Originally Posted by nun
If the OP qualifies for Medicare they can keep paying the premiums while abroad and return to the US for treatment of major things. Minor medical stuff could be done locally and paid out of pocket. FYI if you don't keep paying the Medicare premiums and ever return to the US then the Medicare premium will increase by 10% for every year that you missed it.
Also don't forget to pay your US taxes, including US tax on any foreign income and interest, file FATCA and FBAR if necessary and comply with local tax regulations.
Actually, one will always be eligible for Medicare Part A without paying premiums. This is the core part of Medicare.
It is Part B and Part D, I believe, that fall under the regime you mention whereby you must effectively start paying the dues or be locked out.
Part B is currently around $105 per month. I am not very knowledgeable about Part D but I think there are very inexpensive monthly options if you want minimal coverage.
Whether or not to enroll in and pay the Part B fees is a big decision for many 65 year old expats. How committed am I to this expat lifestyle? How often would I go back to the USA for visits and would I start adding medical checks to those visits? Etc.