Medicare Benefits Outside the USA

[Purron]

A friend of mine and his wife would like to travel and possibly retire abroad. He's concerned about not being able to use Medicare outside the USA and thinks this should change. I confirmed the lack of Medicare benefits outside the USA on the State Department website here:

Federal Benefits and Federal Agency Services for American Citizens Abroad

I told him this is likely due to the potential for increased Medicare fraud which, as we all know, is a huge problem now. Is this the reason Medicare isn't available outside the USA? What options are available for health coverage for American citizens traveling and/or retiring abroad?

 

[westcoast]

Some MC supplements will cover a percentage of medical expenses incurred while traveling abroad, though there is a limit. Others may be able to advise whether this Medigap coverage applies while living abroad.

 

[MichaelB]

Insurance everwhere in the world is domestic and provides only limited extra-territorial coverage. The only countries I am aware of that provide coverage to visitors do so through treaties that are based on reciprocal coverage. Vacationers and short term travelers can get policies in their home base to cover medical expenses across their travel destination, and people intending long term stays need to get local coverage at their destination. Many countries have private or public insurance options.

Medigap F provides coverage outside the US but only limited, emergency care.

 

[donheff]

MichaelB has it right. Travelers coming here from countries with national health plans get travelers health insurance. I assume some foreign business travelers have global coverage as do many of us through employer plan. But once on Medicare we need to look toward our supplemental coverage or travel insurance for coverage abroad. Even on a good employer based plan you need to carefully check coverage. When I go on Medicare I will keep (and continue to pay for) my Federal insurance as a supplemental plan - it covers overseas travel.

 

[Purron]

Insurance everwhere in the world is domestic and provides only limited extra-territorial coverage. The only countries I am aware of that provide coverage to visitors do so through treaties that are based on reciprocal coverage. Vacationers and short term travelers can get policies in their home base to cover medical expenses across their travel destination, and people intending long term stays need to get local coverage at their destination. Many countries have private or public insurance options.

Medigap F provides coverage outside the US but only limited, emergency care.

Thanks MichaelB. Very useful. What countries, if any, do provide coverage under their national health care plans to citizens traveling or living overseas?

 

[brewer12345]

Some MC supplements will cover a percentage of medical expenses incurred while traveling abroad, though there is a limit. Others may be able to advise whether this Medigap coverage applies while living abroad.

Almost 3 years ago, dad fell on vacation in Mexico and ended up with a concussion, bleeding in the brain, etc. He ended up in an intensive care unit for a few days and a regular room for a week or so. My parents never thought about coverage outside the US. Mom ended up calling me for help in figuring out how to pay the hospital and basically she just got the debit card linked to their large taxable account turned on to a full blast spigot for a short period of time. I think the final tally was $18k (would have been a million in the US). They were able to recover most of that from Dad's medicare advantage plan. The flip sid eto a lack of coverage outside the US is vastly lower medical costs in most of the rest of the world.

 

[MichaelB]

Purron, I don't know. A family member living in Austraila says they are covered in some European countries, and a European family member says they can get healthcare anywhere in the EU. No such luck for us in the US.

Brewer makes a good point, which is in many countries the cost is much lower for urgent and emergency care.

 

[obgyn65]

Yes. This is one of the reasons why I keep my EU passport too as I plan to spend time there when I FIRE.

a European family member says they can get healthcare anywhere in the EU. No such luck for us in the US.

Brewer makes a good point, which is in many countries the cost is much lower for urgent and emergency care.

 

[Meadbh]

Purron, I don't know. A family member living in Austraila says they are covered in some European countries, and a European family member says they can get healthcare anywhere in the EU. No such luck for us in the US.

Brewer makes a good point, which is in many countries the cost is much lower for urgent and emergency care.

Yes, but you must be resident in Europe to get the EHIC card.

Applying for a card - Employment, Social Affairs & Inclusion - European Commission

 

[CoolChange]

Thanks MichaelB. Very useful. What countries, if any, do provide coverage under their national health care plans to citizens traveling or living overseas?

Just some quick personal observations that might be interesting:

• I believe Panama still covers tourists, actually anyone, for the first 30 days they are in the country.
• New Zealand seems to provide free coverage to anyone in that country at least for emergencies. I am not sure what their official policy is; but, that seems to the current actual practice.
• Mexico does not provide this kind of coverage to my knowledge; but, the healthcare is inexpensive enough that I have just paid out of pocket without attempting to get reimbursement from my USA based medical insurance. (Fortunately, I have not had serious issues requiring expensive procedures.)
• I do not believe the UK provides any kind of free coverage to tourists from the USA as they do for tourists from many other countries.

 

[nun]

A friend of mine and his wife would like to travel and possibly retire abroad. He's concerned about not being able to use Medicare outside the USA and thinks this should change. I confirmed the lack of Medicare benefits outside the USA on the State Department website here:

Federal Benefits and Federal Agency Services for American Citizens Abroad

I told him this is likely due to the potential for increased Medicare fraud which, as we all know, is a huge problem now. Is this the reason Medicare isn't available outside the USA? What options are available for health coverage for American citizens traveling and/or retiring abroad?

Many US citizens that retire abroad continue to pay Medicare insurance so they can return to the US for health care. If they can become resident in a foreign country they might well also qualify for local health insurance which is usually far less expensive that in the US.

 

[nun]

Just some quick personal observations that might be interesting:


[*]I do not believe the UK provides any kind of free coverage to tourists from the USA as they do for tourists from many other countries.

All emergencies are treated in the UK at no cost to the patient.

 

[george76]

a European family member says they can get healthcare anywhere in the EU.

Correct me if I'm wrong, but my understanding is that yes, they can healthcare anywhere in the EU. However, it mainly covers care in case of an accident or sudden illness. It wouldn't cover ongoing care.

 

[Meadbh]

Correct me if I'm wrong, but my understanding is that yes, they can healthcare anywhere in the EU. However, it mainly covers care in case of an accident or sudden illness. It wouldn't cover ongoing care.

Quote:

"How does it work?
When you show your EHIC, you will receive treatment under the same conditions and at the same cost (free in some countries) as people insured in that country. Be aware that each country’s healthcare system is different. Services that cost you nothing at home might NOT be free in another country."

European Health Insurance Card - Employment, Social Affairs & Inclusion - European Commission

 

[george76]

Quote:

"How does it work?
When you show your EHIC, you will receive treatment under the same conditions and at the same cost (free in some countries) as people insured in that country. Be aware that each country’s healthcare system is different. Services that cost you nothing at home might NOT be free in another country."

European Health Insurance Card - Employment, Social Affairs & Inclusion - European Commission

From your link:
A free card that gives you access to medically necessary, state-provided healthcare during a temporary stay in any of the 27 EU countries, Iceland, Lichtenstein, Norway and Switzerland.

 

[Nords]

A friend of mine and his wife would like to travel and possibly retire abroad. He's concerned about not being able to use Medicare outside the USA and thinks this should change. I confirmed the lack of Medicare benefits outside the USA on the State Department website here:
What options are available for health coverage for American citizens traveling and/or retiring abroad?

Like Brewer says, it's cheaper to pay out of pocket than it is to fret about Medicare or Medicare supplemental insurance. Read Billy & Akaisha Kaderli's website about her recent finger injury, or the medical stories from their readers.

My spouse gets her dental checkups/cleaning in a Bangkok department store. When you add in the round-trip plane tickets it's about the same price that we'd pay in the U.S.

If your friend is really worried then he might want to buy insurance for air medevac back to the U.S. If he's diving then he should have DAN insurance for recompression chamber treatment. And if he's bungee jumping then... well, maybe he should wear a helmet camera.

 

[nun]

Like Brewer says, it's cheaper to pay out of pocket than it is to fret about Medicare or Medicare supplemental insurance. Read Billy & Akaisha Kaderli's website about her recent finger injury, or the medical stories from their readers.

Most US citizens who retire abroad should carefully consider whether to start paying Medicare when they reach 65 because for each year they don't pay the premium increases by 10% should they ever want to get back into Medicare. So only stop paying if you are certain that you're leaving the US for good and have adequate foreign coverage.

 

[george76]

Most US citizens who retire abroad should carefully consider whether to start paying Medicare when they reach 65 because for each year they don't pay the premium increases by 10% should they ever want to get back into Medicare. So only stop paying if you are certain that you're leaving the US for good and have adequate foreign coverage.

This might be a stupid question. I tried to google it and search on our forums here. But I get confused as to what actually needs to be paid. What is the current premium for a 65-year old? I get confused with Premium part A, B,C,D.

In other words, if I lived abroad and I think one day I want to move back to the US and get into Medicare, what should I count in paying each year (or month) in premium?

 

[REWahoo]

$104.90/mo beginning this month, unless your modified gross income exceeds $85,000 ($170,000 for a couple). Medicare Part B Premiums Increase Slightly in 2013

This is the premium for Part B. You paid your Part A premiums through a payroll tax while working.

 

[george76]

$104.90/mo beginning this month, unless your modified gross income exceeds $85,000 ($170,000 for a couple). Medicare Part B Premiums Increase Slightly in 2013

This is the premium for Part B. You paid your Part A premiums through a payroll tax while working.

Thank you! So about $1200. Not too bad.

 

[theOAP]

Many US citizens that retire abroad continue to pay Medicare insurance so they can return to the US for health care.

Some may, but we simply take out travel insurance when going back to the US. It's far, far less expensive than $1,200 a year. And yes, the (US) coverage is quite good. The spouse has had cancer and DVT's, so we purchase from a specialist provider. It includes medical repatriation to the home country. Basic travel policies here always carry a significantly higher premium if the travel is to include the US.

I'm covered by Medicare Part A. The reason I made sure I had the card, even though I live abroad (it's worthless here), was to ensure I could get through the US hospital doors in the first place!

Although, as you point out, there can be problems:
If I were ever to return to the US as a full time resident, I'll have much, much larger premiums to pay.

I have two travel insurance policies, one as mentioned above, and one free from my bank due to a higher level account. The first policy will increase yearly by larger amounts once I reach 70. The second policy (with the bank) will be terminated by the bank once I reach 70.

 

[nun]

Some may, but we simply take out travel insurance when going back to the US. It's far, far less expensive than $1,200 a year. And yes, the (US) coverage is quite good. The spouse has had cancer and DVT's, so we purchase from a specialist provider. It includes medical repatriation to the home country. Basic travel policies here always carry a significantly higher premium if the travel is to include the US.

I'm covered by Medicare Part A. The reason I made sure I had the card, even though I live abroad (it's worthless here), was to ensure I could get through the US hospital doors in the first place!

Although, as you point out, there can be problems:
If I were ever to return to the US as a full time resident, I'll have much, much larger premiums to pay.

Surely you aren't currently covered by any parts of Medicare if you are not paying Part B. If you moved to the US you could apply to pay B and then A would kick in too.

 

[theOAP]

Surely you aren't currently covered by any parts of Medicare if you are not paying Part B. If you moved to the US you could apply to pay B and then A would kick in too.

According to the Federal Benefits Unit at the Embassy, yes, I am when in the US. Thankfully, I've not had to test the system,...yet. I trust your knowledge enough to know you wouldn't make a rash statement without some reasoning. Why do you doubt the coverage when in the US?

Edited to add: I am talking about the availability of PART A only.

 

[TrvlBug]

Surely you aren't currently covered by any parts of Medicare if you are not paying Part B. If you moved to the US you could apply to pay B and then A would kick in too.

You do not need Part B to be covered by Part A, hospital coverage. DH just turned 65, is still working so is covered by his employer's insurance. We were advised by the SSA to sign up for Part A anyway so that Medicare hospital coverage becomes secondary to his employer's primary. Very unlikely he'll need it, but you never know.

When he retires, he'll sign up and pay the additional premium for Part B.

 

[kramer]

I am retired in the Philippines and I no longer have USA health insurance. However, after I am 65 (still 18 years away), one option I hope to have (if I am still retired in this region) is that I could use Part A Medicare in Guam. It is about a 3.5 hour flight.

I might use it if it were something very expensive and the price of the care, partially reimbursed by Part A Medicare, would be around the same or less that I would pay in cash at a high quality private hospital in a different country.

Of course, one would probably encounter the same issues we have now for cash payers in the USA system. How much will my medical procedure cost? Well, we have no idea sir.

The way pricing works in many private hospitals abroad is that you will receive a quote for the 25th and 75th percentile for people with your condition.