I still have an active bill and service with my US provider and my phone has 1 physical sim and 1 eSIM. I turn on the physical sim from the US when I need to get text messages or OTP. I get travel days each month so I don’t get any extra charge and typically only use it once per month or less. It stays off but still inside my phone 99% of the time.
US citizens don’t have a passport office to attend. We make one application and a payment with a return envelope and send via mail. The Embassy won’t allow onsite appointments for passport renewal the last I checked.
it’s all done online and regular post mail now. Instructions are on the embassy website. If you have questions you can PM. Will be happy to help as I did mine last year
cash and Veteran’s Administration Foreign Medical Program. The FMP only pays for my service connected disabilities which only covers a few things. I also have accident insurance for my motorbike to cover medical due to accidents.