Americans in Thailand- How are you using Medicare ?

OK so I've been going round in circles on this for weeks and my head is spinning.

I turn 65 in a few months and the Medicare question is driving me mad.

Everyone back home assumes you just sign up and that's it sorted. Nobody tells you it's basically useless if you're living outside the US — Thailand included. Found that out the hard way after spending an afternoon on the phone with Social Security.

So now I'm stuck with the Part B decision. Pay the premiums every month for coverage I can't actually use here, or drop it and risk a permanent 10% penalty for every year I delay if I ever go back. Which at my age is a real possibility.

Part A I get — no premium so that's a no-brainer, sign up regardless. But Part B stings when you're paying for nothing.

For now I'm just using a private international plan which covers me fine here, but the thought of those Part B penalties stacking up is keeping me up at night.

Anyone else been through this? What did you actually decide and do you regret it? Would love to hear from people who've already wrestled with this rather than read another government FAQ that assumes way too much.