Ah, the part b dilemna, at $149 per month and a $200 deductible adds up to $1985 annual expense, that same money can buy a good medical plan in Thailand . Also if you opt out of part b and re enroll in the future a penalty will be added monthly. But you can call Soc Sec foriegn payment division in Baltimore and ask for a technical specialist and apply for a exemption based on living in a foreign country.