A few more simple questions, COBRA, foreign coverage

[teejayevans]

I saw a reference to the fact that if you qualify for COBRA coverage, you can't
get individual insurance (in PA). Since my COBRA coverage would be twice as
much as if I got my own, I prefer to skip the COBRA, anybody who knows for
sure can confirm that? Also I like to lock into a insurance carrier while I'm still
in good health. If its a PA regulation, I could find a carrier in my current state
(NC) and switch residency if I use one of the carriers MKLD mention in the other
thread.

Also if I spend a majority of my time outside the USA, is there any
gotcha's regarding health insurance, is this something explicit (foreign coverage)
that I need to look for or ask for?

I'm assuming HSA can be used to pay for medical fees no matter what country
I'm in, yes?
Thanks, Tom

[REWahoo]

Originally Posted by teejayevans

I saw a reference to the fact that if you qualify for COBRA coverage, you can't
get individual insurance (in PA). Since my COBRA coverage would be twice as
much as if I got my own, I prefer to skip the COBRA, anybody who knows for
sure can confirm that?

A very good source of individual state insurance information is the Georgetown University Health Policy Institute. Here is a link to their consumer guide for PA:

http://www.healthinsuranceinfo.net/pa00.html

[teejayevans]

Originally Posted by REWahoo!

A very good source of individual state insurance information is the Georgetown University Health Policy Institute. Here is a link to their consumer guide for PA:

http://www.healthinsuranceinfo.net/pa00.html

Thanks, that has a lot of good info.
Tom

[kramer]

TJ,

Most US domestic policies are going to have limited coverage overseas. I think the typical is that you will have 30 days of coverage outside of the US. So when spending time out of the US you can either buy specific coverage for that or just go bare. If you are in your 40s, you can get decent worldwide travel coverage for less than $50/month. But for anything chronic, you would have to come back to the US and get it treated there under your US health insurance. The foreign travel insurance I mentioned above is more for emergencies, evacuation to appropriate hospital, etc. To give you an idea on foreign travel coverage, the quote I had for early 40's male was around $41/month for $100K (or so) max coverage, $46/month for $250K max, all with $2500 deductible. YOu can specify coverage by the month.

Yes, you can use HSA funds for foreign health care expenses. Typically, you would just pay out of pocket. And then at the end of the year decide how much to take out of your HSA, up to the amount that you spent, and just transfer that out of the HSA. You do not actually have to write checks out of your HSA account at the time of usage, etc.

By the way, my friend from India is getting a visa to visit Italy for a few days. He has to show not only proof of health insurance, but also that the health insurance will directly reimburse an Italian health care provider. I have not heard of this requirement for an American passport (Americans don't need a visa to visit most countries). But just to be safe, if I were overseas, I would want a copy of my travel health insurance policy with me (and also scanned in, accessible by email).

Kramer

[teejayevans]

Thanks Kramer,
That's what I was afraid of, I'm going to send some email to a few of the
companies MKLD mention that have coverage across states, see what
they say.
Its funny that there are international insurance agencies that provide
health insurance, with exception of the USA.
I also have the problem that my state residency is more of a mail drop,
I'll rarely be in that state, since most plans are PPO now, I will have to
check if the PPO is nationwide.
thanks for the info

[Billy]

(Americans don't need a visa to visit most countries).

Kramer, this is not correct. We, US Citizens, need visas just like other countries. Visas are a complicated subject. Here in Thailand there are entire websites explaining all of the different types, pros and cons.

Its funny that there are international insurance agencies that provide
health insurance, with exception of the USA.

Here's one I recently found that does include the US. They have 3 different plans. http://www.premier-ih.com/home.php


Billy
RetireEarlyLifestyle.com

[kramer]

Originally Posted by Billy

Kramer, this is not correct. We, US Citizens, need visas just like other countries. Visas are a complicated subject. Here in Thailand there are entire websites explaining all of the different types, pros and cons.

Billy, yes, I think I got confused on my language. What I was talking about was that a US or EU citizen can just show up at most countries as a tourist, and get a 30 to 90 day entry visa. For residents of the developed world, there is a whole application process to go through for this privilege. For instance, I can just show up at the Rome airport and get in, no problem. My Indian friend must go through a complicated pre-approval process that takes a minimum of four weeks after the torturous paperwork has been submitted.

I was assuming the original poster was talking about traveling, not living in a foreign country. I agree that getting a residence type visa for a foreign country is always a headache, even for an American

Kramer

[taxmar1]

Kramer, I travel overseas ALOT with my BCBS policy (the one we were discussing in the other thread), and it covers me for as long as i want. But I"m charged "out of network" prices, which means i'm responsible for 40% of charges, as opposed to 20% if i was using in-network docs in the US. And, "out of network" also means higher deductible. But it's good enough to not need to buy travel insurance.

[kramer]

Originally Posted by taxmar1

Kramer, I travel overseas ALOT with my BCBS policy (the one we were discussing in the other thread), and it covers me for as long as i want. But I"m charged "out of network" prices, which means i'm responsible for 40% of charges, as opposed to 20% if i was using in-network docs in the US. And, "out of network" also means higher deductible. But it's good enough to not need to buy travel insurance.

Taxmar, thanks for the info. My policy (if I get accepted) will have a $10K out-of-network deductible. But after that, I would be very happy if they covered the expenses. But I don't know if they cover overseas. I guess the deductible is so high that I figure I will be paying out of pocket overseas, anyway.

This is one reason that I prefer high deductible, low premium policy -- I don't have to worry about these difficult reimbursement issues as much. I may also be working overseas for a year or two and have local health insurance coverage in that country. But I will keep my US policy.

Kramer

[Billy]

This is one reason that I prefer high deductible, low premium policy -- I don't have to worry about these difficult reimbursement issues as much. I may also be working overseas for a year or two and have local health insurance coverage in that country. But I will keep my US policy.

Where will you be working, Kramer?

We feel basically the same way as you mentioned above, finding most local health care/insurances to be adequate and affordable.

Be well,
Akaisha
Author, The Adventurer's Guide to Early Retirement

[kramer]

Where will you be working, Kramer?

HI Billy, My current plan is to try teaching English overseas (75% chance, anyway). But I have not decided where yet. I plan to take a long trip to Asia starting later this year, and check out some possible locations in person When I return, I would take an intensive one month certification course, and then head back to try out some teaching. South Korea and Taiwan seem to have the most and best paying opportunities. I haven't ruled out my beloved Mexico, either

Kramer

[Billy]

Sounds like a good plan, Kramer.

We meet English teachers here in Thailand all the time. Some are simply passing through on to their next assignment (Philippines, S. Korea, China) or others have actually taught right here in town.

Seems like a pretty good way to see a country and get involved in the culture. Don't forget the advantages of private teaching -- businesses would really like that I believe.

Another friend of ours is a math wiz and he said the Thai schools were 'bidding' on his math services!

I don't know that you would need to carry health insurance here in Thailand... so affordable... Don't know about the other countries.

Good luck!
Akaisha
Author, The Adventurer's Guide to Early Retirement

[Billy]

OOOPs -- Kramer I forgot to mention that we have a friend who runs a school for teaching English in Southern Taiwan. If you are interested in his name and email, PM us and I'll give you that info.

Be well,
Akaisha
Author, The Adventurer's Guide to Early Retirement

[kramer]

Thanks, Akaisha

Another friend of ours is a math wiz and he said the Thai schools were 'bidding' on his math services!

I am a math guy, too (BS Physics, MS Electrical Engineering) so maybe I should think about that!

My approach is to get a few months of experience under my belt and meet some people. And then to think about other kinds of opportunities (like private teaching). My main motivation is to get more engaged in the culture of where I am working. From the ESL internet boards, there are opportunities to teach other subjects that come from originally teaching English.

In the more prosperous places, like Korea and Taiwan, there is actually some pretty serious money in private teaching (although it is not legal in either country, most teachers do it).

Kramer I forgot to mention that we have a friend who runs a school for teaching English in Southern Taiwan. If you are interested in his name and email, PM us and I'll give you that info.

Thanks, Akaisha. After I have my certificate and if I decide to teach in Taiwan (a definite possibilty), I will definitely contact you about this

My family is excited about my travels, too. My mom and my cousin want to fly over and join me when I am traveling through Thailand and Malaysia. So many places . . . so little time.

Kramer

[Billy]

Kramer

I am a math guy, too (BS Physics, MS Electrical Engineering) so maybe I should think about that!

Hi Kramer -- I don't wanna hijack this thread, but yes, absolutely, think about teaching math(s). Like I said, our friend was conducting 'bidding wars'! You are never going to get rich - money wise - doing this teaching at a school, but you will make lifetime contacts and affect lives. That is something worthwhile, and you never know where those contacts will lead in your life. Schools and institutions don't pay the same rates as in the States, you know.

In the more prosperous places, like Korea and Taiwan, there is actually some pretty serious money in private teaching (although it is not legal in either country, most teachers do it).

Right. When I was teaching English in Mexico, I donated my services because I didn't have papers. But I was stopped often by business men and women who wanted to learn 'business English' so they could get a one-up in the world.

We knew teachers who supported themselves very well on this private tutoring.

Good luck!
Akaisha
Author, The Adventurer's Guide to Early Retirement

[Tracy42]

Originally Posted by taxmar1

Kramer, I travel overseas ALOT with my BCBS policy (the one we were discussing in the other thread), and it covers me for as long as i want. But I"m charged "out of network" prices, which means i'm responsible for 40% of charges, as opposed to 20% if i was using in-network docs in the US. And, "out of network" also means higher deductible. But it's good enough to not need to buy travel insurance.

The BCBS Association has a website accessible by members (requires your ID number) with a listing of participating international hospitals and doctors. https://international.worldaccess.co...asp?page=login

Additionally, if you arrange (precert) hospitalizations through the "Blue Card Worldwide Service Center" also referenced in the above link, they treat the hospitalization as in network and and the claim gets filed for you. Might be worth checking out before your next trip. Tracy

[taxmar1]

Wrong. When you're outside the US, you're always out of network. (but I can see how someone can be confused by the issue, since the BCBS site lists a few hospitals in various countries, making it look like they might be "in network"---but in fact, those are only ones that BCBS "has some familiarity" with and some "previous experience" with. All out of network. Call anyone at BCBS and they'll tell you there is no "in-network" outside the US.

[mykidslovedogs]

Originally Posted by taxmar1

Wrong. When you're outside the US, you're always out of network. (but I can see how someone can be confused by the issue, since the BCBS site lists a few hospitals in various countries, making it look like they might be "in network"---but in fact, those are only ones that BCBS "has some familiarity" with and some "previous experience" with. All out of network. Call anyone at BCBS and they'll tell you there is no "in-network" outside the US.

Actually, you are not correct on that. With Blue Cross individual plans, you do have some worldwide network coverage. Here is the link:

http://www.bcbs.com/coverage/types/

"For inpatient care at a BlueCard Worldwide® hospital that was arranged through the BlueCard Worldwide Service Center, 1.800.810.BLUE (2583), you only pay the provider the usual out-of-pocket expenses (non-covered services, deductible, co-payment and co-insurance). The provider files the claim for you."

I see what you mean though, the benefits may be paid differently than they are paid on your regular plan as per the small print, especially if you don't utilize the correct channels for claims filing.

[Helena]

Originally Posted by taxmar1

Kramer, I travel overseas ALOT with my BCBS policy (the one we were discussing in the other thread), and it covers me for as long as i want. But I"m charged "out of network" prices, which means i'm responsible for 40% of charges, as opposed to 20% if i was using in-network docs in the US. And, "out of network" also means higher deductible. But it's good enough to not need to buy travel insurance.

FYI

Check with your local plan - out of network services
for a medical emergency diagnosis within 48 hours
of onset of the condition would probably pay network
benefits.