You don't need to buy your own SIM - it comes with its own international roaming SIM, with free data for 8 years.
As for what happens, nobody knows, because nobody's run out the four years yet. When they announced the four free years, they also said that the clock started for existing customers on January 1, 2014, so nobody will hit the end for another year and some.
I'd guess that it'll end up being a paid subscription after that, but nobody really knows yet. I wouldn't be surprised if Tesla doesn't know yet. I wouldn't be too surprised if they just make it free for life, since it's pretty cheap to provide and so important to the car, but that might just be wishful thinking on my part.
There is a rumor their cellular costs far exceed their Supercharger electricity costs.