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Medicare Benefits Outside the USA
Old 01-04-2013, 02:29 PM   #1
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Medicare Benefits Outside the USA

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?
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Old 01-04-2013, 02:46 PM   #2
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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.
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Old 01-04-2013, 03:06 PM   #3
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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.
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Old 01-04-2013, 03:40 PM   #4
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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.
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Old 01-04-2013, 06:14 PM   #5
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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?
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Old 01-04-2013, 11:36 PM   #6
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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.
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Old 01-05-2013, 06:48 AM   #7
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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.
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Old 01-05-2013, 08:57 AM   #8
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Yes. This is one of the reasons why I keep my EU passport too as I plan to spend time there when I FIRE.

Quote:
Originally Posted by MichaelB
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.
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Old 01-05-2013, 09:08 AM   #9
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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.

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Old 01-05-2013, 11:28 AM   #10
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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.
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Old 01-05-2013, 11:52 AM   #11
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Quote:
Originally Posted by 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?
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.
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Old 01-05-2013, 11:56 AM   #12
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Originally Posted by CoolChange

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.
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Old 01-05-2013, 12:19 PM   #13
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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.
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Old 01-05-2013, 12:27 PM   #14
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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."


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Old 01-05-2013, 12:39 PM   #15
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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.
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Old 01-05-2013, 10:07 PM   #16
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Originally Posted by Purron View Post
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.
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Old 01-07-2013, 09:06 AM   #17
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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.
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Old 01-07-2013, 09:24 AM   #18
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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?
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Old 01-07-2013, 09:29 AM   #19
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$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.
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Old 01-07-2013, 09:39 AM   #20
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$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.
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