Pros and Cons of Living in Thailand vs. the USA for older Americans

[Jingthing]

Many older Americans on this forum are considering retiring in Thailand which they can do visa-wise as early as age 50. Many others are already living in Thailand, either briefly or for several years or even decades. Others are considering repatriating back the the USA.

 

There are many pros and cons of the Thailand vs. the USA decision for older Americans. Many of the issues are very specific to individuals, but not all. Many of the issues would be similar for people from other nations vs. the USA, but not all.

 

That's why I thought this topic may have value. There are specific USA issues that impact on this decision for older Americans. For example, Medicare. Useless in Thailand, but not exactly free in the USA either as a large portion of older Americans spend a significant percentage of their income for out of pocket medical expenses even while on Medicare (and additions). 

 

Why limit it to older Americans? Let's face it, concerns of older people are very different than people moving here in their 20's. 

 

These issues are a moving target. Conditions in Thailand change. Conditions in the USA change. Your personal situation changes as well.

 

I think there is enough "meat" here to make this thread a thing. But we shall see.

 

Caveat -- by no means is this a political debate thread. There are always threads on Thaivisa to debate U.S. politics. But that doesn't mean that the content here has to be totally castrated either. When there are government policy changes happening in the USA (or potential ones) that impact on this topic, they are fair game to mention, regardless of whether you agree with the changes or not. 

Edited January 27, 2018 by Jingthing

[wwest5829]

Having had heart issues, I found this greatest health concern made insurance coverage cost prohibitive and excluded "pre-existing conditions". And so I am "self insured". I have kept paying the $109.00 monthly Medicare Premium in the US "in case" but with the existing system requiring ever greater "co-pays" and (sorry but it is pertinent), the Republican threat looming over Medicare, I am in need of a closer look at whether continuing to look at Medicare as a "back-up" as anything viable. That $109.00 per month could pay for my monthly medications.

[XDoodlebugger]

15 minutes ago, wwest5829 said:

Having had heart issues, I found this greatest health concern made insurance coverage cost prohibitive and excluded "pre-existing conditions". And so I am "self insured". I have kept paying the $109.00 monthly Medicare Premium in the US "in case" but with the existing system requiring ever greater "co-pays" and (sorry but it is pertinent), the Republican threat looming over Medicare, I am in need of a closer look at whether continuing to look at Medicare as a "back-up" as anything viable. That $109.00 per month could pay for my monthly medications.

 

The Medicare issue will need addressed, the "kick the can down the road" has been going on for far too long but any changes will be for the new generations to worry about. Those of us at or near retirement age should not see that great of a deviation with any party in control, it is political suicide to do otherwise. 

 

[Pinot]

I think of my little Phuket beach town as a retirement community with Thai girls. You can live very well here on $3000/month. SS fulfills that half that nut. There is no place in America where I can live as well as I do here. A beautiful young Thai wife, good friends, I'm living the life. 

 

Having done well in the market I'm now traveling in April and May. I've found the Algarve to be perfect getaway for a month and checking out Greece as well this time around. 

 

Changing conditions? The USD/Baht situation is becoming more of an issue. I hope the $ will improve this year. 

 

I've been here 8 years. I wasn't happy with my trip back to the Bay Area last year. I felt like a duck out of water and was glad to return to LOS after a couple of weeks. $140 a night at Motel 6? See ya. 

[Jingthing]

There is no doubt that bang for the buck/baht-wise Thailand will win over the USA overall quite easily, generally speaking.

But even with that, there are exceptions.

For example an older expat with uninsurable medical problems could rather easily be financially ruined in Thailand, but in the USA with Medicare, even though not close to free as far as out of pocket expenses, might ultimately be better off from a survival POV back home. 

 

The harsh reality is this choice to leave the USA as an older American can have really significant consequences. On long term financial health, on literal health, and even on life span. 

Edited January 30, 2018 by Jingthing

[1FinickyOne]

38 minutes ago, Jingthing said:

There is no doubt that bang for the buck/baht-wise Thailand will win over the USA overall quite easily, generally speaking.

But even with that, there are exceptions.

For example an older expat with uninsurable medical problems could rather easily be financially ruined in Thailand, but in the USA with Medicare, even though not close to free as far as out of pocket expenses, might ultimately be better off from a survival POV back home. 

 

The harsh reality is this choice to leave the USA as an older American can have really significant consequences. On long term financial health, on literal health, and even on life span. 

I think that there are more than a few elderly in USA who are struggling with basic cost and style of living. Meds, lodging, food, car and insurance, the list goes on. My parents last few months on earth were spent in a nice nursing home which at ten thousand dollars a month each was probably a bargain.

 

Be it here there or anywhere, being ill with out the funds is a horror. 

[Jingthing]

Absolutely, but I just want to inject the thought that the calculation isn't quite as simple and obvious as it might seem when things are going swimmingly. Especially long term when sheit happens, as it tends to eventually do. 

[XDoodlebugger]

12 minutes ago, Jingthing said:

Absolutely, but I just want to inject the thought that the calculation isn't quite as simple and obvious as it might seem when things are going swimmingly. Especially long term when sheit happens, as it tends to eventually do. 

Yes, a very good friend of mine retired in Thailand in 2015 and was using social security to fund it, by 2016 he was in a hospital and ran through his savings and had to rely on family and friends for the bills. A terrible position to be in, especially as he was a veteran and could have both medicare and Veterans Administration healthcare back in the US. Passed away not too long after the hospital stay. 

[JimGant]

Quote

That $109.00 per month could pay for my monthly medications.

It's more than that, beginning this year. Unless you've got a modified gross income (modified with such things as tax exempt income) of more than $85,000 single, this year's medicare premium will be up to $134 (or $109 plus whatever your cola raise was). This certainly promises to continue upwards. Fortunately, for the many retired military here (including reservists), this medicare premium pays for Tricare Overseas medical coverage, which is still a huge bargain (but probably for not too much longer).

 

And, while decent long term care costs in the US are pretty exorbitant (unless you began paying premiums early on), self financing for diaper changers, plus necessary medical house calls, is certainly affordable for many of us here. We even planned for our long term care by over-building on our property, allowing for live-in caretakers. My townhouse in DC certainly wasn't up to that, let alone the cost of any live in caretakers.

 

Nope. Don't miss anything in the US -- except maybe a decent steak at a decent price. And, unless the dollar completely tanks (doubtful), should remain content with our decision to move here to the end.

[Jeffrey346]

23 minutes ago, XDoodlebugger said:

Yes, a very good friend of mine retired in Thailand in 2015 and was using social security to fund it, by 2016 he was in a hospital and ran through his savings and had to rely on family and friends for the bills. A terrible position to be in, especially as he was a veteran and could have both medicare and Veterans Administration healthcare back in the US. Passed away not too long after the hospital stay. 

I thought US Veterans get insurance reimbursement anywhere. Is that not the case?

[XDoodlebugger]

10 minutes ago, Jeffrey346 said:

I thought US Veterans get insurance reimbursement anywhere. Is that not the case?

Wasn't the case with my friend.

[Jeffrey346]

Healthcare expense can bankrupt anyone without insurance no matter where they live.

The issue here in Thailand is the quality of medical care. Almost 3 years ago I had a heart attack. They used paddles to revive me twice. The hospital doctors and staff did save my life, but their follow up care almost killed me.

I was released from the hospital with a bag full of meds and tols to come back in 6 weeks for a follow up.

After 4 days I was back in the emergency room as I just didn't feel well and was dizzy all the time.

Well, they gave me Dramamine and sent me home.

I did some research and found out who is the best Cardiologist in the NE. I got an appointment, he did a very comprehensive exam and told me I have a blood clot in my heart and need a second stent which was done while I was there. The clot was managed with meds and today I feel great.

Now for the cost.. The initial heat attack and second stent cost over B500,000. That could be a huge expense for most people. Myself included.

Fortunately, my wife works for the Government and my out of pocket expense was under B3000.

[Jingthing]

If staying in the U.S. or repatriating, this information is definitely of concern especially for those that will be relying mostly (or only) on their social security check for income. I think many younger people make the false assumption that Medicare is basically nationalized "free" healthcare but only for people over 65. But it isn't.

 

On comparing to Thailand, given the high cost of even these out of pocket medical expenses, is it possible for many older Americans, living in Thailand "self insuring" might be a wiser move financially? I suppose the answer is yes sometimes depending on what happens to you personally. 

 

 

Quote

 

Out-of-pocket health-care costs likely to take half of Social Security income by 2030, analysis shows

A new analysis by the Kaiser Family Foundation has found out-of-pocket health-care costs for Medicare beneficiaries are likely to take up half of their average Social Security income by 2030.

As many seniors already know, Medicare does not cover an increasing number of expenses related to health care. Among these are supplemental insurance premiums, deductibles, long-term care and dental services.

Many Medicare recipients need to prepare for a big chunk of their income to be consumed by these out-of-pocket costs, according to Kaiser, a nonpartisan, nonprofit group that analyzes health-care issues.

 

 

 

http://thewiredjournal.com/out-of-pocket-health-care-costs-likely-to-take-half-of-social-security-income-by-2030-analysis-shows/

 

Edited January 30, 2018 by Jingthing

[Suetape]

Two different situations.  Just being a veteran does not; however, retired military with a military pension does.  

[malibukid]

very eZ life style here in LOS, but not a great place to have a romantic relationship compared to California with great weekend romantic escapes to SF, Palm Springs, Maui, Sadona. ect, and of course the L.A. club/parties/concerts and restaurant scene.  but do not miss the traffic, dry cleaners, parking, diner reservations. traffic, traffic.

but LOS close to much more interesting places, i.e. India, Bali, Vietnam with vastly more interesting cultures.  miss little things like my Cliff Bars and great Mexican food.  great if you are an older single guy who loves to travel.  

seen the Stones enough times. done.

 

Edited January 30, 2018 by malibukid

[thrilled]

There are pros and cons of living in both countries.In the US nearly everyone has central air.The house is at the same temperature.In Thailand whatever room that has the air conditioner is cool if it’s turned on.In Thailand if you live in the city and take walks the smell can get really bad.Also many streets areas have trash.They look really bad.If you’r not careful some of the soi dogs will bite you.Transportation 

most likely A songthew or A tuk tuk.Not very enjoyable.Don’t get me wrong plenty 

of undesirable things about the US also.

[sanmyn]

I moved full time to Thailand in 1995. I am now 82 years old. I have been lucky medical wise, as I have never been sick in Thailand. Medicare is deducted from my SS and I pay Blue Cross Antham $550 a month for up to 1M coverage over Medicare. Yeah, foolish I think as coverage outside the US is nil. I think of it as backup insurance but I know I should drop it. 

The weather here is a big factor for me. I love the warmth. SF just became too cold; I keep my condo there but seldom return. I live in Naklua, near Pattaya and now have several friends here. I enjoy my life here and would not return to the States. Living cost is a fraction of San Francisco. 

[newnative]

     For my partner and myself, the pros of living here far outweigh the cons.  We can live far better here on my SS and state pension than we could in the USA.  Looking down the road, we have just bought a condo large enough to provide space for a caregiver--I'm certain that if we reach advanced ages it will be cheaper to pay a live-in caregiver here than to pay for a nursing home in the USA.  

[MyFriend You]

5 hours ago, wwest5829 said:

Having had heart issues, I found this greatest health concern made insurance coverage cost prohibitive and excluded "pre-existing conditions". And so I am "self insured". I have kept paying the $109.00 monthly Medicare Premium in the US "in case" but with the existing system requiring ever greater "co-pays" and (sorry but it is pertinent), the Republican threat looming over Medicare, I am in need of a closer look at whether continuing to look at Medicare as a "back-up" as anything viable. That $109.00 per month could pay for my monthly medications.

This $109 per month you speak of - is that all you are paying for Medicare part B??  If so, I think you should keep it...........a single prescription can cost you lots more.  I only used mine once for a Flu Shot, came to $175.00, I had to pay $16.00............its worth it even if you only visit once or twice a year.

[Mansell]

One of my reasons for leaving the USA was everything was too easy, almost sanitized, and that to me equated with boring. I moved to California from England in the early seventies. The first thing I noticed was you really didn't drop in on somebody, but set things up weeks in advance....never really liked that as it removed the spontaneity of an evening. I could have lived there now, but life became a formula......and I cannot stand doing the same thing every week. I left England when I found myself saying the same thing I said a year ago.......I found that scary. Some people are happy living in a rut, not me. I now have a Thai lady 33 years younger than me with 7 and 11 year old boys. Nothing is boring and life is a constant challenge every day, but gratifying in so many ways. I am very lucky as I am 74 next month and have great health with none of the age related issues most seniors have......just a bit with the eyes to deal with. I cycle many times a week through the rice fields, I play badminton.....would love to play tennis, but not much happening around here with that sport. I couldn't live this life in the States and have so much fun.....and of course costs here are amazingly cheap.....a three bedroom two storey house only five years old for 10,000 baht a month with an option to buy for 2.5 million. Where I lived in Santa Monica it wouldn't buy a two car garage. 555 Living here is a no brainer. How lucky we all are to be here.

[MyFriend You]

1 hour ago, sanmyn said:

I moved full time to Thailand in 1995. I am now 82 years old. I have been lucky medical wise, as I have never been sick in Thailand. Medicare is deducted from my SS and I pay Blue Cross Antham $550 a month for up to 1M coverage over Medicare. Yeah, foolish I think as coverage outside the US is nil. I think of it as backup insurance but I know I should drop it. 

The weather here is a big factor for me. I love the warmth. SF just became too cold; I keep my condo there but seldom return. I live in Naklua, near Pattaya and now have several friends here. I enjoy my life here and would not return to the States. Living cost is a fraction of San Francisco. 

Maybe not so, I have a friend and his wife, both have Blue Cross Blue Shield, they go to Thai Hospitals and just show there card, it is accepted everywhere.      

 

[xyznot]

1 hour ago, thrilled said:

There are pros and cons of living in both countries.In the US nearly everyone has central air.The house is at the same temperature.In Thailand whatever room that has the air conditioner is cool if it’s turned on.In Thailand if you live in the city and take walks the smell can get really bad.Also many streets areas have trash.They look really bad.If you’r not careful some of the soi dogs will bite you.Transportation 

most likely A songthew or A tuk tuk.Not very enjoyable.Don’t get me wrong plenty 

of undesirable things about the US also.

I find songthaws and tuk tuks fine for the price 20 baht and 50 baht respectively or motorcycle taxis 20 baht and an all day car and driver 1000 baht.  20 years here and not a problem with soi dogs although I carry a cane. Transportation 10% of what I'd pay in the USA as I don't like driving anymore.  

[MyFriend You]

3 minutes ago, Mansell said:

One of my reasons for leaving the USA was everything was too easy, almost sanitized, and that to me equated with boring. I moved to California from England in the early seventies. The first thing I noticed was you really didn't drop in on somebody, but set things up weeks in advance....never really liked that as it removed the spontaneity of an evening. I could have lived there now, but life became a formula......and I cannot stand doing the same thing every week. I left England when I found myself saying the same thing I said a year ago.......I found that scary. Some people are happy living in a rut, not me. I now have a Thai lady 33 years younger than me with 7 and 11 year old boys. Nothing is boring and life is a constant challenge every day, but gratifying in so many ways. I am very lucky as I am 74 next month and have great health with none of the age related issues most seniors have......just a bit with the eyes to deal with. I cycle many times a week through the rice fields, I play badminton.....would love to play tennis, but not much happening around here with that sport. I couldn't live this life in the States and have so much fun.....and of course costs here are amazingly cheap.....a three bedroom two storey house only five years old for 10,000 baht a month with an option to buy for 2.5 million. Where I lived in Santa Monica it wouldn't buy a two car garage. 555 Living here is a no brainer. How lucky we all are to be here.

You have been blessed, enjoy Muang Thailand my friend, you deserve it.

[Muzarella]

If Health Insurance is the issue, ask AIA about.... They insure without health exam and pre-existing condition exeptions up to 70 year old, on its cash value program starting about 3000 THB/month payment. The problem to go to the USA to use Medicare if necessary will be only if the problem, like a big accidente, will impede to get a plane to do it.

The only problem for Americans living here is to become  fluent in Thai....Without the language.... everything is more complicated and expensive...and any kind of relationship and/or friendship with a Thai people will suffer.... Anyway..all depends of your expectations... and your standars, here or in the USA.

[MyFriend You]

2 hours ago, Jeffrey346 said:

I thought US Veterans get insurance reimbursement anywhere. Is that not the case?

Closest VA Hospital is in the Philippines - there is another smaller one on Guam, but even they fly to PI for treatment.        VA is only good in the US and its Territories.  

[MyFriend You]

1 hour ago, Suetape said:

Two different situations.  Just being a veteran does not; however, retired military with a military pension does.  

?????  to what are you responding??

[1FinickyOne]

4 hours ago, Jingthing said:

Absolutely, but I just want to inject the thought that the calculation isn't quite as simple and obvious as it might seem when things are going swimmingly. Especially long term when sheit happens, as it tends to eventually do. 

Prognostication of the future is not going to be easy, especially as to heath issues. 

[wwest5829]

50 minutes ago, TunnelRat69 said:

This $109 per month you speak of - is that all you are paying for Medicare part B??  If so, I think you should keep it...........a single prescription can cost you lots more.  I only used mine once for a Flu Shot, came to $175.00, I had to pay $16.00............its worth it even if you only visit once or twice a year.

That is what I pay to maintain the Medicare, I needed. Sorry, I was not clear, I live fulltime in Thailand I would only return to the US for some illness needing over a half a million baht in care ... if then.

[Pinot]

The American healthcare system...oh my Buddha

 

 

[theguyfromanotherforum]

6 hours ago, Pinot said:

A beautiful young Thai wife,  

 

 

 

Been browsing this forum for nearly a decade. Many pictures of Thai/Farang couples posted be it on the casual thread or as a news item. Have yet to see a single "beautiful" Thai woman so many of you claim to have lulz