It is legal but if she doesn't use it in the US then it is not excepted in any other country.
We live outside the US and have contacted medicare to decline the part B coverage. It would cost us monthy to have it and we can not use it where we live.
She must not sign her medicare card or tear it off the packing material, just send it back to their office as is. She can either call or go into any ss office and fill out the paperwork to decline the medicare.
They give out part A no matter what but I doubt that is of any real use without the part B.
She will save herself at least $100. a month if she declines the coverage. If she can't use it then why pay for it.
I am not 100% sure about the enrollment dates, it is so confusing. I do know that if she later wants the coverage it is going to cost a certain % more for every years she declined having it.
We pay out of pocket where we now live for national health coverage. Everyone no matter their age or medical issues pays the exact same amount every month.
Those with jobs have the employers pay and everyone not working pays themselves or the gov. helps with low income people.
There are still private doctors and clinics that will either only except cash for services or will work with the national health plan and have lower prices then cash only private doctors.
Doctors who work for the national health expect tips for services though, in many ways going to a private doctor can be cheaper depending on how much tipping is needed. We do not tip private doctors only the ones who work for national health.
The knowing of how much and when to tip is the biggest issue here, tip too much and they take advantage and if you don't tip enough then they may skip some treatments on you.