Living abroad 3-6 months at a time?

[explanade]

Thank you, such a nondescript acronym.

 

[obgyn65]

Hello Alan - it is my understanding IMG also offers long term medical coverage worldwide (not only travel insurance) for those who spend 6 months abroad.

International Medical Group for travel insurance.

 

[Alan]

Thank you, such a nondescript acronym.

Google is your friend (I had never heard of that particlar TLA either)

Hello Alan - it is my understanding IMG also offers long term medical coverage worldwide (not only travel insurance) for those who spend 6 months abroad.

Thanks for the follow-up. (I didn't read all the weblink in depth, just trying to find out what IMG stood for.)

It looks like a good resource to explore for long term international stays. Do you have personal experience with the company on your long trips?

 

[explanade]

So what would you do, if you're not under Medicare, you'd drop whatever personal insurance you have and get one of these travel international policies for the months you're abroad?

Problem is it's not so easy to go in and out of insurance coverage in this country with issues about preexisting conditions and so forth. If you're grandfathered into a policy and you develop a chronic condition, you don't want to drop the policy for the times when you're out of the country.

 

[Alan]

So what would you do, if you're not under Medicare, you'd drop whatever personal insurance you have and get one of these travel international policies for the months you're abroad?

Problem is it's not so easy to go in and out of insurance coverage in this country with issues about preexisting conditions and so forth. If you're grandfathered into a policy and you develop a chronic condition, you don't want to drop the policy for the times when you're out of the country.

When we lived in the UK last year for 7 months I'm sure we could have bought much cheaper insurance, but there was no way I was going to risk dropping my US insurance during that period.

 

[kevink]

Having moved back and forth between the U.S. and Mexico a couple of times in the past few years I'll say that while you certainly don't want to drop U.S. coverage if you have pre-existing conditions that would cause you to be denied coverage down the road, there's certainly no problem with dropping and re-applying otherwise, at least in our limited experience.

World Nomads has already been mentioned and we as well as several friends who've done really extensive way "off the grid" travel (e.g. backpacking for weeks in Borneo, river rafting in Ethiopia) for up to a year at a time have been very happy with their coverages and costs.

From an expat point of view the truly scary prospect isn't "going naked" in Mexico or wherever, but the prospect of returning to the U.S. where costs truly could wipe you out. Pretty much all of the travel policies for expats have two prices: one for "worldwide excluding U.S." which is reasonable, and another much higher price that includes U.S. coverage. Just f.y.i.

 

[Gone4Good]

So what would you do, if you're not under Medicare, you'd drop whatever personal insurance you have and get one of these travel international policies for the months you're abroad?

Problem is it's not so easy to go in and out of insurance coverage in this country with issues about preexisting conditions and so forth. If you're grandfathered into a policy and you develop a chronic condition, you don't want to drop the policy for the times when you're out of the country.

I would never drop my US insurance or exchange it for something like traveler's insurance that may not be guaranteed renewable or cover me for long-term chronic illness. As a US citizen, expensive health insurance is just part of my reality. One that I have to plan for and can't avoid.

With a US policy, I don't feel the need to get secondary travel insurance. I self insure most things anyways because I have a high-deductible policy. I'm really not worried about one-time medical bills of four or even five figures. I have insurance to cover bills in the six and seven figures. And those kind of bills I'll only face in the one place where I absolutely would never "go naked."

 

[obgyn65]

Hello Alan - have you actually read IMG schedule of benefits? It's actually better than other plans I have seen. Access to PPO network in the US and IPAD internationally. The Gold plus option looks pretty good, no coinsurance, deductibles from 250 to 10k. You can get optional riders + coverage for pre-existing conditions. $5M lifetime maximum benefit limit. Annual premium for a 47 year old male , with $2,500 deductible is $1,700 a year. Looks good to me.

When we lived in the UK last year for 7 months I'm sure we could have bought much cheaper insurance, but there was no way I was going to risk dropping my US insurance during that period.

 

[Gone4Good]

Looks good to me.

It does, but it's non-HIPPA and it looks like you're ineligible for coverage or renewal if you're in the U.S. for more than six months per year. So it's probably not a good option for someone who expects to, or even might, return to the U.S.

Eligibility: U.S. citizens must reside abroad or plan to leave the U.S. on their effective date and plan to reside abroad for at least six of the next 12 months.

Renewal of Coverage: You must continue to meet the eligibility requirements outlined above in order to renew.

I know I worry about developing a condition that makes me uninsurable outside my state. I'd like the option to live wherever I want, not where my health insurance policy is. I can't imagine putting myself in the postion where I couldnt return home to the U.S. if I wanted.

 

[obgyn65]

Please check the IMG website and call them. The benefits plan looks good to me for those who live 6 months abroad.

So what would you do, if you're not under Medicare, you'd drop whatever personal insurance you have and get one of these travel international policies for the months you're abroad?

Problem is it's not so easy to go in and out of insurance coverage in this country with issues about preexisting conditions and so forth. If you're grandfathered into a policy and you develop a chronic condition, you don't want to drop the policy for the times when you're out of the country.

 

[Alan]

It does, but it's non-HIPPA and it looks like you're ineligible for coverage or renewal if you're in the U.S. for more than six months per year. So it's probably not a good option for someone who expects to, or even might, return to the U.S.



I know I worry about developing a condition that makes me uninsurable outside my state. I'd like the option to live wherever I want, not where my health insurance policy is. I can't imagine putting myself in the postion where I couldnt return home to the U.S. if I wanted.

Thanks for digging deeper.

I would have the same concerns.

 

[Chuckanut]

What kind of policy and with which company did you get this evacuation coverage?

Typically, medical evacuation is with travel insurance policies.

I got the plan from this place: On Call International - Emergency Medical and Travel Assistance

They call it travel assistance, not travel insurance. I do not know if that is just wording or if there is some legal difference.

I believe it is for trips of 90 days and less, not for long term life as an ex-pat. It is just evacuation insurance, nothing for medical care, lost luggage, cancellation refunds, terrorist attacks, changes in romatic partners, etc.

 

[obgyn65]

Not sure I understand your comment about HIPAA (you mean HIPAA, not HIPPA, correct ?). Why wouldn't your care in the US covered by HIPAA laws and regulations ?

Why wouldn't this coverage be appropriate for someone who wishes to return to the US full time at say age 60 or 65?

Sorry, just trying to understand your comments.

Global Medical Insurance

It does, but it's non-HIPPA and it looks like you're ineligible for coverage or renewal if you're in the U.S. for more than six months per year. So it's probably not a good option for someone who expects to, or even might, return to the U.S.



I know I worry about developing a condition that makes me uninsurable outside my state. I'd like the option to live wherever I want, not where my health insurance policy is. I can't imagine putting myself in the postion where I couldnt return home to the U.S. if I wanted.

 

[Sarah in SC]

I got the plan from this place: On Call International - Emergency Medical and Travel Assistance

They call it travel assistance, not travel insurance. I do not know if that is just wording or if there is some legal difference.

I believe it is for trips of 90 days and less, not for long term life as an ex-pat. It is just evacuation insurance, nothing for medical care, lost luggage, cancellation refunds, terrorist attacks, changes in romatic partners, etc.

Our World Nomads policy had that as part of the coverage. I wanted to have the medical as well, because, well, there are a ton of places we've been and are probably going that you couldn't get evacuated out of unless you were important enough to have a Blackhawk touch down and snatch you out of there!
But I can say that I spent a mind-numbing few days researching policies and finally just gave in to what most backpacker/budget travelers use rather than the bells and whistles favored by many Americans traveling short-term.

 

[Gone4Good]

Why wouldn't this coverage be appropriate for someone who wishes to return to the US full time at say age 60 or 65?

Sorry, just trying to understand your comments.

I'd never say this insurance isn't appropriate for anyone. There are plenty of people who this might just work fine for. But for U.S. citizens the eligibility and rewewal requirements should be carefully considered and disclosed.

With this insurance, if I develop an expensive chronic medical condition, I'm effectively prevented from permanently returning to the US without losing my health insurance. That's a big deal. At least it is to me.

It might be less of a problem for someone a couple years away from Medicare eligibility. I'm 25 years away, and quite likely more. But even if I were 55, I think I'd want to preserve the option of coming back home if I choose.

People change their minds and situations change, sometimes surprisingly quickly. A younger me never dreamed I'd be living the life I am now. I have no idea what I'll be doing five or ten years down the road. The last thing I want to do is make a choice that potentially limits those future options. That doesn't mean this insurance isn't right for anyone. It's just not right for me.

 

[Sarah in SC]

I'd never say this insurance isn't appropriate for anyone. There are plenty of people who this might just work fine for. But for U.S. citizens the eligibility and rewewal requirements should be carefully considered and disclosed.

With this insurance, if I develop an expensive chronic medical condition, I'm effectively prevented from permanently returning to the US without losing my health insurance. That's a big deal. At least it is to me.

It might be less of a problem for someone a couple years away from Medicare eligibility. I'm 25 years away, and quite likely more. But even if I were 55, I think I'd want to preserve the option of coming back home if I choose.

People change their minds and situations change, sometimes surprisingly quickly. A younger me never dreamed I'd be living the life I am now. I have no idea what I'll be doing five or ten years down the road. The last thing I want to do is make a choice that potentially limits those future options. That doesn't mean this insurance isn't right for anyone. It's just not right for me.

I agree with this. The thought of being seriously ill, in another country, and not being able to come "home", is a total freak-out for me. I'm okay with dealing with acute situations (I think), but I keep remembering that girl on the Mototaxi Junket who wound up with an emergency appendectomy in Pisco (a fairly small city south of Lima, Peru). You think she didn't want to get home ASAP after that? Whew!

 

[Surewhitey]

When living abroad, you're probably going to make acquaintance with a couple lawyers and learn about their healthcare system in the first few months. Not too much different than the states. Then find a GP who can help you through the process of the possibility of a major problem.

We also have a hospital liason group in our area who assist in many ways free to the congregations here in our religious organization.

Also the out of pocket costs are minimal and the health insurance is very reasonable if you go that way.

 

[Gone4Good]

When living abroad, you're probably going to make acquaintance with a couple lawyers and learn about their healthcare system in the first few months. Not too much different than the states. Then find a GP who can help you through the process of the possibility of a major problem.

Sure. Some people effectively relocate overseas, building a network of friends and acquaintances. For them, home is abroad. If they get sick, they have their support network on hand, a relationship with a GP, and fluency in the local language. The insurance described sounds perfect for them (although I'd still be wary of giving up my option to return to the US with health insurance).

For others, like me, "abroad" means travel; sampling different regions, countries and cultures. If we settle anywhere for any length of time we don't intend it to be permanent. Our friends and family remains in our home country. If either one of us gets seriously ill, we'll be back to the U.S. as soon as we're able to fly because that is where our support network resides. Maybe we could change that with time, but that is a hard thing to do and one best not planned on in advance.

 

[kcowan]

We were looking for a shorter period like ~2 weeks but the best deals seemed to be for 4 adults in an apartment. So maybe best for 2 compatible couples. I think occasionally a new listing will pop up and be grabbed if it's really a good price.

We would up just staying in a hotel in the Rue Cler for 115 Euros/night.

We did Rue Cler for 2 nights, then (after my bucket list trip to Normandy) returned to Marais for a condo with another couple for a week. It was VRBO and worked fine: owned by a couple from Irleand and totally remodelled about 5 years ago.

Then we did VRBO again in Nice with the same couple after we separated to see different parts of France.

 

[obgyn65]

Hello Gone4Good. I understand your concern, but please could you let me know what about IMG worldwide coverage (e.g. US included) makes you believe that if you develop an expensive chronic medical condition, you are effectively prevented from permanently returning to the US ? There is no discontinuity of coverage as far as I am aware (as long as you continue to pay your annual premiums).

With this insurance, if I develop an expensive chronic medical condition, I'm effectively prevented from permanently returning to the US without losing my health insurance. That's a big deal. At least it is to me.

 

[Gone4Good]

Hello Gone4Good. I understand your concern, but please could you let me know what about IMG worldwide coverage (e.g. US included) makes you believe that if you develop an expensive chronic medical condition, you are effectively prevented from permanently returning to the the US ? There is no discontinuity of coverage as far as I am aware (as long as you continue to pay your annual premiums).

You're only eligible for coverage and for renewal of coverage if you spend six months or more out of the US every year. That pretty much prevents you from permanently returning to the US and keeping your IMG insurance. That is true regardless of whether you're sick or healthy, but is obviously a bigger issue if you're sick.

Eligibility: U.S. citizens must reside abroad or plan to leave the U.S. on their effective date and plan to reside abroad for at least six of the next 12 months.

Renewal of Coverage: You must continue to meet the eligibility requirements outlined above in order to renew.

 

[obgyn65]

Sorry I was not clear. Someone in his/her 40s could theoretically travel 6 months a year until the age of 65, pay annual his/her IMG premiums for coverage (i.e. to cover diabetes type 2 treatment for example starting in his/her 50s) and return to the US permanently when Medicare starts. Correct ?

You're only eligible for coverage and for renewal of coverage if you spend six months or more out of the US every year. That pretty much prevents you from permanently returning to the US and keeping your IMG insurance. That is true regardless of whether you're sick or healthy, but is obviously a bigger issue if you're sick.

 

[Gone4Good]

Sorry I was not clear. Someone in his/her 40s could theoretically travel 6 months a year until the age of 65, pay annual his/her IMG premiums for coverage (i.e. to cover diabetes type 2 treatment for example starting in his/her 50s) and return to the US permanently when Medicare starts. Correct ?

Yes, of course they could.

Once they've decided to go that route, our 40 year old may discover within the next two and one half decades:

1) Medicare eligibility has been dramatically altered
2) He can no longer afford to travel six months of every year
3) He's become too sick to travel six months of every year
4) His mother has become very ill and he wants to be home to take care of her
5) He's met a girl who wants to settle down in the states
6) He just doesn't feel like traveling any more

Now it's certainly reasonable that our 40 year old would consider everything that could potentially go wrong with his plan, and decide that they're all low probability events that are worth risking. Terrific! Bon voyage! My point isn't that it's impossible for a U.S. citizen to make an IMG policy work, it's just that it has specific risks that are worth considering.

 

[Lsbcal]

Maybe I missed it in this thread, does Medicare + a Medicare Advantage program generally give you some overseas coverage on short trips -- maybe up to 1 month?

 

[obgyn65]

Perfect. We agree.

We could also envision a situation where the 40 year old would travel abroad 6 months a year for say 10 years, then buy a good healthcare coverage from UH, BCBS, etc to make sure there is continuity of insurance, then wait for Medicare to kick in.

Yes, of course they could.