Opting Out Of Medicare

“Kathleen, Medicare is automatically deducted from Social Security. How is this handled when living in Panama?”

–Terry R., United States

Unfortunately, the U.S. government has the two, Medicare and Social Security, tied together. If you opt-out of Medicare, then the U.S. government will stop sending you Social Security payments. A group is fighting this as it is illegal, but, for now, this is the reality. One reasonable option would be to invest in local health insurance wherever you’re living but keep Medicare, as well, for emergencies. This would mean returning to the United States for medical care, but, again, could be a very reasonable strategy.


“Kathleen, I have never written to you before this, but I am compelled to congratulate your husband Lief and daughter Kaitlin for the new website they have just launched. In more than 11 years of living in Boquete, this is the best source of information for expats I have seen to date by a long shot. It would be a pleasure to join all of you for the inauguration celebration, but I will be in Medellin on my way to Alaska. (And you might tell your mother that I am 77 years of age.)

“Continued good luck to all of you.”

–George M., Panama


“Kathleen, I love so much your writings and perspectives you offer to the expat retirees that finally decided to write directly. Cannot come from Paris, where I am living now, for your Arizona workshops, but if and when you have something similar in Europe, please count me in…”

–Jozef C., France