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Medicare Part B: keep paying, or drop it?

Medicare does not cover care outside the US. So while you live in Portugal, Part B buys you nothing — except the option to return without a penalty. Dropping it triggers a permanent surcharge of 10% of the premium for every full 12 months you were unenrolled, payable for the rest of your life if you come back.

2026 standard Part B premium: $202.90/month. Penalty rule: +10% per full 12-month gap, permanent. Last verified 29 July 2026 (medicare.gov). Late-enrollment also means waiting for a General Enrollment Period — a coverage gap of up to a year on return.

Years you expect to live abroad If you returned to the US, how many years would you likely use Medicare after coming back? How likely are you to move back to the US eventually? (%)

What this leaves out — on purpose

Premiums rise most years (this tool holds them flat, which favors “keep”), IRMAA surcharges apply at higher incomes, and some people qualify for Special Enrollment Periods that soften the penalty. The number this tool cannot know is the one that matters most: how certain you are about never coming back. Most people are less certain than they think — the honest base rate is that a meaningful share of American retirees in Portugal return within 5 years.

Information tool, not insurance, financial or Medicare enrollment advice. Verify current premiums and your enrollment options at medicare.gov or with SHIP (free State Health Insurance Assistance Program counselors) before deciding.