare, you are not required to enroll in Part B. Medicare Part A is automatic. As long as you use VA, you do not have to worry about the penalty.”
“If you move to Spain and cancel Part B, but later return to the US, you must wait for the enrollment period and pay a 10% penalty for each year you were not enrolled.”
“You are NOT penalized if you can show proof of coverage for the time you lived outside of the US. The Federal Benefits Unit at the American Embassy handles these cases, but they are slow in processing requests.”
“The lesson here is clear: DO NOT give up your Medicare Part B EVER!”
“The Medicare Part B premium is $185 in 2025. If you wait to enroll at a future date, there is a 10% per year permanent penalty. By the time you are 75, your premium will have doubled. However, if you never return to the US, you can save the premium costs instead. Planning ahead is key.”
Conclusion
According to Spainguru’s Facebook group members, appealing Medicare Part B penalties is nearly impossible. Once you decline Part B and later choose to re-enroll, you are subject to a 10% penalty for every 12 months you were not enrolled.
Read our article “Should You Cancel Medicare Part B after Moving to Spain?“
Some expats have successfully avoided penalties by proving they had credible health coverage while living abroad. VA healthcare users do not need to enroll in Part B, but they must remain within the VA system.
Experts recommend keeping Part B if there is a possibility of returning to the US for healthcare, especially for major medical conditions. If one plans to stay abroad indefinitely, canceling Part B could be a financial decision, but it comes with risks.
