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My father, 93 just passed away in São Paulo Brazil. His wife is 92 and Brazilian. She is still alive. I find no reason for her to pay Medicaid cause she will not return to the States. However, she does have Social Security and both have always filed income tax and paid the fees. What should she do? Does she lose Social Security pensions if she does not pay Medicaid?

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Are you referring to Medicare?
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Perhaps you're referring to Medicare rather than Medicaid?

I don't really understand why Medicare might be an issue now, unless she's just approaching 65. Otherwise, how does the Medicare issue arise now?

She doesn't have to have Medicare if she's turning 65, and if she's in the general age range of your father and doesn't have it yet, I'm not even sure if she could get it.

I think the issue is what do you really think is mandatory when receiving SS?

People do choose not to receive Medicare benefits but typically would have alternate health care coverage.
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Sounds like you are talking about Medicare Part B, the monthly premium. I think you can get that waived since she is not ever going to come to the US. Talk to SSA people - I think you can work this out but I'd go to the trouble of doing it officially "right".
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St hull - I’d be more concerned if your mom can still get your late dads SS income. SS eligibility for non-citizen spouses once the SS primary spouse dies varies and wildly. There are countries on the never-will-pay list and then others are and within this group varies as to what status your father was for his SS payment and what your moms is (like if she had 40 ssa quarters). And then add in if they were / are dual nationals & if their home country has a pension system.

Not a single simple answer & to me this is more important that trying to get around not having the $100+ a mo taken out for Medicare from the SSA monthly income.

SSA has a pretty detailed section of their website dedicated to this as there are huge amount of SS retirees in Latin America. You can email SSA with ? as well. Some counties (Mexico,Panama) are just easier to retire to & keep SS$ flowing. Good luck!
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