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


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You can afford:
 --to rent a condo with a pool
  --to dine out regularly
  --to get a $60 massage for $10
  --to get home care 24 hours a day by a sweet lady for a fraction of what it would cost for care by an assortment of raging rhinos back home
  --to go to the emergency room and not get a bill for $12,000 that your insurance refuses to pay
  --to relax on your balcony in January
  --to look at girls in short skirts without fear of being sued or locked up.
  -
 
Yeah those are some upsides but there are downsides too. Let's not oversell it. It's not for everyone and there are issues and costs to being an expat.

Sent from my [device_name] using http://Thailand Forum - Thaivisa mobile app

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4 hours ago, TunnelRat69 said:

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.      

 

I have blue cross blue shield , Tried to call them and ask but I kept going around in circles. after 1 hr I gave up. went to their website  and the only there were only 5 territories outside the US that were covered. Panama and Uruguay were the only actual countries. 

There are many different Blue cross blues shield  subsidiaries mine is Empire Blue Cross Blue shield. In see from a search on the internet that there is a Blue Cross Blue Shield Thailand , which I suspect is what your friends have, or they have purchased Travel insurance from their US based BCBS plan.

anyway please find our an Post, also PM me if you can because I might miss the post.

Thank you   

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Some people go back and forth a lot or think that they will. Maybe think again, based on this article. Specifics are about Ecuador but it translates to Thailand.

 

 

Quote

 

Expenses that many expats and potential expats fail to consider: Travel back home and medical costs

...

These two expenses rarely show up in cost summaries for destinations abroad, and they rarely seem like a big deal when planning to retire overseas.

 

What expenses am I thinking of? Trips back home, medical care and health insurance.

 

 

https://cuencahighlife.com/travel-back-home-and-medical-costs-are-often-overlooked-by-expats-and-are-potential-budget-breakers/

 

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5 hours ago, TunnelRat69 said:

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.

 

I'm looking at the Blue Cross website. There's a "global" option, but it goes straight to BUPA (not that there's anything wrong with that of course). Your friend may have had Blue Cross previously before moving to Thailand. Were they federal employees or something? Interested to learn.

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I think about this subject a lot lately...staying or going back to the USA...or maybe moving to another spot ( I also hold an EU passport). 

 

I think the healthcare thing is a big concern. In the USA Medicare is not enough even to cover even routine stuff. Supplemental insurance is needed. Here in Thailand I pay a pretty hefty premium for 1m in coverage with a low deductible with no exam, preconditions or age limitations. It covers me anywhere in the world except the USA. If I moved back I would drop this coverage and add supplemental insurance to fill in the Medicare gaps.

 

Beyond health...all the pros and cons stated above make perfect sense so its up to the individual. In my case the big thing missing is a small circle of good friends. In either place I would have a hard time with that and loneliness is starting to creep in. Still, I find Thailand entertaining and there are many fine things to do, places to eat, interesting neighboring countries for added experience.

 

You can find the same things in the USA I suppose but I don't see an advantage tipping either way after you consider cost, transportation, walkability, etc, etc. However, as some have pointed out, language is key. But I am very bad with learning when it comes to math and language as I am slightly dyslexic. And now at 68 finding it difficult to move out of the comfort zone where there are local English speakers.

 

Finally, I do wish the Thai bureaucracy was more friendly to retirees (and foreigners in general). I've paid enough taxes here over the years to support several small villages and on that score there is no payback in retirement.

PS... as for the retirement visa, a good lawyer makes life a lot easier. Yeah it costs a bit but has proven to me to be hassle free.

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26 minutes ago, pmarlowe said:

I think about this subject a lot lately...staying or going back to the USA...or maybe moving to another spot ( I also hold an EU passport). 

 

I think the healthcare thing is a big concern. In the USA Medicare is not enough even to cover even routine stuff. Supplemental insurance is needed. Here in Thailand I pay a pretty hefty premium for 1m in coverage with a low deductible with no exam, preconditions or age limitations. It covers me anywhere in the world except the USA. If I moved back I would drop this coverage and add supplemental insurance to fill in the Medicare gaps.

 

Beyond health...all the pros and cons stated above make perfect sense so its up to the individual. In my case the big thing missing is a small circle of good friends. In either place I would have a hard time with that and loneliness is starting to creep in. Still, I find Thailand entertaining and there are many fine things to do, places to eat, interesting neighboring countries for added experience.

 

You can find the same things in the USA I suppose but I don't see an advantage tipping either way after you consider cost, transportation, walkability, etc, etc. However, as some have pointed out, language is key. But I am very bad with learning when it comes to math and language as I am slightly dyslexic. And now at 68 finding it difficult to move out of the comfort zone where there are local English speakers.

 

Finally, I do wish the Thai bureaucracy was more friendly to retirees (and foreigners in general). I've paid enough taxes here over the years to support several small villages and on that score there is no payback in retirement.

PS... as for the retirement visa, a good lawyer makes life a lot easier. Yeah it costs a bit but has proven to me to be hassle free.

Older than you Sunshine...but yes what you quote is true, especially loneliness,  have to weigh up pros and cons   but heres one to go for.....  Medifee

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12 hours ago, Jeffrey346 said:

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

Not sure anyone responded to your question. As for care overseas, if retired military, you have Tricare Overseas. Not if just served and receiving care via VA.

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3 hours ago, pmarlowe said:

as for the retirement visa, a good lawyer makes life a lot easier. Yeah it costs a bit but has proven to me to be hassle free.

If you've got somebody reputable in mind then please send me a private message and let me know who he or she might be. Thanks!

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It is not just a matter of the expense of un-insured medical treatment in Thailand is also the lousy after care and infrastructure here

 

In the US you have laws that mandate disabled access to government buildings, disabled parking rules are ENFORCED, if poor you can obtain home health aides for little or nothing, there are local medical transportation programs, "meals on wheels"  and other such programs for seniors, etc.

 

Every time I drive through Pattaya and see these disabled guys in the motorized chairs , dodging traffic in the street because they can't use the sidewalk, I think There but by the grace of god go I 

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15 hours ago, Jingthing said:

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. 

 

 

 

 

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

 

 

That article is a bunch of bologna 

 

None go untreated in America even if they pay nothing

 

They say this

Quote

The average Social Security income for all Medicare beneficiaries in 2013 was $13,375

That means these folks qualify for free coverage thru most States

 

Also even if they own a home (primary residence) it will not be taken away or used as valuation

 

Bottom Line from  my viewpoint

For older Americans in Thailand (or any foreign country) it is great if you have the liquidity to fund 100% support

of yourself there. AKA: No Safety Nets

 

IF not then do not wait till your so old/dying to return as returning to even the US takes energy & funds to restart your life

 

But at the end of the day the biggest difference is you have a safety net in your home country you do not have in foreign countries (& why should you?)

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Don't confuse eligibility for care at veterans medical facilities in the US with the veterans healthcare outside of US. In the case of the later if you are retired US military (20+ years service} you are eligible for "Tricare for life" this is the insurance that reimburses you for 75% of approved medical costs incurred outside US {also serves as supplement to medicare while in the US. After incurring $3k+ of copay costs in a year TFL will cover 100% of approved medical costs. The availability of care in US veterans administration medical facilities has a much lower bar for eligibility albeit a bit complicated. Again this is only available at Veterans administration medical facilities in the US.

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9 hours ago, Ruffian Dick said:

I'm looking at the Blue Cross website. There's a "global" option, but it goes straight to BUPA (not that there's anything wrong with that of course). Your friend may have had Blue Cross previously before moving to Thailand. Were they federal employees or something? Interested to learn.

Yes they were Dept of State and had BCBS in the USA before moving too Thailand full time.  I will ask if they use it with BUPA, and how they are billed.   my insurance is pay up front, then 80% reimbursed.  But if I am in the US I can somtimes use the card and get billed, used it once in Hawaii, but am comfortable paying up front and getting reimbursed, all on-line.

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13 hours ago, theguyfromanotherforum said:

 

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

Beauty is in the eyes of the beholder..............

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14 hours ago, Jingthing said:

Yeah those are some upsides but there are downsides too. Let's not oversell it. It's not for everyone and there are issues and costs to being an expat.

Sent from my [device_name] using http://Thailand Forum - Thaivisa mobile app
 

Downside: 

  --nobody makes (American-style) biscuits and gravy

  --sweet pickles are really hard to find. Bread n butter variety impossible

  --riding on motorbike taxis is always a challenge

  --as is getting across the Thai National Raceway called 2nd Road

  --and sifting through the hundreds of young ladies professing their love for you as you search for the sincere lass. Tough work, that.

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4 hours ago, Langsuan Man said:

It is not just a matter of the expense of un-insured medical treatment in Thailand is also the lousy after care and infrastructure here

 

In the US you have laws that mandate disabled access to government buildings, disabled parking rules are ENFORCED, if poor you can obtain home health aides for little or nothing, there are local medical transportation programs, "meals on wheels"  and other such programs for seniors, etc.

 

Every time I drive through Pattaya and see these disabled guys in the motorized chairs , dodging traffic in the street because they can't use the sidewalk, I think There but by the grace of god go I 

You tell em boss.  But.  Not only does the USA rape the health care consumer (The U.S. spends more on healthcare than other countries with similar economic status, yet its health outcomes are worse in many ways). but " Medical errors are the third leading cause of death in the U.S., after heart disease and cancer, causing at least 250,000 deaths every year,"

 

www.latimes.com/nation/la-na-healthcare-comparison-20170715-htmlstory.htm

 

https://www.usnews.com/news/articles/2016-05-03/medical-errors-are-third-leading-cause-of-death-in-the-us

 

I think the after care in Thailand is brilliant with great rooms equipped with fridge and dishes and the family is welcome to stay.  I normally have 4 or more ladies sleeping in my room whenever I'm ill to make sure I am treated right and there is the high class food available and a great coffee shop just outside my door. 

hospital room.jpg

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On 1/30/2018 at 2:31 PM, 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.

Addendum: Just received the SS statement for next year. SS raised $27.00 a month. Medicare Premium raised $25.00 a month. My net SS gain per month? $2.00 ... $24.00 a year ... that will make a difference ... not!

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1 hour ago, wwest5829 said:

Addendum: Just received the SS statement for next year. SS raised $27.00 a month. Medicare Premium raised $25.00 a month. My net SS gain per month? $2.00 ... $24.00 a year ... that will make a difference ... not!

The American "health care" racket is an enormous scam.  Thanks to Uncle Scam and his never ending forays into social engineering it's only gotten worse.  There is a glimmer of hope that it will go down in cost in the coming year but I wouldn't hold my breath about that.   The key is to live as healthy as possible and enjoy it while it lasts.  There are no gaurantees about anything short of death and taxes.

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Posting this article which is titled about eviction not so much about eviction per se, but for it's content about the trends in the housing situation in the USA which have been developing for decades now. People that have stayed in the USA would likely be aware of this stuff, but Americans that have lived abroad a long time might not be.

 

Here is my very very gross national generalization. Obviously there are local variations.

Rent demand is very high and supply is limited pushing up rents.

Housing prices to buy bubbled and then crashed but there has been a recovery and it's continuing an a upward trend. 

 

So for the less than moneyed, renting OR buying a decent place (and staying in it) may be a very big issue, especially in desirable areas.

 

I guess this puts the health care thing in perspective.

 

It's DEFINITELY more affordable to secure lower priced and livable housing in Thailand, generally dramatically so compared to most U.S. markets. 

 

Quote

“We have these demographic shifts that are happening,” says Mary Cunningham, co-director of the Metropolitan Housing and Communities Policy Center at the Urban Institute, a Washington think tank. “There’s income stagnation, and there just isn’t the [housing] supply needed to meet the demand. There’s this rising number of renters, and people are coming out of the homeownership market. That’s putting a lot of pressure on rents all across the income spectrum.”

https://www.curbed.com/2018/1/24/16925074/apartment-eviction-process-gentrification

 

To add, I think for some people long settled in Thailand, even if they want to repatriate to the USA, that just might not be realistic to ever happen, financially speaking.


For example, when someone sells a house in a hot market and then moves to the sticks, it may often mean he'll never be able to afford to live in a hot market again. In the context of this thread, the USA is the hot market and Thailand is the sticks. 

Edited by Jingthing
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22 hours ago, fotunate said:

Don't confuse eligibility for care at veterans medical facilities in the US with the veterans healthcare outside of US. In the case of the later if you are retired US military (20+ years service} you are eligible for "Tricare for life" this is the insurance that reimburses you for 75% of approved medical costs incurred outside US {also serves as supplement to medicare while in the US. After incurring $3k+ of copay costs in a year TFL will cover 100% of approved medical costs. The availability of care in US veterans administration medical facilities has a much lower bar for eligibility albeit a bit complicated. Again this is only available at Veterans administration medical facilities in the US.

I am confused when I go to Tricare overseas. It shows a family $300 deductible, $150 for me and the wife. Not sure if it pays 75, 80 or 100% of approved procedures. Have not used Tricare Overseas yet...

 

There is no copay in the USA as long as covered by Medicare, Tricare for Life pays the rest... Wife and I both had operations last year in the 30k range no cost to us... Free meds at the base pharmacy. 

Edited by johndudorn
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On 1/30/2018 at 9:57 PM, theguyfromanotherforum said:

 

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

I know a local masseuse in our small city. She has terrible acne all over her face. In the last couple of years, she has ballooned about the hips and butt. Not your classic beauty. And yet, her eyes burn bright with passion and smarts. She is inncredibly sensual. She is married and not available but for me, would be far preferable to what most see as a beauty. There is so much more than what meets the eye.

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23 hours ago, xyznot said:

You tell em boss.  But.  Not only does the USA rape the health care consumer (The U.S. spends more on healthcare than other countries with similar economic status, yet its health outcomes are worse in many ways). but " Medical errors are the third leading cause of death in the U.S., after heart disease and cancer, causing at least 250,000 deaths every year,"

 

www.latimes.com/nation/la-na-healthcare-comparison-20170715-htmlstory.htm

 

https://www.usnews.com/news/articles/2016-05-03/medical-errors-are-third-leading-cause-of-death-in-the-us

 

I think the after care in Thailand is brilliant with great rooms equipped with fridge and dishes and the family is welcome to stay.  I normally have 4 or more ladies sleeping in my room whenever I'm ill to make sure I am treated right and there is the high class food available and a great coffee shop just outside my door. 

hospital room.jpg

I once came back from Africa with Malaria, was in Bumrungrad intensive care section - I woke up after being out for 2 days, with a pretty nurse on both sides of me holding my hands.........luckily, I was still active duty in US Govt and US Embassy picked up the bill............sold me on health care in Thailand!!!! 

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On ‎1‎/‎30‎/‎2018 at 3:46 AM, Pinot said:

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. 

Yeah, I think I will very shortly be like you.  Certainly spending 1/2 the year or more in Thailand. I got plenty of passive income, and I have not even started social security yet, so money is not likely to be an issue.  I do enjoy many parts of the USA as I have relatives in Florida and friends in Southern California, and the SoCal weather really is nice and there are lots of things to see and do in California.  I plan to ge medical insurance in Thailand, while waiting for my Medicare age which is 4 years from now.  At the moment, medical insurance in the USA is crazy too much expensive, like $500/month for an individual  outside of work.  So once I leave work, where my current medical is only $72/month I will have to do something

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On ‎1‎/‎30‎/‎2018 at 1:57 PM, Ruffian Dick said:

I had foot problems last year. Didn't like walking really long distances. Actually used the "lift" at Doi Suthep. Walking in the streets was all right, I could manage it, but I wonder how I would manage if I had serious mobility issues.

yes.  Mobility would be challenging to difficult in many places.  can't park your car easily.  Having space to unload your cart/wheel chair, sidewalks, well, they are hit and miss depending on the city and area.  Just getting around in the heat and humidity is tough.  Just compare walking around in dry Southern California versus Hot and humid Thailand for example.

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On ‎1‎/‎30‎/‎2018 at 8:01 AM, newnative said:

     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.  

I totally agree with you on the home care.  the trick will be finding somebody properly medically capable.  Over the years I have seen discussions of expats arranging such things and I expect or at least hope somethngs will be more readily available

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