Moving overseas is one of the biggest decisions you'll make in retirement or while managing a disability. This guide cuts through the confusion about what happens to your benefits when you leave the United States.
The bottom line: Your retirement and SSDI benefits generally continue overseas. But SSI stops completely after 30 days. Medicare doesn't work abroad. And the rules for non-citizens are completely different.
This guide covers real scenarios, specific dollar amounts, insider knowledge from 20+ years in the Social Security Administration, and step-by-step checklists to keep you from making costly mistakes.
| Benefit | US Citizen | Non-Citizen |
|---|---|---|
| Retirement (Title II) | ✅ Generally yes | ⚠️ 6-month limit |
| SSDI | ✅ Generally yes | ⚠️ 6-month limit |
| SSI | ❌ Stops after 30 days | ❌ Stops after 30 days |
| Medicare | ❌ No coverage abroad | ❌ No coverage abroad |
You've paid Social Security taxes your whole career. You've earned your benefits. The question isn't whether you deserve them overseas—it's which ones actually continue, and under what conditions.
Title II Benefits (Retirement, SSDI, Spousal, Survivor): These generally continue overseas for US citizens, in most countries worldwide. You can live abroad indefinitely and keep receiving your monthly payment.
SSI (Supplemental Security Income): This is a hard stop. After 30 consecutive days outside the United States, your SSI benefits cease. There are NO exceptions—not for medical emergencies, not for family deaths, not for anything. If you go back and forth across the border frequently, you need to count your days very carefully.
Medicare: This generally provides NO coverage outside the United States. This shocks people who've paid Medicare taxes for 40+ years. Medicare is designed for US-based healthcare providers and won't reimburse foreign hospitals or doctors—with extremely rare exceptions.
Are you a US citizen, or are you a non-citizen (green card holder, visa holder, etc.)? This matters hugely. US citizens can receive retirement and SSDI benefits in most countries indefinitely. Non-citizens hit a wall: the "alien non-payment provision" stops benefits after 6 consecutive months outside the US, with limited exceptions.
Before you move, use the SSA's Payments Abroad Screening Tool (online at ssa.gov). Enter your situation: citizenship status, country of destination, benefit type. It will tell you exactly what to expect.
This is the most important distinction to understand before you move. Where you were born—or where you became a citizen—determines almost everything about your benefits abroad.
You can generally receive retirement and SSDI benefits in most countries indefinitely. Your benefits continue. Your monthly payment arrives (via direct deposit or check). Life continues as if you never left.
The main restrictions: Cuba and North Korea. Period. No payments to those countries under any circumstances. A few Treasury-restricted countries may also have payment limitations.
You can travel freely between countries. You can spend 3 months in France, 6 months in Mexico, whatever. The only rule: you must respond to the SSA's Foreign Enforcement Questionnaire (form SSA-7162) every few years, which confirms you're still alive and still want your benefits.
The rules are much stricter. The "alien non-payment provision" means your benefits stop after 6 consecutive months outside the United States, unless you meet one of these exceptions:
Cuba: NO US Social Security payments to Cuba, period. Not for citizens, not for non-citizens, not for anyone. This has been the law since 1992.
North Korea: No payments. This has been in effect since 2008 due to the Treasury Department's Office of Foreign Assets Control (OFAC) sanctions.
Other Treasury-restricted countries: Iran, Syria, Crimea region, and a few others are under OFAC sanctions. Payments may be restricted or prohibited.
Tom was a green card holder who worked 22 years in the US and 15 years in Mexico. At age 62, he decided to move back to Mexico permanently to be near his family. He didn't ask SSA whether the alien non-payment provision applied. He just left. Six months later, his benefits stopped. He couldn't get them restarted without a totalization agreement or 40+ work credits—which he didn't have. He lost $36,000+ in retirement income that he couldn't recover. SSA's rule was clear in the handbook; Tom just didn't read it.
If you're receiving Social Security benefits abroad, SSA will periodically send you a form called the Foreign Enforcement Questionnaire (form SSA-7162). This is not optional. This is not a suggestion. This is a requirement.
The form asks you to verify that you're still alive, still eligible to receive benefits, and still want your benefits to continue. It's called "proof of life." You must complete it and return it within the deadline SSA gives you—usually 30-60 days.
You might see follow-up questions like: "Have you been convicted of a crime?" "Have you become a citizen of another country?" "Is your address still the same?" Answer honestly. These questions matter.
If you miss the deadline to return the form, SSA will suspend your benefits. Your monthly payment stops. And getting them restarted from overseas is a nightmare. You'll have to contact the Federal Benefits Unit (FBU) at the US embassy or consulate, fill out new paperwork, and wait weeks or months for SSA to process everything.
Here's a horror story you need to know about: occasionally, SSA incorrectly records a beneficiary as deceased. Maybe SSA received a death notice with your name and confused you with someone else. Or there was a clerical error in their database. When you try to contact SSA from overseas to correct the record, it's extremely difficult. You can't walk into a local SSA office. Phone calls from overseas cost money. Email support is slow.
Dr. Ed's advice: If you ever receive a notice saying SSA thinks you're deceased, contact the Federal Benefits Unit immediately. Don't wait. Get copies of documents proving you're alive (passport, recent bank statements, letters from a doctor). This can take months to unravel, and during that time, your benefits don't flow.
If your address changes, you move to a different country, you get married or divorced, or your work situation changes significantly (especially if you're on SSDI), report it to SSA immediately.
If you're a US citizen receiving Social Security retirement benefits and you move overseas, your benefits generally continue. Your monthly payment keeps flowing. You can live abroad indefinitely (with the exceptions of Cuba, North Korea, and a few other restricted countries).
There's no rule that says you have to live in the United States to receive your retirement check. You've earned it through 40 qualifying work credits. SSA doesn't suddenly decide to take it away because you moved to Portugal or Thailand or Costa Rica.
The average US retirement benefit in 2026 is about $1,907/month. That varies based on your earnings history and your age when you claimed. If you're claiming at 62 (reduced), you might be getting $1,200-$1,400. If you waited until 70 (delayed), you might be getting $2,800+. Your specific benefit amount doesn't change just because you move.
SSA strongly prefers direct deposit. If you're still receiving a paper check mailed to a US address, you need to set up direct deposit before you leave. You won't reliably receive paper checks in most countries, and international mail is slow and unreliable.
Can you file for retirement benefits while you're already living abroad? Yes, but it's more complicated. You'll need to work with the Federal Benefits Unit (FBU) at the US embassy or consulate in your country. They can help you gather the required documents and submit your application to SSA. But you need to start this process several months before your claimed age, because processing takes time.
The FBU is an office of the US State Department located in embassies and consulates worldwide. They act as liaisons between SSA and US citizens abroad. They can:
Not every US embassy has an FBU, but most do. When you move overseas, find out where your nearest FBU is located. You may never need it, but knowing its location and hours is critical if problems arise.
Getting your money when you live abroad is simpler than most people think. SSA has systems in place specifically for overseas beneficiaries. But you need to plan ahead.
SSA offers the International Direct Deposit Program (IDDP) in 48+ countries. IDDP allows SSA to deposit your benefit directly into a foreign bank account instead of a US account. This is the cleanest, easiest solution.
Countries with IDDP include: Most of Western Europe, Canada, Mexico, Australia, Japan, South Korea, and many others. If your destination country has IDDP, you can set up direct deposit into a local bank account. Your benefit arrives on the 3rd, 4th, or 5th of each month (depending on your birth date), just like it would in the US.
To set up IDDP:
If your destination country doesn't participate in IDDP (which is true for some countries), you have a few options:
Option 1: Keep a US Bank Account Have your benefit deposited into a US bank account that works internationally. Then transfer money to your foreign account as needed. This works, but you pay currency conversion fees each time you transfer.
Option 2: Use an International Bank Account Some US banks (like Charles Schwab, or some credit unions) offer accounts with no foreign transaction fees. You can use these to receive your benefit in USD and access funds from abroad without excessive fees.
Option 3: Get a Cash Advance Card Some international money transfer services (like Wise, formerly TransferWise) offer cards that allow you to receive USD deposits and spend them abroad with minimal fees.
If you're receiving your benefit in USD but living in a country where you need the local currency, you'll eventually need to convert. SSA uses Treasury Department exchange rates when converting payments (though this is rare; most beneficiaries arrange the conversion themselves through their bank).
Key point: Your Social Security benefit is always calculated and paid in US dollars. The amount doesn't change based on currency fluctuations. If your benefit is $1,900/month, you get $1,900. If the dollar weakens against the euro, that $1,900 buys less in euros—but SSA doesn't adjust your payment to compensate.
Even if you set up IDDP or a foreign account, Dr. Ed recommends keeping a US bank account for life. Why? Because occasionally SSA needs to verify something with you. Or you need to access your old bank account for tax purposes. Or you want to collect Social Security documentation for an overseas loan. A US bank account is a lifeline.
Many banks now allow you to open and maintain a US account entirely online, even from abroad. Look for banks with no international restrictions and no minimum balance requirements.
Most countries are unrestricted—meaning US citizens can receive retirement benefits there indefinitely. But a few countries are completely off-limits. And non-citizens face additional restrictions you need to understand.
Cuba: No US Social Security benefits to Cuba under any circumstances. This has been the law since 1992. Even a layover in Cuba can complicate things (don't travel to Cuba while receiving US benefits without consulting SSA first).
North Korea: No payments to North Korea. Virtually no US citizens live there, but it's in the law.
The US Treasury Department (Office of Foreign Assets Control, or OFAC) restricts financial transactions with certain countries. This affects Social Security payments. Countries currently under OFAC restrictions include:
Payments to these countries are not allowed. If you need to move to one of these places for work or family reasons, contact SSA beforehand. There may be workarounds or special circumstances, but don't assume your benefits will continue.
If you're a non-citizen (green card holder, visa holder, etc.) and you don't meet an exception, your benefits stop after 6 consecutive months outside the US. This is the "alien non-payment provision."
The exceptions that allow non-citizens to receive benefits abroad are:
The US has totalization agreements with 30 countries. These agreements help workers who split careers between the US and another country. They can combine work credits from both countries to qualify for benefits.
The 30 countries: Australia, Austria, Belgium, Brazil, Canada, Chile, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Luxembourg, Netherlands, Norway, Poland, Portugal, Slovak Republic, Slovenia, South Korea, Spain, Sweden, Switzerland, United Kingdom, Uruguay.
Notable countries WITHOUT agreements: Mexico, China, India, Philippines, Vietnam, Thailand, Indonesia, Malaysia, Singapore. If you're moving to a popular expat destination like Mexico or the Philippines and you're not a US citizen, you need to understand that the 6-month rule may apply.
Maria was a permanent resident (green card holder) with 28 work credits under US Social Security. She'd worked 15 years in the US and decided to retire to Oaxaca, Mexico. She assumed her SSDI benefits would continue because she'd been in the US system for so long. But without 40+ work credits or a totalization agreement, the alien non-payment provision applied. At 7 months abroad, her benefits stopped. Maria had no choice but to move back to the US to restart her benefits. She lost 4 months of income and had to abandon her retirement plan.
What if you live in an unrestricted country but need to travel through Cuba or Iran for a connecting flight? This is complicated. Technically, if you spend more than a few days in a restricted country, SSA may consider you "residing" there and suspend benefits. If you're in this situation, contact the FBU before you travel and ask for guidance. Some circumstances allow brief passages through restricted countries without affecting benefits.
If you're receiving SSDI (Social Security Disability Insurance) and you move overseas, the same general rules apply as retirement benefits: US citizens can generally continue receiving benefits in most countries. But managing a disability from abroad brings extra challenges.
Like retirement benefits, SSDI benefits continue for US citizens abroad in unrestricted countries. Your monthly disability payment keeps flowing. You don't lose benefits simply because you moved.
The average SSDI payment in 2026 is about $1,550/month, though this varies widely based on your age and earnings history.
SSA periodically reviews whether you still meet the medical criteria for disability. These are called Continuing Disability Reviews (CDRs). If your case is selected for a CDR, SSA will send you medical forms to complete and may request records from your doctors.
Completing a CDR from overseas is harder than from the US. You may need to:
Sometimes SSA wants you to attend a Consultative Examination—an in-person evaluation by a doctor or psychologist to assess your condition. If you're overseas, how does this work?
SSA can arrange for a CE with a doctor in your country. But this requires coordination through the FBU, and it may take months to arrange. The doctor must be willing to report to SSA and use SSA's specific evaluation format. Not all foreign doctors want to do this—it's extra paperwork for them.
If SSA can't arrange a CE in your country, they may ask you to travel back to the US for one, or to travel to a nearby US embassy country where one can be arranged. This can be expensive and time-consuming.
If you're on SSDI and planning to move overseas, prepare now:
These steps take the pressure off when SSA asks for documentation. You don't have to rely on your new foreign doctor to dig through records and understand US reporting requirements.
One of the great things about SSDI is that you're allowed to work and earn money while receiving benefits—up to certain limits. The same rules apply overseas as in the US, but foreign earnings can complicate things.
You can earn up to $1,210/month (in 2026) without it affecting your disability status. This is called "substantial gainful activity" or SGA. If you earn more than $1,210/month, SSA may determine that you can work and that you're no longer disabled.
There's also a Trial Work Period (TWP) where you can earn any amount for 9 months (not necessarily consecutive) without losing your benefit. But once you exceed SGA in a month, it counts against your TWP.
After your TWP ends and you return to work at SGA levels, you lose benefits.
If you're working overseas—whether for a US company, a foreign company, or self-employment—your earnings count. SSA doesn't make an exception for foreign work. You must report your earnings to SSA, just as you would if you were working in the US.
Here's where it gets tricky: if you're earning in a foreign currency, how does SSA count your income? SSA uses the average monthly exchange rate from the Treasury Department to convert foreign earnings to US dollars. This means your income in local currency might push you over the SGA threshold in some months and not others, depending on exchange rates.
Example: You're working in Mexico and earning 20,000 pesos/month. At the current exchange rate (roughly 17 pesos per USD), that's about $1,176/month—just under the $1,210 SGA limit. But if the peso weakens and the exchange rate becomes 15 pesos per USD, suddenly you're earning about $1,333/month, which exceeds SGA. You must report this to SSA, and your benefit may be affected.
If you're self-employed abroad—maybe running a small online business, freelancing, consulting—the rules are the same but harder to document. You need to track income, expenses, and net earnings just as you would in the US. But you may not have standard invoices, receipts, or tax documents that SSA recognizes.
Dr. Ed's advice: Keep meticulous records. Use accounting software. Maintain a business journal. If SSA ever asks, you need to be able to prove what you earned and what you spent. Foreign businesses don't always use the same accounting standards as US businesses, so be extra clear in your documentation.
The Ticket to Work program is a Social Security initiative that allows beneficiaries to work without immediately losing benefits. You're assigned a "ticket" and work with an employment network. However, Ticket to Work is generally not available to beneficiaries living overseas. If you're on SSDI and planning to work abroad, contact SSA before you leave to ask about your options.
What if you move abroad, and your condition deteriorates? You need medical evidence to support this. Getting that evidence from a foreign doctor in a foreign language, in a format SSA recognizes, is challenging.
Steps to take:
This process is slow. Plan ahead. Don't wait until your condition is critical to seek help.
At your Full Retirement Age (FRA), your SSDI benefit automatically converts to a retirement benefit. The amount stays roughly the same (sometimes adjusts slightly upward). This happens automatically—you don't need to do anything.
Important: After conversion to retirement, the disability work rules (TWP and SGA) no longer apply. You can earn unlimited income without losing benefits. So if you were careful not to exceed SGA while on SSDI, you can relax once you convert to retirement.
If you're receiving SSDI and you have dependents (spouse, children), they may also be eligible for benefits based on your earnings record. These are called family benefits or "family unit" benefits.
If your spouse or children live overseas with you, the same country restrictions apply to them as to you. If you live in an unrestricted country, they can receive benefits there. If you live in a restricted country, their benefits may stop.
Additionally, your children must be unmarried and under 19 (or under 23 if in full-time school) to receive benefits. If they marry or age out, benefits stop.
If you're a disabled adult child receiving benefits based on your parent's or grandparent's earnings record, the same overseas rules apply to you. If your parent was a US citizen, you can receive DAC benefits overseas (with the same country restrictions). If your parent wasn't a US citizen, the 6-month non-citizen rule may apply to you.
If you die while overseas, your family members may be eligible for survivor benefits (widow/widower, children, parents). These work the same overseas as in the US—they continue for US citizens in unrestricted countries.
This is the most important thing to understand about SSI and international travel: SSI benefits stop after 30 consecutive days outside the United States.
There are NO exceptions to this rule. Not for medical emergencies. Not for family deaths. Not for anything. After 30 days, your SSI check stops. Period.
"United States" for SSI purposes means: the 50 states, Washington DC, and the Northern Mariana Islands. That's it.
Puerto Rico, Guam, US Virgin Islands, and American Samoa are NOT considered part of the United States for SSI purposes. If you move to any of these territories, the 30-day rule applies just as if you'd left the country.
The clock starts the day AFTER you leave the US. So if you leave on March 1st, day 1 is March 2nd. Day 30 is March 31st. On April 1st (day 31), you've been gone 30 consecutive days and your benefits stop.
It's hard to overstate how strict this is. Here are scenarios that don't matter:
SSA will not make exceptions. This is not a rule with wiggle room. This is a statutory rule—it's in federal law. SSA can't waive it, and judges generally can't overturn it.
Some people receive both SSDI and SSI. Maybe your SSDI benefit is low and you qualify for the SSI "top-up" to bring you to a minimum income level. If this is you, here's what happens when you travel:
So you lose the SSI portion but keep the SSDI portion. This can be a significant reduction in your monthly income.
So you traveled abroad, maybe you miscounted your days, maybe you got stuck outside the US longer than you planned. What happens to your SSI benefits when you come back?
Your SSI benefits are never interrupted. You return to the US, and your check keeps flowing as if nothing happened. No paperwork needed (though SSA may ask about the trip during their annual review).
Important: Keep proof. Keep your boarding passes, passport stamps, airline tickets, receipts from hotels. If SSA ever questions whether you were really gone, you need to prove exactly when you left and when you returned. Passport stamps are the gold standard.
Your benefits stopped when you hit 30 days. Now you've returned to the US. Here's what happens:
This process is not automatic. If you don't report your return, SSA may not restart your benefits quickly. You could lose months of payments unnecessarily.
If you've been outside the United States for 12 or more consecutive months, SSA treats this as if your SSI eligibility ended permanently. Even if you return to the US, you must file a NEW SSI application. You can't simply restart your old case.
This means:
This is why SSI recipients need to be extremely careful about extended international travel. A 13-month trip can permanently disrupt your benefits.
Frank was 58, receiving SSI, and his sister invited him to visit family in the Philippines for what he thought would be 4-5 weeks. Frank didn't count his days carefully. He left May 1st. He thought he'd be back by June 2nd (32 days). But his return flight was delayed, and he didn't get back until June 4th. That was 35 days abroad. His SSI stopped on May 31st (at the 30-day mark). When he returned, he had to call SSA to restart benefits. He lost June and part of July. The processing took 6 weeks. He also had to repay SSA $850 for benefits he received in June and July (since he wasn't supposed to get them). If Frank had counted his days, he could have extended his trip by just a few weeks and come back on day 29 instead.
If you're on SSI and you want to travel internationally, you CAN do it—but only for short trips. And you must count your days obsessively.
To be safe, limit any international trip to 29 days maximum. That gives you a one-day buffer just in case.
Both the day you leave and the day you return count toward your 30-day limit. This catches people off guard. If you think you're going for exactly 30 days (leaving on the 1st, returning on the 30th), you've actually been gone 30 days, and your benefits stop.
So if you leave on May 1st and return on May 29th, you've been gone 29 days. Safe. If you leave on May 1st and return on May 30th, you've been gone 30 days. Your benefits stop.
Before you travel, tell SSA that you're taking a trip. Ask them to note it in your file. When you return, bring:
If your passport doesn't get stamped (which can happen in some countries with certain visa arrangements), you need multiple types of documentation. Don't rely on just one piece of evidence.
If you're not a US citizen but are receiving SSI (as a permanent resident or visa holder), international travel creates an extra complication: immigration re-entry.
Some non-citizens need a "re-entry permit" to leave the US and return without losing their immigration status. If you leave without the right paperwork, SSA might not be the only agency penalizing you—Immigration might question whether you still have valid status.
Before any international trip as a non-citizen on SSI, consult with an immigration attorney. Make sure your visa/status allows you to leave and return. The last thing you want is to come back from a 4-week trip and discover that Immigration now questions your right to be in the US.
If you can't check all these boxes, don't travel. SSI is too risky to play fast and loose with the rules.
Here's a fact that shocks millions of people: Medicare generally does not provide coverage for healthcare services outside the United States.
You've paid Medicare taxes for 40+ years. You earned your Medicare eligibility. And then you move to another country and discover that Medicare won't pay for your doctor's visit, your hospital stay, or your prescriptions. It feels unfair. But it's the rule.
This applies to all Medicare parts:
For Medicare purposes, "United States" includes: the 50 states, Washington DC, Puerto Rico, Guam, US Virgin Islands, American Samoa, and the Northern Mariana Islands.
This is actually broader than SSI's definition of the US. You CAN use Medicare in Puerto Rico, Guam, and the Virgin Islands (even though you can't use SSI there). But anywhere else is off-limits.
If you move to Spain and have a heart attack, Medicare won't pay. The Spanish hospital bill is yours. If you live in Thailand and develop diabetes, Medicare won't cover your doctor visits or insulin. If you're in Germany and need a hip replacement, Medicare won't cover it. You're on your own financially.
Some people have medical emergencies overseas and assume Medicare will cover them. It won't. The bill can be devastating—tens of thousands of dollars for a hospital stay in some countries.
Medicare generally doesn't cover care abroad. But there are three extremely narrow exceptions. They cover so few people that you probably don't qualify—but here they are.
If you're on a cruise ship and you have an emergency, and the ship is within 6 hours of sailing to a US port, Medicare might cover your emergency care on the ship.
In practice: This almost never comes up. Most cruise ships have medical facilities that handle emergencies, and they bill you directly (or through your cruise insurance). Medicare involvement is rare.
If you live near the US border (Canada or Mexico) and a foreign hospital is closer to you than the nearest US hospital, Medicare may cover emergency care at that foreign hospital.
Example: You live in El Paso, Texas, and a Mexican hospital in Ciudad Juárez is closer than the nearest US hospital. If you have an emergency, that Mexican hospital is your closest option, so Medicare might cover it.
In practice: This requires SSA/Medicare to verify that the foreign hospital IS closer than any US hospital option. It's rare, but it applies to people living on the southern border.
If you're traveling from Alaska to the lower 48 states through Canada, and you have an emergency in Canada, Medicare may cover it.
In practice: Very few Medicare beneficiaries travel from Alaska through Canada regularly. This exception is narrow and rarely used.
If you have a Medigap supplement plan, some plans offer foreign travel emergency coverage. Specifically, plans C, D, F, G, M, and N offer this benefit.
Foreign travel emergency coverage typically includes:
This is not comprehensive coverage—it's for emergencies only. And it has strict limits. But if you have a Medigap plan with this benefit and you're traveling abroad for a short time, you have at least some protection.
Medicare doesn't work overseas. So what do you do? You have options, and planning ahead is critical.
Dozens of insurance companies offer international health insurance specifically for expats. Plans vary widely in price, coverage, and exclusions. Here's what to expect:
Shop around. Compare plans from companies like IMG Global, World Nomads, Cigna, Aetna, and regional providers in your destination country.
Medicare Part B costs $202.90/month in 2026 (for people with high incomes; lower-income beneficiaries pay less). If you're moving overseas, should you keep paying?
If you might return to the US within a few years: YES, keep Part B. If you drop Part B and then return to the US after more than a few years, you'll owe a late enrollment penalty. This penalty is 10% of your Part B premium per year you were eligible but didn't enroll. It's permanent. If you dropped Part B in 2027 and didn't return until 2032, your penalty is 50%. That's $100+/month forever.
If you're absolutely certain you're never returning to the US: You could consider dropping Part B. But this is a hard decision to make with certainty. People change their minds. Health crises happen. Life circumstances shift. If there's ANY chance you'll return, keep Part B.
Most people don't pay a premium for Part A if they have 40+ qualifying work credits. It's free. You might as well keep it. If you ever return to the US, you'll have hospital coverage from day one.
A few countries have reciprocal healthcare agreements with the US or with countries that have agreements with the US. This means US expats might be able to access healthcare through the local system.
Examples:
But these are not alternatives to insurance. They're supplemental. They don't cover everything, and access can be limited if you're not a citizen. Don't move to Mexico, Spain, or Portugal assuming you'll rely on their public systems. Get proper international health insurance as your primary coverage.
Even if your international insurance covers doctor visits and hospital care, prescription drugs can be complicated. Some medications are available cheaper overseas than in the US. Others are restricted or unavailable.
Before you move, research your specific medications:
Bring copies of your prescriptions and medical records. These help local doctors understand what you're taking and why.
Diane was 66, on Medicare, and moved to Costa Rica to be near her daughter. She didn't arrange international health insurance because she thought her Medicare covered her. When she got a severe bladder infection, she visited a local doctor. The doctor prescribed an antibiotic, but didn't realize Diane was allergic to sulfa drugs (which was listed in her US records). Diane had an allergic reaction. She needed hospitalization. Medicare didn't pay. The bill was $18,000. The hospital worked with her to set up a payment plan, but she spent the next 5 years paying it back. If Diane had gotten international insurance (maybe $40-50/month), the entire hospital bill would have been covered.
The number one regret Dr. Ed hears from overseas expats is not maintaining or securing adequate health insurance. They save money by skipping insurance. Then one health crisis—one hospital stay, one emergency surgery—wipes out years of savings. Don't be that person. Get international health insurance. It's not optional.
Moving overseas raises big Medicare questions. A licensed advisor can help you understand your options, avoid penalties, and find the right plan — for free.
Through Chapter Advisory, LLC — a licensed, independent Medicare agency.
24Help.org is a Chapter affiliate. This is a free service.
If you've worked in the United States and in another country, you might qualify for Social Security benefits from both countries. International Social Security agreements (called "totalization agreements") make this possible.
A totalization agreement is a bilateral treaty between the US and another country. It prevents you from paying Social Security taxes to both countries for the same work period, and it allows you to combine work credits from both countries to qualify for benefits.
Why do they exist? Because otherwise, you could work 10 years in the US (9 years short of the 40 credits needed for US benefits) and 10 years in Canada (short of Canada's requirements) and qualify for benefits in neither country. A totalization agreement says: "Combine those 20 years of work. If one country says you qualify based on the combined total, pay benefits."
The US currently has totalization agreements with these 30 countries:
Australia, Austria, Belgium, Brazil, Canada, Chile, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Luxembourg, Netherlands, Norway, Poland, Portugal, Slovak Republic, Slovenia, South Korea, Spain, Sweden, Switzerland, United Kingdom, Uruguay.
Notable countries WITHOUT agreements: Mexico (huge gap for US expats with Mexican family ties), China, India, Philippines, Vietnam, Thailand, Indonesia, Malaysia, Singapore, Turkey, Russia.
This is critical: If you've worked in Mexico and the US, there is NO totalization agreement. You can't combine your Mexican work credits with your US credits. This affects millions of US-Mexico cross-border workers.
When you qualify under a totalization agreement, each country pays you a portion of the benefit based on the credits you earned there.
Example: Maria worked 20 years in the US (earned 80 work credits) and 10 years in Germany (earned 120 German credits). Neither country alone would give her a full benefit—the US needs 40 credits, Germany needs a different threshold. But combined, she qualifies.
Important: The US doesn't count your German years as if they were US work. The totalization agreement doesn't artificially boost your US benefit calculation. Instead:
So totalization is useful when you have SOME credits in each country but not enough in any one country to qualify. It's less useful if you have plenty of credits in one country—you'd get the full benefit in that country anyway.
Australia, Austria, Belgium, Brazil, Canada, Chile, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Luxembourg, Netherlands, Norway, Poland, Portugal, Slovak Republic, Slovenia, South Korea, Spain, Sweden, Switzerland, United Kingdom, Uruguay.
Not all agreements are the same. Some cover only retirement benefits. Others cover disability and survivor benefits too. Here's a quick overview:
If you're researching a specific country, the SSA website (ssa.gov/international) has details on each agreement.
Mexico: This is the big one. Mexico and the US do not have a totalization agreement. Millions of Americans with Mexican roots or ties can't use totalization. If you worked in Mexico, you generally can't use those credits in the US system (with limited exceptions).
China, India, Philippines, Vietnam, Thailand: No agreements. These are popular expat destinations, so this affects many people.
How do you apply? The process depends on the country:
International coordination takes time. SSA might take weeks to contact the foreign agency. The foreign agency might take months to respond. Then there's processing time in both countries. Dr. Ed's advice: start the process 6-12 months before you plan to claim benefits. Don't wait until you're about to turn 62 or 65.
James worked 15 years in Canada, then moved to the US and worked 22 years in the US. Neither country alone would give him a full benefit (Canada required more years, US required 40 credits which he didn't have). But under the Canada-US totalization agreement, he could combine. He applied 10 months before his claimed age. It took 8 months for SSA to get a response from the Canadian Pension Plan administration. He started getting his dual benefits 2 months after he turned 62. If James had waited to apply, he would have started receiving benefits months late, and he wouldn't have received back-pay for the missed months.
Here's where totalization becomes particularly important for non-citizens: if you're a non-citizen (green card holder) and you move overseas, the 6-month alien non-payment provision might stop your benefits. But a totalization agreement can be an exception.
If you're a non-citizen receiving US retirement or SSDI benefits, benefits stop after 6 consecutive months outside the US—unless you meet an exception. One key exception: if you're receiving benefits under a totalization agreement, the 6-month rule may not apply.
Example: Tom is a Canadian permanent resident (green card holder) living in the US. He worked 15 years in Canada and 25 years in the US. He qualifies under the Canada-US totalization agreement. He moves back to Canada. Even though he's not a US citizen, because his benefits are based on a totalization agreement with Canada, he can continue receiving his US Social Security benefit indefinitely in Canada.
Another exception: if a non-citizen has 40 or more qualifying work credits under the US Social Security system (regardless of totalization), they may be exempt from the 6-month rule. This allows them to receive benefits overseas.
Example: Maria is a Mexican permanent resident (green card holder) who worked 35 years in the US—far more than the 40 credits needed. When she moves to Mexico, even though there's no Mexico-US totalization agreement, her 40+ credits give her an exception to the 6-month rule. She can receive her US benefits in Mexico indefinitely.
If you're a non-citizen and you're thinking about moving overseas, before you move, call SSA and ask whether an exception applies to you. Ask specifically:
Don't assume anything. SSA's answer will determine whether you can safely move overseas or whether you risk losing your benefits permanently.
Moving overseas while on Social Security (or any federal benefit) requires planning. Start 3-6 months before your move. Here's what to do.
When: 3-6 months before you leave
How:
What they'll do: SSA will flag your file. They'll send you information about foreign benefit procedures. They'll confirm which rules apply to you (citizen vs. non-citizen, country restrictions, etc.). This conversation is crucial—ask questions.
When: 2-3 months before you leave (before you physically move)
For direct deposit:
Open your foreign bank account before you leave the US if possible. Many banks require you to be present in person to open an account. Get this done while you're still here.
When: Before you leave
Why: This online account lets you manage your Social Security from anywhere with internet. You can:
Setting it up is free. Go to ssa.gov/myaccount. You'll need to verify your identity, which is much easier to do from the US than abroad.
When: 2 months before you move
What to do:
You may never need the FBU, but knowing where it is could be a lifesaver if your benefits stop, you get a confusing letter, or you need to complete official paperwork.
When: 3 months before you move
Ask yourself:
Write these answers down. Use the SSA Payments Abroad Screening Tool (ssa.gov) to check your specific situation.
Your monthly benefit amount will NOT change just because you move. Your deposit date will remain the same (3rd, 4th, or 5th of the month depending on your birthday). Your federal taxes will NOT be withheld overseas (but you still owe US income taxes as a US citizen on worldwide income—this is a separate tax filing issue).
Essential feature: No foreign transaction fees. No ATM fees worldwide.
Dr. Ed's top recommendations:
Do NOT use: Banks that charge 3-4% foreign transaction fees or charge per ATM withdrawal. Over a year, you'll lose thousands in fees.
This is critical. Direct deposit is reliable. Checks are not. You need your SSA benefit reliably every month.
Call SSA now: 1-800-772-1213. Ask them to set up direct deposit.
Your Social Security benefit is paid in US dollars. If the dollar strengthens, your purchasing power in your destination country decreases. If the dollar weakens, it increases.
Example: Your benefit is $2,000/month USD. You live in Mexico where the exchange rate is 17 pesos per dollar. Your $2,000 gets you 34,000 pesos. If the peso strengthens and the exchange rate becomes 20 pesos per dollar, your $2,000 now only gets you 40,000 pesos—but wait, that's more. Actually, if the dollar weakens (exchange rate drops to 15 pesos per dollar), your $2,000 now only gets you 30,000 pesos. That's less purchasing power.
Point: Monitor exchange rates. Know what your benefit is worth in local currency. Budget accordingly. Don't assume your purchasing power stays constant.
As a US citizen, you must file US taxes even while living abroad. Additionally, you have international reporting requirements:
Penalties for non-compliance are severe: $10,000+ per violation. Don't ignore these requirements. Use a CPA familiar with expat taxation to keep your filings straight.
If you're still working overseas, the Foreign Earned Income Exclusion allows you to exclude roughly the first $120,000 of foreign earned income from US taxation. But Social Security benefits don't qualify for this exclusion—you still owe taxes on your SS benefit.
This matters if you're on SSDI and working overseas. Track your income carefully. Report all earnings to both SSA and the IRS.
Keep Part B?
Keep Part A? Almost always yes. It's usually free and gives you hospital coverage if you return.
When: 3 months before you leave
What to get: A comprehensive plan that covers doctor visits, hospital, emergency care, and ideally prescriptions.
Get quotes from:
Expected costs: $250-$600/month for comprehensive coverage (varies by age and coverage level).
Especially if you're on SSDI:
Store these electronically (cloud backup, USB drive). Keep hard copies too. These documents help your new overseas doctor understand your history without redundant testing.
If possible before you move:
Ideally, schedule a "meet and greet" visit soon after you arrive. Don't wait until you're sick to find a doctor.
Medicare doesn't cover dental or vision. Neither do most international health plans. Before you leave:
Frank moved to Thailand on a tight budget. He skipped getting dental work before leaving, figuring he'd just visit a Thai dentist when needed. Six months later, he needed a root canal. The Thai dentist did the work for a fraction of US cost ($400 vs. $1,500), but the quality was questionable. The tooth failed 18 months later, and the replacement implant cost him $3,000. If Frank had gotten the root canal done in the US before leaving, he would have avoided the problem entirely.
Critical: SSA will periodically send you the Foreign Enforcement Questionnaire (form SSA-7162) or other notices. You MUST respond.
You must report these changes to SSA:
SSA offices are open during Eastern Time (ET). If you're overseas in a drastically different time zone, you need a system:
This online account is your best friend. Check it regularly:
This is Dr. Ed's biggest advice: Don't go silent. Many overseas beneficiaries try to avoid contact with SSA, worried something will go wrong. Instead, they create bigger problems.
You should:
Your Social Security benefits are yours. You earned them. You can receive them overseas (with exceptions for restricted countries and non-citizen rules). But you have to actively manage your benefits, stay in touch with SSA, and follow the rules.
The people who lose benefits are usually people who:
You now know the rules. Use that knowledge. Plan ahead. Stay in touch with SSA. Respond promptly. Report changes. Keep your documentation. Follow the rules. And your benefits will continue reliably, no matter where in the world you are.