Medicare After You Move to Vietnam: Keep Part B or Drop It?

If you move to Vietnam after 65, you will have to decide what to do with Medicare Part B. Medicare almost never pays for care in Vietnam, but Part B costs money every month, and dropping it can cost more later. This post sets out the trade-off with Medicare's and Social Security's own numbers. It doesn't tell you which to choose.

What Medicare covers while you live in Vietnam

Medicare usually doesn't cover health care while you're traveling outside the U.S.; in most cases, you pay all of the costs. ¹ Medicare pays abroad only in rare cases, and these almost never apply to someone living in Vietnam. ¹

Medicare drug plans don't cover prescription drugs you buy outside the U.S. ¹ Medicare supplement insurance (Medigap) policies may cover emergency care when you travel outside the U.S.; Medicare describes this as cover for travel, so don't count on it as health insurance for living in Vietnam. ¹

So in Vietnam you need local or international health insurance. Our healthcare guide lists what it costs at your age.

What keeping Part B costs

The standard Part B premium is $202.90 a month in 2026, and the yearly deductible is $283. ² If you keep Part B, Social Security will likely take the premium out of your monthly payment. ³

Estimate: at the 2026 standard premium, keeping Part B costs $202.90 × 12 = $2,434.80 a year. ²

With a higher income you pay more. Social Security uses the tax return the IRS gives it, generally your 2024 return for 2026 premiums, and you can ask for a lower amount after a life-changing event (Form SSA-44). ⁴ These are the 2026 amounts from the CMS table: ²

Married, lived with your spouse at any time in the year, and filing separately: over $109,000 and under $391,000 adds $446.30 (total $649.20); $391,000 or more adds $487.00 (total $689.90). ²

The late penalty

If you go without Part B when you could have had it, the penalty is an extra 10% for each full 12-month period you could have had Part B and didn't, and for most people that's a lifetime penalty. ⁵ Social Security's booklet for people living abroad says the same: a 10% higher premium for each 12-month period you could have been enrolled but were not. ³

Estimate, for illustration only: drop Part B for 5 full years and the penalty is 50%. At the 2026 premium that is about $101.45 a month on top of $202.90, for as long as you have Part B. The premium changes every year. ^{5 2}

Getting Part B back later

Moving abroad, or moving back, doesn't by itself let you sign up later without a penalty. The only abroad-related exception is for some overseas volunteers. ⁶

If you drop Part B and later want it back, you'll usually have to sign up during the General Enrollment Period (January 1–March 31), with coverage from the month after you sign up, and pay a late penalty for as long as you have Part B. ^{7 6}

How to drop Part B

To drop Part B, you usually need to send your request in writing and include your signature; contact Social Security. ⁷ Your coverage ends at the end of the month after the month you send it: file on April 5, for example, and Part B ends May 31. ⁷

Drug coverage has its own rules. Ask Medicare (1-800-MEDICARE) before you drop drug coverage.

If you have TRICARE For Life

If you have TRICARE For Life and Medicare, you must keep Part B even though Medicare doesn't cover care overseas; TRICARE For Life will be your primary payer. ⁸

Keep or drop: the trade-off

Social Security's booklet puts both sides: "It may not be to your advantage to sign up and pay the premium ... if you will be out of the U.S. for a long period of time. However, if you do not sign up ... you will pay a 10% higher premium for each 12-month period ..." ³

The choice depends on whether you expect to come back to the U.S. for care, how long you plan to stay, and what local insurance costs you. Our post on living on Social Security in Vietnam shows how the Part B premium changes what reaches your account, and step 5 of the plan covers health insurance before you move.

General information, not legal, tax or medical advice. Rules change; confirm with Medicare (1-800-MEDICARE) or Social Security before you drop coverage.