Foreign Travel, Volunteers And Medicare

My name is Mickie Douglas. I work for Social Security as a Public Affairs Specialist and I’m replacing Howard Kossover. I just said that so I could officially state for the record that Howard is irreplaceable.  Howard was a well-loved and much respected Social Security employee.  We will all miss him, but some are maybe just a little bit envious that he is out there right now possibly planning trips to everywhere imaginable.  Maybe he will send us a postcard from the Boundary Waters.  Or Bermuda.   Or Barcelona.   Happy travels, Howard.



While Medicare isn’t always on the top of everyone’s travel “To Do” list, there are some points you may want to consider before you depart for foreign countries. Especially if you plan to become an international volunteer.

Medicare Pamphlet for Area Voices                                            Medicare & You 2016 Cover Area Voices                              


Medicare is the U. S. national health insurance program for those who are age 65 or older, or disabled.  Medicare does not generally cover health services you get outside the United States.  If you plan to be outside the country for a long time, you may choose to cancel your Part B coverage, which requires a premium, when you leave the country to do volunteer work.  You may decide to do this because you get health coverage from the organization sponsoring your volunteer work and will be out of the country for an extended period.

This is what you need to know to re-enroll in Medicare Part B when you return.   You will be eligible for a special enrollment period of 6 months if you have been outside the U. S. volunteering in a program that covers a 12- month period sponsored by a tax-exempt organization.  (You can find the definition of a tax-exempt organization here: ).  You had to have had health insurance that provided coverage outside the U. S. for the duration of the volunteer service.

The enrollment period is the 6-month period that begins the earlier of the first day of the month following the month for which the:

  • individual was no longer serving as a volunteer outside of the United States;
  • organization no longer has tax-exempt status; or
  • Individual no longer has health insurance that provides coverage outside of the United States.

Whether you sign up before or after the coverage you had while outside the country ends determines when your Medicare Part B starts again.  If you enroll after your current coverage ends, coverage always begins the next month.  For example, if coverage ends September 30 and you enroll in October, coverage begins November 1.  In this case, you will have a gap in coverage.  If you enroll 30-60 days before your health insurance coverage ends, you will be enrolled beginning the following month.  You will need to tell Social Security which month you want coverage to start.  For example, if your current coverage ends September 30 and you enroll in August, you need to indicate whether you want coverage to start in August or September.  (Write when you want coverage to start in the Remarks section of the CMS-40B form you will complete to re-enroll—see below.)

After you re-enroll, you will receive a Medicare card showing that you have Part B coverage. If you haven’t received your Medicare card after 30 days, you can use your my Social Security account to obtain a letter verifying that you have Medicare Part B.  If you do not have a my Social Security account yet, use this link to sign up for one now: .  (You can use your account to manage your benefits when you need to change your address; start or change your direct deposit; get a replacement Medicare card; get a replacement SSA-1099 for tax season or get a letter with proof of your benefits and/or Medicare.  Under certain circumstances, in some states such as North Dakota, you can even get a replacement Social Security card using your my Social Security account.  Find more information at this link: .)

The two forms you need to reenroll in Medicare are available online.

First, you need to complete a CMS-40B Application for Enrollment in Medicare – Part B (Medical Insurance) available at  Under Downloads, choose the form labeled CMS40B-E unless you need the Spanish version of the form shown below it.

The form contains fillable fields. You can complete the form; print it out and save a copy for yourself. Return the form along with the second form (see next paragraph) to your local Social Security office.

Additionally, your tax-exempt sponsoring organization will need to complete form CMS-L564 Request for Employment Information available at   Under Downloads, click on CMSL564E.  (The second form is the Spanish version.)  Ask your tax-exempt sponsoring organization to complete the form.   Completion of the form establishes that you were covered by health insurance while you volunteered and when that coverage ended.

Use this link to mail the two forms to the Social Security office that services your home address:  (Click on Find an Office).

Following these steps can make your re-enrollment in Medicare Part B easy and convenient. You will have fond memories from your volunteer days and you will have taken the necessary steps to start your Medicare Part B coverage again.