I know that Medicare doesn't pay for services in Nicaragua, and I know that the additional parts of Medicare (Part B, C, D) have premiums that also won't do me any good outside the country. I know there are penalties for not signing up for Part B. I'm wondering what other ExPats living in Nicaragua do about Medicare and it's Premiums. Do you pay premiums for services you most likely won't use just as insurance? Do you opt out? Do you sign up for local health insurance (what types are available)?
Forgive me if you think this is too personal to answer. I'm trying to figure out how to allocate scarce funds for my retirement.