DEPARTMENT OF HEALTH & HUMAN SERVICES

Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore, MD 21244-1850 

Welcome to Medicare!

Today you join more than 50 million Americans who have health care coverage from Medicare, the federal 

health insurance program run by the Centers for Medicare & Medicaid Services (CMS).

Because you’re entitled to Social Security retirement or disability benefits, you’re automatically enrolled 

in Medicare Part A (hospital insurance). You don’t need to pay a monthly premium for Part A. We’ll send 

you a Medicare card showing you have Medicare Part A only.

You have a choice to enroll in Medicare Part B (medical insurance). You only get Part B if you sign up for 

it. You have to pay a monthly premium for Part B if you choose to enroll.

You may have heard about the Health Insurance Marketplace. Medicare isn’t part of the Marketplace. Since 

you live outside the United States, you’re not eligible to use the Marketplace to enroll in health coverage. 

If you move to the continental United States, you shouldn’t enroll in a plan through the Marketplace for 

individuals or families. 

This letter has information about Part B to help you make your decision about enrolling in this coverage. 

Read it over carefully before making any decisions.

Can I use my Medicare coverage while I’m living outside the United States?

In general, Medicare doesn’t cover health care you get outside the United States. The 50 states, the District 

of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American 

Samoa are considered part of the U.S.

Should I enroll in Part B?

Deciding whether to enroll in Part B depends on your situation.

● I don’t have other medical insurance and I plan to return to the United States. If you don’t have 

medical insurance and plan to return to the U.S., you may want to enroll in Part B. If you enroll, 

you will have coverage for the types of items and services listed in the enclosed brochure when you 

get care in the U.S. You’ll need to have Part B in order to join a Medicare Advantage plan or buy a 

Medigap policy.
2

● I have TRICARE or CHAMPVA coverage. If you have TRICARE (insurance for military retirees, 

and their families) or CHAMPVA coverage, you must have Part B to keep that coverage. (However, 

if you’re an active-duty service member or the spouse or dependent child of an active-duty service 

member, you may not have to get Part B when first eligible. You can get Part B during a Special 

Enrollment Period without a penalty.)

● I’m still working, or my spouse (or a family member, if I’m disabled) is still working. If you 

have health insurance benefits through an employer because you or your spouse (or a family member, 

if you’re disabled) is still working, you may want to keep that coverage. You may have a Special 

Enrollment Period to sign up for Part B later without a penalty. Ask your employer if they require you 

to sign up for Part B.

● I have coverage through another insurance plan and I’m not working. If you plan to return to the 

U.S., you may want to enroll in Part B. You’re not eligible for a Special Enrollment Period when this 

coverage ends. 

How much does Part B cost?

Most people pay the standard monthly premium for Part B. In 2017, the standard premium is $134.00. The 

premium will automatically be deducted from your Social Security benefit payment when your coverage 

starts. If your benefits aren’t enough to pay the whole Part B premium, the Social Security Administration 

will bill you for your premium. You’ll pay more if you have a higher income. The premium amount can 

change each year. Visit Medicare.gov/eligibilitypremiumcalc to get an estimate of your Part B premium.

Can I enroll later?

Medicare limits when you can enroll in Part B. In most cases, if you don’t sign up for Part B within 8 

months of the date on this letter, you’ll have to pay a late enrollment penalty for as long as you have 

Part B. Also, you may have to wait until the Medicare General Enrollment Period (from January 1 to 

March 31) to enroll in Part B and coverage will start July 1 of that year. 

If you wait to sign up, you’ll pay 10% more for each full 12-month period you could have had Part B but 

didn’t take it. You’ll have to pay this late enrollment penalty as long as you have Part B. Visit 

Medicare.gov/eligibilitypremiumcalc to get an estimate of your premium based on when you think you’ll 

want to enroll in Part B.

You can enroll in Part B later, without penalty, if:

● you’re 65 or older, you or your spouse is currently working, and you’re covered by an employer or 

union group health plan based on that employment.

● you’re under 65 and disabled, you or a family member is working, and you’re covered by an 

employer or union group health plan (with at least 100 employees) based on that employment.

If this applies to you, you can sign up for Part B anytime while you’re covered by an employer or union 

group health plan based on current employment, or for up to 8 months after the group health plan coverage 

or the employment ends, whichever happens first. Most people who enroll in Medicare Part B during the 

Special Enrollment Period don’t pay a late enrollment penalty.
3

IMPORTANT NOTES:

● If you have COBRA coverage, VA coverage or a retiree health plan, you don’t have coverage based 

on current employment. You’re not eligible for a Special Enrollment Period when that coverage ends.

● If you have TRICARE (insurance for military retirees, and their families), you must have Part B to 

keep TRICARE. You must have Part B to keep CHAMPVA coverage.

● If you’re still working and plan to keep your employer or union coverage, you should talk to your 

employer benefits administrator to help you decide the best time to enroll in Part B.

How do I enroll in Part B?

You need to complete an enrollment application to get Part B. Social Security must get your request no later 

than 8 months after the date of this letter. The earlier you send the form, the sooner your Part B coverage can 

start.

To enroll you can:

● Sign and mail the enclosed form in the envelope provided, or

● Go to Medicare.gov/forms-help-and-resources/forms/medicare-forms.html and download Form 

CMS-40B (Application for Enrollment in Medicare Part B). Complete the application and sign it. 

Then, return the completed application using the envelope provided or mail it to:

Social Security Administration

P.O. Box 17769

Baltimore, MD 21235-7769 United States of America

Get answers to your Medicare questions

If you have questions about how to enroll in Medicare, contact any United States Consular office. If you live 

in the Philippines, please contact the U.S. Veterans Administration Regional Office in Manila.

You can also visit socialsecurity.gov or call Social Security’s toll-free number, 1-800-772-1213, Monday 

through Friday between 7:00 a.m. and 7:00 p.m. TTY users should call 1-800-325-0778. When you call 

have your Social Security number handy.

Enclosure

Nondiscrimination Notice - The Centers for Medicare & Medicaid Services (CMS) doesn’t exclude, 

deny benefits to, or otherwise discriminate against any person on the basis of race, color, national origin, 

disability, sex, or age. If you think you’ve been discriminated against or treated unfairly for any of these 

reasons, you can file a complaint with the Department of Health and Human Services, Office for Civil 

Rights by:

● Calling 1-800-368-1019. TTY users should call 1-800-537-7697. 

● Visiting hhs.gov/ocr/civilrights/complaints. 

● Writing: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence 

Avenue SW, Room 509F, HHH Building, Washington, D.C. 20201

Notice of Availability of Auxiliary Aids & Services - We’re committed to making our programs, benefits, 

services, facilities, information, and technology accessible in accordance with Sections 504 and 508 of 

the Rehabilitation Act of 1973. We’ve taken appropriate steps to make sure that people with disabilities, 

including people who are deaf, hard of hearing or blind, or who have low vision or other sensory limitations, 
4

have an equal opportunity to participate in our services, activities, programs, and other benefits. We provide 

various auxiliary aids and services to communicate with people with disabilities, including: 

● Relay service — TTY users should call 1-877-486-2048. 

● Alternate formats — This packet is available in alternate formats, including large print, Braille, data 

CD and audio CD. To request your packet in an alternate format: 

• Call 1-844-ALT-FORM (1-844-258-3676). TTY users should call 1-844-716-3676. 

• Send a fax to 1-844-530-3676. 

• Send an email to AltFormatRequest@cms.hhs.gov. 

• Send a letter to: Centers for Medicare & Medicaid Services Offices of Hearings and Inquiries 

(OHI) 7500 Security Boulevard, Room S1-13-25 Baltimore, MD 21244-1850 

Attn: CMS Alternate Format Team

Note: Your request should include your name, phone number, mailing address where we should send the 

packet, and the packet name “Foreign IEP Packet.” Also include the format you need, like Braille, large 

print, audio CD, or a qualified reader.

Help in other languages - If you, or someone you’re helping, has questions about Medicare, you 

have the right to get help and information in your language at no cost. To talk to an interpreter, call 

1-800-MEDICARE (1-800-633-4227).
5

If you, or someone you’re helping, has questions about Medicare, you have the right to get help 

and information in your language at no cost. To talk to an interpreter, call 1-800-MEDICARE 

(1-800-633-4227).

ُساعده أسئلة بخصوص Medicare فإن من حقك الحصول على المساعدة و 

العربیة (Arabic (إن كان لدیك أو لدى شخص ت

المعلومات بلغتك من دون أي تكلفة. للتحدث مع مترجم إتصل بالرقم MEDICARE1-800- ) 1-800-633-4227( .

հայերեն (Armenian) Եթե Դուք կամ Ձեր կողմից օգնություն ստացող անձը հարցեր ունի

Medicare-ի մասին, ապա Դուք իրավունք ունեք անվճար օգնություն եւ

տեղեկություններ ստանալու Ձեր նախընտրած լեզվով։ Թարգմանչի հետ խոսելու

համար զանգահարեք 1-800-MEDICARE (1-800-633-4227) հեռախոսահամարով։

中文 (Chinese-Traditional) 如果您,或是您正在協助的個人,有關於聯邦醫療保險的問

題,您有權免費以您的母語,獲得幫助和訊息。與翻譯員交談,請致電 1-800-MEDICARE 

(1-800-633-4227).

فارسی (Farsi (اگر شما، یا شخصی کھ بھ او کمک میرسانید سوالی در مورد اعلامیھ مختصر مدیکردارید، حق این را 

دارید کھ کمک و اطلاعات بھ زبان خود بھ طور رایگان دریافت نمایید. برای مکالمھ با مترجم با این شماره تماس زیر

بگیریدMEDICARE1-800-) 1-800-633-4227(.

Français (French) Si vous, ou quelqu'un que vous êtes en train d’aider, a des questions au sujet 

de l'assurance-maladie Medicare, vous avez le droit d'obtenir de l'aide et de l'information dans 

votre langue à aucun coût. Pour parler à un interprète, composez le 1-800-MEDICARE (1-800-

633-4227) 

Deutsch (German) Falls Sie oder jemand, dem Sie helfen, Fragen zu Medicare haben, haben Sie 

das Recht, kostenlose Hilfe und Informationen in Ihrer Sprache zu erhalten. Um mit einem 

Dolmetscher zu sprechen, rufen Sie bitte die Nummer 1-800-MEDICARE (1-800-633-4227) an. 

Kreyòl (Haitian Creole) Si oumenm oswa yon moun w ap ede, gen kesyon konsènan Medicare, se 

dwa w pou jwenn èd ak enfòmasyon nan lang ou pale a, san pou pa peye pou sa. Pou w pale 

avèk yon entèprèt, rele nan 1-800-MEDICARE (1-800-633-4227). 

Italiano (Italian) Se voi, o una persona che state aiutando, vogliate chiarimenti a riguardo del 

Medicare, avete il diritto di ottenere assistenza e informazioni nella vostra lingua a titolo 

gratuito. Per parlare con un interprete, chiamate il numero 1-800-MEDICARE (1-800-633-4227). 

日本語 (Japanese) Medicare (メディケア) に関するご質問がある場合は、ご希望の言語で情報を取

得し、サポートを受ける権利があります (無料)。通訳をご希望の方は、1-800-MEDICARE (1-800-633-

4227) までお電話ください。
6

한국어(Korean) 만약 귀하나 귀하가 돕는 어느 분이 메디케어에 관해서 질문을 가지고

있다면 비용 부담이 없이 필요한 도움과 정보를 귀하의 언어로 얻을 수 있는 권리가

귀하에게 있습니다. 통역사와 말씀을 나누시려면 1-800-MEDICARE(1-800-633-4227)로

전화하십시오. 

Polski (Polish) Jeżeli Państwo lub ktoś komu Państwo pomagają macie pytania dotyczące

Medicare, mają Państwo prawo do uzyskania bezpłatnej pomocy i informacji w swoim języku. 

Aby rozmawiać z tłumaczem, prosimy dzwonić pod numer telefonu 1-800-MEDICARE (1-800-

633-4227).

Português(Portuguese) Se você (ou alguém que você esteja ajudando) tiver dúvidas sobre a

Medicare, você tem o direito de obter ajuda e informações em seu idioma, gratuitamente. Para

falar com um intérprete, ligue para 1-800-MEDICARE (1-800-633-4227).

Русский(Russian) Если у вас или лица, которому вы помогаете, возникли вопросы по поводу

программы Медикэр (Medicare), вы имеете право на бесплатную помощь и информацию на 

вашем языке. Чтобы воспользоваться услугами переводчика, позвоните по телефону 1-800-

MEDICARE (1-800-633-4227). 

Spanish (Español) Si usted, o alguien que está ayudando, tiene preguntas sobre Medicare, usted 

tiene el derecho a obtener ayuda e información en su idioma sin costo alguno. Para hablar con 

un intérprete, llame al 1-800-MEDICARE (1-800-633-4227).

Tagalog (Tagalog) Kung ikaw, o ang isang tinutulungan mo, ay may mga katanungan tungkol sa 

Medicare, ikaw ay may karapatan na makakuha ng tulong at impormasyon sa iyong lenguwahe 

ng walang gastos. Upang makipag-usap sa isang tagasalin ng wika, tumawag sa 1-800-MEDICARE 

(1-800-633-4227). 

Tiếng Việt(Vietnamese) Nếu quý vị, hay người mà quý vị đang giúp đỡ, có câu hỏi về Medicare, 

quý vị sẽ có quyền được giúp và có thêm thông tin bằng ngôn ngữ của mình miễn phí. Để nói 

chuyện qua thông dịch viên, gọi số 1-800-MEDICARE (1-800-633-4227). 
2017

Welcome 


to 

 Medicare 


for people 


living in other 


countries
 

CENTERS FOR MEDICARE & MEDICAID SERVICES 
2
 
Medicare Overview 

Medicare is health insurance for people 

65 or older, under age 65 with certain 

disabilities and people of any age with 

End Stage Renal Disease (permanent 

kidney failure requiring dialysis or a 

kidney transplant). 

This brochure provides an overview 

of the Medicare Program, Medicare 

Advantage Plans, and Medicare 

prescription drug plans. It summarizes 

Medicare covered services and provides 

information about Medigap (Medicare 

Supplement Insurance) policies. 

IMPORTANT: Medicare generally 

cannot pay for any of your hospital 

or medical bills unless you receive 

your medical care in the United States 

(including Puerto Rico, the Virgin 

Islands, Guam, the Northern Mariana 

Islands, and American Samoa). 

Under certain limited circumstances, 

medical services provided in Canada 

or Mexico also may be covered by 

Medicare, but only if you are living in 

the United States. 

You can only enroll in a Medicare 

Advantage Plan or a Medicare 

Prescription Drug Plan if you are 

living in the United States. 

3
 
 

 

Medicare Part A 

(Hospital Insurance) 

Medicare Part A (hospital insurance) 

helps cover your inpatient care in 

hospitals and skilled nursing home 

facilities (not custodial care or long-term 

care). It also covers hospice care and 

some home health care. It also includes 

care in critical access hospitals and 

inpatient rehabilitation facilities. 

Hospital Stays 

Medicare Part A helps cover semiprivate rooms, meals, general nursing 

and other hospital services and supplies. 

Skilled Nursing Facility Care 

(up to 100 days) 

Covered services include semiprivate 

room, meals, skilled nursing and 

rehabilitation services, and other 

services and supplies. 

Home Health Care 

Medicare Part A coverage includes parttime or intermittent skilled nursing care 

and physical therapy, speech-language 

pathology and occupational therapy. 

Hospice Care 

Medicare Part A coverage can include 

part-time or intermittent skilled nursing 

care and physical therapy, speechlanguage pathology and occupational 

therapy. 

4
 
Medicare Part B 

(Medical Insurance) 

Medicare Part B (medical insurance) 

helps cover medically necessary services 

like doctors’ services, outpatient care, 

home health services, durable medical 

equipment and other medical services. 

Part B also covers many preventative 

services. 

Medical and Other Services 

Medicare Part B covers doctors’ 

services outpatient medical and surgical 

services and supplies, diagnostic tests, 

durable medical equipment and more. 

Medicare helps cover a one-time 

“Welcome to Medicare” preventative 

visit during the first 12 months you 

have Part B. 

Clinical Laboratory Services 

Medicare Part B covers blood tests, 

urinalyses, and some screening tests. 

Home Health Care 

Medicare Part B coverage can include 

part-time or intermittent skilled care 

and physical therapy, speech-language 

pathology and occupational therapy. 

Outpatient Hospital Services 

Medicare Part B helps to cover hospital 

services and supplies received as a 

hospital outpatient. 

5
 
Medicare Part B Covered Preventive 

Services 

Medicare Part B covers many preventive 

services to help you live a longer, 

healthier life. You pay nothing for 

most preventive services if you get 

the services from a doctor or other 

qualified health care provider who 

accepts assignment. How often you can 

get each service varies. Some services 

are covered only for people with certain 

conditions or risk factors, so check with 

your doctor about what’s right for you. 

You must have Medicare Part B to get 

help paying for these Medicare-covered 

preventive services. 

For more information about Medicare 

Part A and Part B covered services, visit 

Medicare.gov. 

Medicare Part C 

(Medicare Advantage Plans) 

Medicare Advantage Plans (like an 

HMO or PPO) are a way to get your 

Medicare coverage through private 

companies approved by Medicare. 

These plans include Part A, Part B, and 

usually other coverage like prescription 

drugs (Part D). You usually pay a 

monthly premium (in addition to your 

Part B premium) and a copayment 

or coinsurance amount for covered 

services. Costs, extra coverage, and 

rules vary by plan. If you choose not 

to join a Medicare Advantage Plan, in 

most cases, you’ll get your Medicare 

coverage through Original Medicare. 

6
 
Medicare Part D 

(Medicare Prescription Drug Coverage) 

In general, Medicare offers prescription 

drug coverage to everyone with 

Medicare. This coverage is offered 

by private companies approved by 

Medicare. To get prescription drug 

coverage you can join a 

•	 Medicare Prescription Drug Plan that 

adds coverage to Original Medicare 

and certain Medicare Advantage 

Plans, or 

•	 Medicare Advantage Plan that 

includes prescription drug coverage. 

Generally, you’ll have to pay a monthly 

premium for Medicare prescription drug 

coverage. 

Original Medicare 

Original Medicare is one of your health 

care choices. You’ll have Original 

Medicare unless you choose to join a 

Medicare Advantage Plan. You can see 

any doctor or provider who’s enrolled 

in Medicare and accepting new patients. 

You don’t need referrals. 

In Original Medicare, if you have 

Medicare Part A and/or Part B, you get 

all the Part A and/or Part B covered 

services listed earlier in this brochure. 

You must sign up for Part B and pay 

a monthly premium to get the Part B 

covered services. 

You also have to pay additional costs 

(like a deductible, coinsurance, or 

7
 
co-payment) for some Medicare-covered 

services. In addition to Original Medicare, 

you can get more coverage to help pay 

your health care costs. You may get 

Medicare Supplement Insurance (Medigap) 

policy or join a Medicare Prescription 

Drug Plan. You can choose one or both 

of these types of additional coverage. 

Options for Additional Coverage 

Medicare Supplement Insurance 

(Medigap) Policy 

Medigap policies are a type of private 

insurance designed to help pay some 

of your out-of-pocket costs (like your 

coinsurance and deductibles) in Original 

Medicare. Different types of Medigap 

policies, which are identified by letters, 

must all have standardized benefits. This 

means that you can easily compare a 

Plan A sold by one insurance company 

with a Plan A sold by another. Medigap 

policies sold today don’t cover longterm care, private-duty nursing, or 

prescription drug coverage. All policies 

may not be available in your area. 

•	 Buying a Medigap policy – You 

must have both Medicare Part 

A AND Part B to buy a Medigap 

policy. The cost varies depending 

on the company you buy from and 

where you live. You’ll pay a monthly 

premium directly to the private 

company you bought the policy from, 

in addition to your Part B premium. 

8
 
•	 When you can buy – The best time 

to buy a Medigap policy is during 

the 6-month period that starts with 

the first month you’re age 65 or 

older AND enrolled in Medicare 

Part B. This is called your Medigap 

Open Enrollment Period. During this 

period, you can buy any Medigap 

policy sold in your area. After this 

period, you may have to pay more, 

or you may not be able to get the 

Medigap policy you want. 

Medicare Advantage Plans 

You must have both Medicare Part 

A AND Part B and live in the United 

States to join a Medicare Advantage 

Plan. When you join a Medicare 

Advantage Plan you will get the Part A 

and Part B covered services previously 

listed in this brochure through the 

Medicare Advantage Plan. In most of 

these plans, there are generally extra 

benefits and lower copayments than 

in Original Medicare and they include 

prescription drug coverage (usually for 

an extra cost). 

Medicare Prescription Drug 

Coverage 

You need to have either Medicare 

Part A or Part B and live in the 

United States to join a Medicare drug 

plan. Medicare drug plans are run by 

private companies that contract with 

Medicare. These plans cover a variety 

9
 
of brand name and generic prescription 

drugs. All Medicare drug plans offer 

at least a basic standard package of 

coverage, but costs and coverage are 

different in every plan. 

If you have, or are eligible for, 

prescription drug coverage from an 

employer or union, TRICARE, the 

Department of Veterans Affairs (VA), or 

the Federal Employees Health Benefits 

Program (FEHBP), read all the materials 

you get from your insurer or plan 

provider. If you still have questions, talk 

to your benefits administrator, insurer, 

or plan provider before you make any 

changes to your current coverage. 

For more information about Medicare 

Prescription Drug Plans, Medicare 

Advantage Plans, and Medigap 

policies, visit Medicare.gov. 

10
 
For More Information 

If you have questions about how to 

enroll in Medicare, contact any United 

States Consular office. If you live in 

the Philippines, please contact the U.S. 

Veterans Administration Regional 

Office in Manila. 

For general questions about the Medicare 

program, visit Medicare.gov. You can 

find the most up-to-date Medicare 

information and answers to your 

questions. 

Medicare is managed by the Centers for 

Medicare & Medicaid Services (CMS). 

CMS is part of the Department of Health 

and Human Services. Social Security 

works with CMS by enrolling people in 

Medicare, qualifying people for Extra 

Help paying their Medicare prescription 

drug costs, and collecting Medicare 

premiums. 

You have the right to get the 

information in this brochure in an 

alternate format. Visit Medicare.gov/ 

about-us/nondiscrimination-notice.html 

or call 1-800-MEDICARE (1-800-633-

4227) for more information. TTY users 

should call 1-877-486-2048 

11
 
“Welcome to Medicare” isn’t a 

legal document. Official Medicare 

Program legal guidance is contained 

in the relevant statutes, regulations, 

and rulings. 

CMS Product No. 11871 

December 2016
 

Paid for by the U.S. Department of Health 

and Human Services. 
REQUEST FOR APPLICATION FOR ENROLLMENT 
 

IN MEDICARE PART B (MEDICAL INSURANCE)



Please send me an application for enrollment in Medicare Part B (medical insurance). 

SIGNATURE 

MEDICARE CLAIM NUMBER 

DATE 

For More Information 

General information about Medicare can be obtained at any U.S. consular office. (If you live 

in the Philippines, please get in touch with the U.S. Veterans Administration Regional Office 

in Manila.) You can also look at Medicare.gov, Medicare’s official website for people with 

Medicare. If you want further details about Medicare or if you want to enroll in Part B in the 

future, you may write to: 

Social Security Administration 

P.O. Box 17769 

Baltimore, Maryland 21235-7769 

U.S.A. 

Medicare documents, including this form are available in alternate formats, including large print, Braille, and 

audio. Call 1-800-MEDICARE (1-800-633-4227) to request a copy. TTY users should call 1-877-486-2048. 

FORM CMS-1739 

November 2017