Medicare Portability

Our Goal: To ensure U.S. citizens have  access abroad to their earned Medicare benefits. 

Citizens who worked in the US, or for US companies, paid into the Medicare system throughout their careers.  Once they begin receiving the Social Security they earned throughout their work lives, their benefit is automatically reduced for the cost of their Medicare.  But US Citizens residing outside the country are unable to use the Medicare they paid for, and continue to pay for, without often-costly travel back to the United States.  Many choose that option.  Others never receive the benefits for which they paid.  This has implications for fairness and cost to the Medicare system.

While different countries of residence present different situations for seniors, the cost of health care in nearly every one is significantly less than in the US, a potential savings that we believe will help the Medicare Trust Fund’s viability over time.

What you can do

  • Contact your Congressional Representatives to ensure they are aware of this inequity and how critical it is to providing fairness and producing potentially significant savings for the Medicare Trust Fund.  Remind them that Democrats voting from abroad provided the margin of victory in multiple races in 2020 and 2018.  
  • Educate other seniors and individuals approaching Medicare age about this issue and ask them to join DA and complete a survey, and become part of the drive to change this unfair and unequal treatment of seniors who retire abroad.

Join DA’s Medicare Portability Task Force.  Send an email to [email protected]

DA Medicare Portability Leadership:

James Savage
| Chair, DA Philippines
Michael March
| DA Thailand Chair
Heather Stone
| DA Israel, Vice Chair/ DA Deputy International Counsel (Global)/ DA Medicare Portability Task Force, Chair/ DA Israel NPO, President
Peter Fischbach
| DA Thailand Treasurer
See all Leaders

Trying to Understand Medicare?  

If you visit the Social Security Administration website to see how Medicare works you’ll find a lot of information, charts, graphs and processes for recipients to follow in order to enroll and use Medicare.  What you won’t find -  us.

Normally deductions for Medicare are taken from most paychecks throughout a worker’s career and before they turn 65 they are able to enroll and subsequently to collect the benefits as they are needed for health care costs.

BUT……….. What Happens When You Live Abroad? 

  • Military?.....US Citizens who served in military combat can access their retiree health care benefits wherever they reside through the Tricare Overseas Program.
  • Government employees?..... Retirees from the federal government also have healthcare insurance that covers them wherever they choose to live 
  • Most everyone else?........You paid in but you can’t collect benefits.

What Options Are You Left With?

  1. Join host countries health plan (if they offer, you qualify and you can afford) - Some countries allow or even require US seniors to opt into their national health care at a cost, paid through local taxes or direct payment. This is an additional cost on top of what they must pay for Medicare services they are unable to use. 
  2. Private Insurance from U.S. or host country ($$$$$$) - But many countries do not offer national health care to expatriates, forcing many seniors to buy additional local or international insurance coverage at significant cost in addition to what they continue to pay for Medicare coverage they are unable to use. 
  3. Travel back to the United States for covered care (if you’ve continued to pay  for  Medicare) - Many Medicare beneficiaries choose to return to the US for serious health care needs, and many for routine health care and regular check-ups and medical tests.  Those American seniors have significant out-of-pocket travel costs, and the Medicare trust pays for their health care at significantly more costly US rates. 
  4. Pay out of Pocket - “self-insure”  (Costs vary by country but tend to be less than what you would pay in the US).


Democrats Abroad is collaborating with other organizations to conduct a feasibility study to establish potential expansion of  Medicare coverage.   

Medicare International (pilot program)

Possible Scenarios

  • Rebate (money deducted plus interest)
  • Expand the system to include those abroad who continue to pay
  • Adopt & expand governmental employee system
  • Adopt and expand military system
  • Offset cost of private insurance or country coverage by negotiated agreement
  • Build relationships between governments for funding/providing services
  • Construct a specific health plan for overseas Americans