If you live in a foreign country when you turn 65 and first qualify for Medicare, you can sign up by requesting enrollment forms from the United States Embassy or Consulate in the country where you currently live. The Social Security Administration (SSA) should also send you a letter explaining that you have entered your Initial Enrollment Period (IEP), along with a form to request an enrollment packet. Be sure to keep copies of any forms that you complete. If possible, it is best to send paperwork via certified mail to ensure their delivery.

If you are collecting benefits from SSA or from the Railroad Retirement Board (RRB) while abroad, you may be automatically enrolled in Part A when you become Medicare-eligible. Follow the steps above to ensure that you are enrolled in Part B if you plan to pay the premium abroad to maintain your Medicare coverage.

If you do not enroll in Medicare Part B during your IEP, you may have to wait until the General Enrollment Period (GEP), which runs January 1 through March 31 each year, with coverage starting the first of the month after the month when you enroll. Make sure you are aware of the consequences of choosing not to enroll during your IEP.

Note: If you do not qualify for premium-free Part A, you may only be able to enroll in Medicare if you live in the U.S. You will have a seven-month period around when you move back to the U.S. to sign up for Part B and premium Part A. This period includes the three months before, the month you establish U.S. residence, and the following three months. To qualify for this period, you must be a U.S. citizen, and you must have lived in a foreign country when you turned 65. You will not owe a late enrollment penalty if you enroll during this period.