To US expats - Registration with Medicare at age 65

[smo]

22 hours ago, riclag said:

Also once they receive that CMS 40B they will act on that whether or not you decide to accept  plan B.

I'm not sending back this form CMS 40B because it concerns part B only:

"APPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE)
WHO CAN USE THIS APPLICATION?
People with Medicare who have Part A but not Part B"

 

and I don't see the point of spending money on something that's not applicable outside the US. Besides at this point there's no record (ie the missing welcome packet) that confirms I have part A. Therefore the only thing I did next was to send another inquiry regarding the medicare card that I should have gotten. Let's see what Manila has to say in their next reply (another 2 week wait.)

 

[taxout]

You can't properly fill out the form because you don't have a Medicare number. I'm surprised she sent it to you without the number. (And if you haven't been assigned a Medicare number yet you certainly don't have Part A yet.)

 

As to skipping enrollment in Part B, consider carefully the consequences. There's the penalty for late enrollment, which will add up quickly. More importantly, you can't just decide to head back to the States and enroll in Part B tout de suite. There's a brief enrollment window that opens each year, and depending on when you arrive back in the US you might have to wait over a year for Part B to take effect. Understand also that Part A doesn't cover all that you might think. It's basically for "hospital" expenses, but if you need surgery, say, Part A doesn't consider the surgeon's and other doctor's fees as "hospital" expenses: they get picked up under Part B. And there are other ways the rules and practices shift what you'd expect are Part A expenses onto Part B.

 

Finally, who knows the future. Enrolling in Part B now really is "insurance" in the purest sense.

 

But your call.

[smo]

On 9/24/2019 at 12:47 PM, taxout said:

You can't properly fill out the form because you don't have a Medicare number. I'm surprised she sent it to you without the number. (And if you haven't been assigned a Medicare number yet you certainly don't have Part A yet.)

 

Yes, thanks for pointing that out. I think this is the number you referred to - see red circle in pic attached. The SS rep (it's a he) not only did not say anything about this number, he also did not reply to my inquiry regarding the welcome packet that was my first and foremost concern. In short he did not say anything about the packet, neither  about part A enrollment as far as I'm concerned. The only thing he said re part A is that it's free. Considering it takes them 2 full weeks to get back to an inquiry, it seemed like they did not really take their time to give a full and appropriate response.

 

Also I'm reconsidering whether to enroll to part B as I'm "coming of age." But I think I will enroll ultimately just to have peace of mind. Again thanks for the caution, appreciated that.

 

[taxout]

They sent you the old form. Social Security numbers are no longer used for Medicare: you get a new completely different sort of number once you've enrolled.

 

Here's the new form:

 

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf

 

I should also have mentioned that without Part B, travel back to the States even for a short period can involve a lot of financial risk, especially as you get older and more prone to problems,

 

Obviously Part B is not a good deal if you live outside the US, but sometimes you just have to recognize the Government has rigged the rules to give you not much choice.

[mrwebb8825]

Thanks to all for this discussion. I won't be taking option "B" either. My wife is looking around and MAY have tracked down a plan that will give me full (?) coverage for both in and out patient care for 2,336 baht a month and covers both government and private hospitals. I'll let you know more when I know more. 

[Sheryl]

Thanks to all for this discussion. I won't be taking option "B" either. My wife is looking around and MAY have tracked down a plan that will give me full (?) coverage for both in and out patient care for 2,336 baht a month and covers both government and private hospitals. I'll let you know more when I know more. 

1. Other thanThai SS (which you must havs been employed to have, or else married to a civil servant) NO insurance privides unlimited full cover. They all have maximum caps.

2. A policy with premiums as low as you mention will have such a low cap as to not be worth having.

Adequate insurance for a 65 year old runs around US $3000 a year. That's inpatient only but includi g certain outpatient treatments e.g. cancer treatment, dialysis, day surgeries.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[smo]

On 9/26/2019 at 2:05 AM, taxout said:

They sent you the old form. Social Security numbers are no longer used for Medicare: you get a new completely different sort of number once you've enrolled.

 

Here's the new form:

 

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf

 

I should also have mentioned that without Part B, travel back to the States even for a short period can involve a lot of financial risk, especially as you get older and more prone to problems,

 

Obviously Part B is not a good deal if you live outside the US, but sometimes you just have to recognize the Government has rigged the rules to give you not much choice.

 

Thanks for the link to the new form (been distracted by coup d'etat in the "homeland" since last week.) Yes I agree that the US gov has "rigged" the system to set up more loops for us to jump through but that's par for the course isn't it when it comes to providing medical care for its citizens? I also started to doubt the competence of the Manila SS rep that I'm dealing with. Considering his answer when I asked about my missing welcome packet and my current enrollment "status" regarding to parts A and B:

 

"The automatic enrollment in Medicare, especially for Part B, only occurs if your mailing address in the record is in the USA. But if it is a foreign address, it is not automatic....Part A (Hospitalization) does NOT involve any monthly premium since you already paid for it while you were working in the USA. Part B (Supplementary Medical Insurance), however, is the one that involves a monthly premium."

 

Seemed like he just voiced the general info and did not directly address my individual case: 1) Have I been enrolled in at least part A? 2) where the heck is my missing welcome packet (or how to go about getting it?) It takes 2 weeks each time to get their office to respond and I hate it when they dole out info in this piece-meal fashion. I wonder if it's better to address my inquiry to SS main office in the US, or would they route me right back to SSA Manila?

Edited September 30, 2019 by smo

[Sheryl]

SS Manila is pretty hopeless.

 

I enrolled in Part B via a US office. You might also be able to do it online.

 

Medicare has an online site www.mymedicare.gov

 

Unlike SS you can create an account while living abroad.

 

You can download all Medicare guides, documents etc and also arrange to receive Medicare statements and documents electronically.

 

Might be a problem to register though as you don't yet know your medicare number.

 

There is a Live Chat function which does not require login to use. Try that. I have found them pretty good. Used it maybe 4 times, 3 out of 4 very helpful, one I got stuck with someone useless but logging off and then reconnecting with someone new solved it.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[taxout]

Call Medicare in the US and find out for sure if you've enrolled in Part A.

 

I've found dealing with Medicare by phone much easier and quicker and pleasant than dealing with Social Security by phone.

 

If you send anything by mail to SS in the US, make sure you've got a tracking number. My application for Part B got lost in the morass that is the SS bureaucracy in Baltimore and it took months to unsort. They seem to have no system at all for following paperwork. Like things lost on a glacier, you just have to wait for it to emerge.

[Pib]

Amen Brother!!!   Unless something has changed a person can call Medicare 24/7.  When the wife was signing up for SS and Medicare "and since Manila" messed up her SS benefit begin date which in turn messed up automatic payment of Medicare Part B premiums we (me and her) called Medicare several times to talk the issue....always got a human on the phone with minutes....a human that seemed to really care.  Your result may vary.  

 

But keep in mind Social Security is responsible for actual enrollment in Medicare.   But the Medicare folks can tell you if you are enrolled or not.

https://www.medicare.gov/forms-help-resources/contact-medicare

[Sheryl]

You can save cost of phone call by doing online Live Chat, likewise 24/7. And when done you can orint out transcript of the call for future refetence.

 

Agree Medicare is much better than SS to deal with.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[taxout]

Am I the only one who hates those online-chat customer service lines? You spend most of your time correcting typing errors and waiting. And many of them -- are you listening AirAsia? -- give you only a few minutes online, and for "security" you discover they can't really do much on your account anyway.

 

Besides, Skype lets you call 1-800 numbers free, so money shouldn't be an issue for calling Medicare.

[Pib]

Oh no....I like the online chat sessions for simple issues.  I can type pretty fast with not too many typos....so the chat sessions usually work out good "if I get a customer rep on the other end that's not clueless."

[Sheryl]

Depends on which one. Some entail long waits and/or can't do much. I have found the Medicare one to be very useful. Waits not excessive and they can and do provide meaningful assistance/info. Being able to save and print out the transcript is useful.

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[smo]

Thank you everyone for your advice, much appreciated. Will contact Medicare next (and report back here dutifully of course.) If it's available 24/7 then I would choose live phone (if put on wait during live chat I tend to get frustrated quick -if put on wait during live phone I tend to get frustrated quick second -:=)

 

Also technically I won't be 65 for another couple of weeks. But at least I can ask them about the welcome packet...(or does it come from SSA?)

Edited October 2, 2019 by smo

[taxout]

When I last called asking where my new card with my new Medicare number was, it turned out they now don't necessarily mail everything overseas they mail domestically.

 

I finally got the card in the mail only after asking for it, but quarterly statements for Medicare B payments never arrive anymore. I just have to guess about due dates and amounts and do bank transfers, then call once or twice a year just to make sure everything's been received.

 

Note that at times -- late at night and especially on weekends -- their computer link with the SS computers may be under maintenance, so help may be limited.

[smo]

2 minutes ago, taxout said:

Note that at times -- late at night and especially on weekends -- their computer link with the SS computers may be under maintenance, so help may be limited.

Great point, thanks  - I usually fall into this trap (last time calling my credit union I was told to call back during office hours as the department I needed to talk to will be available then.)

[taxout]

Well, against my better judgement I just used Medicare Chat, and no sooner had I typed in my long question then it got rejected with a tiny unreadable message telling me I can't use these characters:

 

!, @, #, $, %, ^, &, *, (, ), -, _, +, =, ;, :, ", <, >, /, \, |, or ~

 

Note such common chars as $ and " and ( ) and the colon are barred. Exactly the sort of troublesome reasons I avoid chat,

 

As well, I don't think you can open a Medicare account to use chat without a new Medicare number.

Edited October 2, 2019 by taxout

[Sheryl]

10 minutes ago, taxout said:

Well, against my better judgement I just used Medicare Chat, and no sooner had I typed in my long question then it got rejected with a tiny unreadable message telling me I can't use these characters:

 

!, @, #, $, %, ^, &, *, (, ), -, _, +, =, ;, :, ", <, >, /, \, |, or ~

 

Note such common chars as $ and " and ( ) and the colon are barred. Exactly the sort of troublesome reasons I avoid chat,

 

As well, I don't think you can open a Medicare account to use chat without a new Medicare number.

 

You do not have to have an account to use Chat

 

But if not yet 65 you will not yet have a Medicare number so little reason to contact them. In that case wait till 65.

 

 

[Sheryl]

Another thing to consider re part B - if you go back to the US on visits, nto only will it protect you then but you can get many preventive services completely free. that's what I do, helps  offset the premium expense.

 

If you don't enrol now, the later penalty is not a one time penalty it is a higher premium for the rest of your life.

[taxout]

But if you're not chatting from within your secure online Medicare account, I assume they'll just give general information, not address specifics of your account, since they can't be sure who you are.

 

As to needing health insurance these days when spending anytime at all in the US, you wouldn't think of driving even a couple miles to the supermarket without car insurance. Health insurance is now the same, especially as you age. Given the way hospitals charge the uninsured, the simplest accident, like a broken ankle, can cost a small fortune. Not to even consider anything more serious.

 

By the way, how do you find a doctor these days in the States when you have Medicare? I've heard from friends that in some cities like New York good GPs don't take Medicare, and that if you do find someone, getting an appointment and necessary follow-ups in reasonable time while you're visiting can be difficult. True? Thailand sort of spoils you with all-in-one walk-in services at big hospital OP departments.

[mrwebb8825]

17 hours ago, taxout said:

Health insurance is now the same, especially as you age. Given the way hospitals charge the uninsured, the simplest accident, like a broken ankle, can cost a small fortune. Not to even consider anything more serious.

You could always go to any sanctuary city, claim to be a homeless alien with no papers and they'd build you a new home, give you free medical and start a tax free income for you. So, pick a nice place and fall down. ????

[DEKEM]

On 9/23/2019 at 12:56 PM, riclag said:

I realize your question is while living in Thailand!

I believe the reason you didn't get part A is because you are automatically enrolled in Part A,like everyone else! Also once they receive that CMS 40B they will act on that whether or not you decide to accept  plan B. Then I would think you will get your Medicare card with what your eligible for .

earlier this year, I turned 65.  I didn't get a medicare card for my part A.  so, I contacted them to see when I would get the card.  I was told that I didn't have any medicare coverage because I lived overseas.  and this person whoever it was tried to convince me that was how it stands.  live overseas.  NO coverage at ALL.  in an email, I told her I read up on the rules.  and told her that according to what I read, I am entitled to part A because I paid into it for all the years I worked.  furthermore, I told her that I should be automatically enrolled into the medicare program when I reached age 65 since I had been on ss since age 62.  she responded that is not true.  I almost accepted this BS from this person.  until a few days later, I reviewed my medicare status on my online SS (ssa.gov) where it indicated that I was automatically enrolled in medicare part A.  so, I sent in another email to ss pointing this out.  they STILL didn't want to give me a medicare card for part A.  ranting about how I was living overseas.  I then asked them what would happen if I returned to the USA.  they said yes, you could get your medicare card then.  I countered what happens if I needed emergency care right away the minute I entered the usa.  How would I get the emergency care then if I didn't have the medicare card to show the hospital?  at this point of the email exchange, I got really <deleted> off and wrote to ss quote, "You people treat the illegals better than you do to actual usa citizens.  you let them have all the benefits without a struggle.  how dare you treat me like this."  ..within a week, I got my medicare card for part A.

 

my take from this experience..  don't take it for granted you will get a medicare card for part A, you need to push for it.  there are people in ss that will screw you for everything they can take from you.  they care more for the illegals then they do for american citizens.  they want to take YOUR benefits from YOU to give to the ILLEGALS.    how else will they be able to provide them the benefits?  it has to come from somewhere.  right?

[taxout]

Yes, as I said Medicare has stopped mailing stuff out overseas, I pay Part B premiums directly, but they don't send me the CMS-500 quarterly statement. It doesn't even show up online!

 

Call Medicare -- not SS, which is worse -- and they will after some hemming and hawing send you the card. (You can also order a card online, but better to deal with them directly.)

[smo]

4 hours ago, DEKEM said:

I told her that I should be automatically enrolled into the medicare program when I reached age 65 since I had been on ss since age 62. 

Your situation mirrors mine, and thanks for the account. I assume the "they" in your tale are SS and not Medicare? It's rather disheartening to get misinformation from within the institution as well. What has the USA come to (maybe the answer is unravelling at the moment for the whole world to see?) Anyway, politics aside, like SheryL has mentioned if you don't want the rep you talk/write to, get another one. I usually just say out loud, "I'm not communicating well with you, so let's not waste our time and energy, could you connect me to someone else?" to their face.

 

Okay I will wait to the ripe age of 65 in a couple of weeks then call Medicare and ask for my card. Again thanks to everybody for chiming in, much appreciated. Oh, it's worth noting that when I went back to the US in 2016 for a lengthy home visit I got MediCal (California edition of Medicaid, healthcare coverage for the poor?):free doctor checkup, an expediently done colondoscopy, and free prescription (plus a free for life "Obamaphone"). Only had to pay out of pocket for dental care. Btw, it was an extended visit, 4 months (I was there to make sure that my SS-at-62 kicked into gear, also to "cover" the 2016 election.) My colondoscopy came through on the last week of my trip, it would not have happened had my stay been any shorter.

 

3 hours ago, taxout said:

Yes, as I said Medicare has stopped mailing stuff out overseas, I pay Part B premiums directly, but they don't send me the CMS-500 quarterly statement. It doesn't even show up online!

 

Hmm, could it be that they have stopped sending out the welcome packet as well?

[taxout]

I've gotten the formal letters notifying me I've been accepted for Part A then Part B, but never a Welcome Packet.

[Sheryl]

I don't think I ever got such a packet either and not sure what it would contain . Guide to Medicare can be downloaded on the mymedicare.gov site.

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[ubonjoe]

1 hour ago, Sheryl said:

I don't think I ever got such a packet either and not sure what it would contain .

All i got was a letter with a medicare part a A card and a application form for part B.

 

My card is now no good since it has my old number on it. They sent me a letter informing me it was no longer valid and they were not mailing anything overseas with the number on it. The letter said I could get the new number online but I could not do it.

[bkk6060]

Going thru the process so far cluster F for 2 months.

 

I never put into it but my long time exwife did.  If married for at least 10 years and divorced the other person (me in this case) does get part A.

They have requested supporting documents which I sent.  We will see.

[Sheryl]

1 hour ago, ubonjoe said:

All i got was a letter with a medicare part a A card and a application form for part B.

 

My card is now no good since it has my old number on it. They sent me a letter informing me it was no longer valid and they were not mailing anything overseas with the number on it. The letter said I could get the new number online but I could not do it.

 

Joe,

 

www.mymedicare.gov

Go to "My account"  (create one if you don't already have one)

Then towards the bottom under "What do you want to do?" select "print my Medicare card". You will have to re-input your password first. there is also an option ot have card mailed to you.

 

When did you get that letter? As I received my new Medicare card by mail in Thailand within the past year.