Part B social security

[steveb6]

I am getting ready to apply for social security and debating to apply for part b and pay monthly payments but living in Thailand.  I am currently using Thai Social Security and not sure this will help me to have an exemption for not applying for a Part B without penalty

   Also I am unclear how to begin the application process. Do I apply online and they will forward that to Manila or I have to do something else. I sent an email to Manila for information and got a reply and then I gave them my information and until now I never received an email so I don't have too much luck with the Manila office

[ubonjoe]

There is no penalty for not applying for part B of medicare unless you decide you want to enroll in it later. Medicare is not of any use here.

If you are covered under Thai social security that is probably enough.

Have you recently turned 65.

If your address with the SSA is for here you should get a letter a few months before your 65th birthday informing you about it. You will be given to choice of applying for it then.

[steveb6]

I didn't receive a letter so not sure how to begin the registration. Process

[ubonjoe]

24 minutes ago, steveb6 said:

I didn't receive a letter so not sure how to begin the registration. Process

If you have an account set up on the SSA website you can do it online. 

You can find info about medicare here. https://www.medicare.gov/sign-up-change-plans/index.html

Since you are living outside the states you do not have to sign up for part B.

[taxout]

I couldn't apply for Part B online and had to send in a paper application. I thought maybe the postal system in Manila was not too reliable, so I sent it to Baltimore, which somehow lost the application. Since there's a strict deadline for the application, this led to a lot of hassle, and it took many months of phone calls and letters to untangle. It's clear that SSA -- the huge central office in Baltimore in particular -- has no efficient way of keeping track of all the paperwork it receives; it just disappears into the processing maw. It must be like 1946 working there.

 

So maybe sending it in to Manila is better after all.

 

As to whether to apply for Part B, you have to make your own decision based on your own circumstances. Factors that induced me to apply, apart from the ever-increasing penalty if I applied at a later date:

 

1. Free Part A actually covers very little. Only hospital expenses and only for longer hospitals stays. Not even a doctor's bill for surgery is included, since it's not considered a "hospital" expense. All the real coverage, including that surgeon's bill,  is in Part B.

 

2. If you don't take Part B when you're first eligible, then you can normally only apply during a brief window each year, with coverage starting a few months later. That is, you can't suddenly decide you want Part B down the road and get it immediately. You might have to wait over a year.

 

3. Particularly as you get older, it's pretty risky to spend any time in the U.S. these days without medical insurance. It's like driving a car without insurance. Things sometimes happen. That's a deterrent to spending even a few weeks' vacation in the U.S. if you don't have Part B.

 

4. No matter how certain you are now that you're not going to budge and move back to the U.S., ever, well the only thing really certain in life is that there's no certainty, ever.

 

5. I have no other insurance. Parts A and B aren't perfect, since they work only if I can get to the U.S. for coverage. Nonetheless, having them does provide me a lot of comfort, comfort that's worth the monthly premium.

 

But to repeat, there's no absolute rule for everyone. You'll have to make your own decision based on your own circumstances.

 

[gk10002000]

On 4/16/2018 at 6:05 PM, taxout said:

I couldn't apply for Part B online and had to send in a paper application. I thought maybe the postal system in Manila was not too reliable, so I sent it to Baltimore, which somehow lost the application. Since there's a strict deadline for the application, this led to a lot of hassle, and it took many months of phone calls and letters to untangle. It's clear that SSA -- the huge central office in Baltimore in particular -- has no efficient way of keeping track of all the paperwork it receives; it just disappears into the processing maw. It must be like 1946 working there.

 

So maybe sending it in to Manila is better after all.

 

As to whether to apply for Part B, you have to make your own decision based on your own circumstances. Factors that induced me to apply, apart from the ever-increasing penalty if I applied at a later date:

 

1. Free Part A actually covers very little. Only hospital expenses and only for longer hospitals stays. Not even a doctor's bill for surgery is included, since it's not considered a "hospital" expense. All the real coverage, including that surgeon's bill,  is in Part B.

 

2. If you don't take Part B when you're first eligible, then you can normally only apply during a brief window each year, with coverage starting a few months later. That is, you can't suddenly decide you want Part B down the road and get it immediately. You might have to wait over a year.

 

3. Particularly as you get older, it's pretty risky to spend any time in the U.S. these days without medical insurance. It's like driving a car without insurance. Things sometimes happen. That's a deterrent to spending even a few weeks' vacation in the U.S. if you don't have Part B.

 

4. No matter how certain you are now that you're not going to budge and move back to the U.S., ever, well the only thing really certain in life is that there's no certainty, ever.

 

5. I have no other insurance. Parts A and B aren't perfect, since they work only if I can get to the U.S. for coverage. Nonetheless, having them does provide me a lot of comfort, comfort that's worth the monthly premium.

 

But to repeat, there's no absolute rule for everyone. You'll have to make your own decision based on your own circumstances.

 

Pretty much says it all.  That is what I will be doing, even if I am cooling my heels in Thailand.  Paying for Part B is relatively cheap "insurance" for the future when and if I am back in the USA.

[dddave]

I am currently in the USA.  I am eligible for VA health care and I need knee replacement.

When in 2016 I enrolled for VA healthcare I decided "part B" was redundant and not needed so I unenrolled, saving $130/m.  I now regret that decision.

Though I can get my (double) knee replacement done free at the VA, I may have to wait around 2 to 4 months before it can be scheduled and they are reluctant to do them simultaneously, requiring even more time hanging at my sisters, maybe 6 months or more.

If I still had "part B", I would have the option of going to another hospital and having it done under Medicare but without "B", the outpatient co-pays would be prohibitive.  Most doctors won't even consider you as a patient unless you have "B"

Also, and possibly more important, a friend recently called "Medicare Advantage" to my attention.  I've been reading up on it a bit and still don't really understand all of it but it appears there are "Advantage" plans that include overseas emergency coverage.  This could be a big deal for us in Thailand.  Unfortunately, one must be enrolled in "B"to enroll in an "Advantage" plan.  I will have to wait for next years January to March re-enrolment window to get back into "B".

Do some reading on Medicare Advantage.  Cost depends on your home state but there is a lot of info online.

[meechai]

8 hours ago, dddave said:

Also, and possibly more important, a friend recently called "Medicare Advantage" to my attention.  I've been reading up on it a bit and still don't really understand all of it but it appears there are "Advantage" plans that include overseas emergency coverage.  This could be a big deal for us in Thailand.  Unfortunately, one must be enrolled in "B"to enroll in an "Advantage" plan.  I will have to wait for next years January to March re-enrolment window to get back into "B".

Do some reading on Medicare Advantage.  Cost depends on your home state but there is a lot of info online.

I believe that "may" be true if your a tourist in another country. But if your an expat living abroad then

" If you have a Medicare Advantage or Medicare Part D plan before you move abroad, you should disenroll and stop paying these premiums when you move because these plans require that you live in their service area in order to be enrolled. "

https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/medicare-and-living-abroad/medicare-coverage-when-living-abroad

Edited April 30, 2018 by meechai

[dddave]

14 hours ago, meechai said:

I believe that "may" be true if your a tourist in another country. But if your an expat living abroad then

" If you have a Medicare Advantage or Medicare Part D plan before you move abroad, you should disenroll and stop paying these premiums when you move because these plans require that you live in their service area in order to be enrolled. "

https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/medicare-and-living-abroad/medicare-coverage-when-living-abroad

That's really interesting.  I hadn't seen that restriction but I'll try to dig a little deeper while still in the US and see if there are any ways that emergency coverage can be had by expats.

[taxout]

-- Medicare Advantage is managed care, and it comes with the typical restrictions of managed care in the U.S. That is, apart from emergencies, you're limited to a panel of providers in your own locality, and your care is indeed monitored and managed. Medicare Advantage offers nothing like the flexibility of traditional Medicare Parts A and B, though it provides somewhat fuller benefits in exchange for the limitations of managed care.

 

-- You have to be living in the U.S. to enrol in a  Medicare Advantage plan. And it's a where-is-your-real-home test, so just addressing your mail to your sister won't work.

 

-- Even if you have Medicare Advantage, you're only covered for certain expenses incurred within the first 60 days outside the U.S. That is, after 60 days you'd have to return to the U.S. to reset the clock. As well, limitations apply to coverage of overseas expenses.

 

[IAMHERE]

What is the closest USA entity that Medicare is good for?  Hawaii, Guam, Alaska, Seattle?

[ubonjoe]

55 minutes ago, IAMHERE said:

What is the closest USA entity that Medicare is good for?  Hawaii, Guam, Alaska, Seattle?

At any of these US territories it might be possible. Guam, The Northern Mariana Islands or American Samoa.

Source: https://www.medicare.gov/your-medicare-costs/help-paying-costs/territories/program-in-us-territories.html

[IAMHERE]

Thanks Ubonjoe, looks like cheap flight to Hawaii would be best bet for going to USA to take advantage of Medicare if you could do the timing.

 

 

• Puerto Rico
• The U.S. Virgin Islands
• Guam
• The Northern Mariana Islands
• American Samoa

[allen303]

On ‎4‎/‎29‎/‎2018 at 1:37 PM, dddave said:

I am currently in the USA.  I am eligible for VA health care and I need knee replacement.

When in 2016 I enrolled for VA healthcare I decided "part B" was redundant and not needed so I unenrolled, saving $130/m.  I now regret that decision.

Though I can get my (double) knee replacement done free at the VA, I may have to wait around 2 to 4 months before it can be scheduled and they are reluctant to do them simultaneously, requiring even more time hanging at my sisters, maybe 6 months or more.

If I still had "part B", I would have the option of going to another hospital and having it done under Medicare but without "B", the outpatient co-pays would be prohibitive.  Most doctors won't even consider you as a patient unless you have "B"

Also, and possibly more important, a friend recently called "Medicare Advantage" to my attention.  I've been reading up on it a bit and still don't really understand all of it but it appears there are "Advantage" plans that include overseas emergency coverage.  This could be a big deal for us in Thailand.  Unfortunately, one must be enrolled in "B"to enroll in an "Advantage" plan.  I will have to wait for next years January to March re-enrolment window to get back into "B".

Do some reading on Medicare Advantage.  Cost depends on your home state but there is a lot of info online.

Have your VA doctor refer you under the choice program. I had major surgery on my shoulder 2 Jan using it. Was seeing a great civilian Orthopedic doctor (retired Full Bird from the AF). Went to my VA doctor in Dec. said I was ready to do the shoulder. Typical VA, well you have to get and X-ray first (Had a 2 day old MRI in my hand, did not matter, still had to get an X-ray for VA) then I will refer you to Orth. Then they will look at it. Told him refer me under the Choice Program. The VA doctor put the request in with my orthopedic doctor of my choice. Two week later the civilian doctor had the approval. VA paid for the operation and rehabilitation all done down town. Cost me nothing. Very fortunate, we have some of the best orthopedic surgeons around. They do all the professional athletes, walk in and see all these signed pictures and jerseys on the walls. You know you are in good hands. FYI, My VA doctor told me months before to use Tricare, go to Gulf Breeze where all the great Ortho doctors for the athletes are. My VA doctor said don’t let the VA operate on your shoulder