Moving to USA and applying for Medicare Supplement and RX Plans

[jonnit]

3 hours ago, wwest5829 said:

My understanding is that all citizens eligible for retirement benefits are automatically enrolled in Medicare, Part A at age 65. I also signed up for Part B, for which I pay a monthly premium. As I reside outside US territory, I am not eligible to recieve the benefits. A bit of an issue as I note military retirees are accorded global medical coverage. Both are earned benefits.

I have Medicare Part A and Part B. I have to pay for Part B to be qualified for Tricare For Life. Tricare For Life will reimburse my medical expenses worldwide, although I may have to pay up front and get reimbursed later. I have had a few medical issues while in Thailand, but all the costs were so minimal that I never filed a claim for reimbursement. So, I cannot attest to any problems that could arise. I I only have Part A I can use it in the US anywhere it is accepted, but would only cover a percent of medical bills and not prescriptions. Or, if an emergency I could go to a military facility and receive emergency treatment free.

[uffe123]

good thing I dont have those headaches. VA takes care of all my problems for free.

[cmarshall]

7 hours ago, ericthai said:

Also part D if you dont sign up when eligible or have creditable coverage you will pay a penelty which is 1% per for every month you did not sign up.  Any questions you can PM me I worked in the medicare insurance market for several years. 

Do you have a reference for this?  I don't believe it is true, because expats are not eligible for Part D at all, unlike part B.

[taxout]

"If you enroll in a Part D drug plan within two months of returning to the United States, your coverage will start on the first day of the month after you enroll and you will not be liable for late penalties."

 

https://www.aarp.org/health/medicare-qa-tool/medicare-if-living-outside-united-states/

[BobTH]

8 hours ago, ericthai said:

Also part D if you dont sign up when eligible or have creditable coverage you will pay a penelty which is 1% per for every month you did not sign up.  Any questions you can PM me I worked in the medicare insurance market for several years. 

I agree with you ericthai, this is the point I have been trying to make. It is also what I did not know prior to applying in the USA, however as I have said, I did have creditable coverage while in Thailand so I occurred no penalties. 

[wwest5829]

6 hours ago, jonnit said:

I have Medicare Part A and Part B. I have to pay for Part B to be qualified for Tricare For Life. Tricare For Life will reimburse my medical expenses worldwide, although I may have to pay up front and get reimbursed later. I have had a few medical issues while in Thailand, but all the costs were so minimal that I never filed a claim for reimbursement. So, I cannot attest to any problems that could arise. I I only have Part A I can use it in the US anywhere it is accepted, but would only cover a percent of medical bills and not prescriptions. Or, if an emergency I could go to a military facility and receive emergency treatment free.

Thanks, confirms my understanding. I doubt any cost benefit studies have been done concerning savings in Medicare coverage here in Thailand versus returning for coverage in US. My heart attack here in 2015 (stent + 2 angioplasties and mini stroke) cost a total of $11,000.00 USD. Critical care for a week so no return to US possible. I have a BC/BS Core supplemental policy that pays up to $5,000.00 USD annually so the billing was $6,000.00 out of pocket. With US deductibles/co-pays, I am not sure what a US bill would have looked like. I would be well pleased to have the same as Tri-care coverage here. Thought about keeping the Part B Premium to enhance my SS but ... look at it as a backup should something major develop (that would allow the flight home).

[wwest5829]

8 hours ago, ericthai said:

Correct if eligible for free part A (need to work about 10 years) you are auto enrolled. Part B is optional, good you signed up to avoid the penalty. The issue was people would not enroll in part B when turning 65 so not pay the part B premium and then they get sick and run out sign up for part B and this was becoming a big issue so they instituted the penalty.

 

It would be nice if Medicare could pay something for citizens enrolled and living outside the USA.

 

The military have their own coverage for retired service families called Tricare. This is the best coverage and covers worldwide, which our men and women deserve it!!

Thanks for confirming my understanding. As to Tri-care, absolutely it is an earned benefit. I only ponder that there is no issues of reimbursing for care here in Thailand so Medicare benefits could be extended here on the same earned benefit basis. Certainly the medical care costs are far more reasonable for world class care. I think, the only way for Medicare coverage to be extended would be studies showing overall cost savings versus retirees returning to US for more costly care.

[Langsuan Man]

56 minutes ago, wwest5829 said:

As to Tri-care, absolutely it is an earned benefit

Unfortunately they changed the rules in the middle of the game.  Through some change in the law , Tri Care enrolees are required to have Medicare Part B, for which they pay , so I would characterize is as an earned benefit that you now have to pay to use

 

Does not effect me but I always thought that they screwed military retirees health care as bad as they screwed up the GI Bill  

[BobTH]

15 hours ago, taxout said:

"If you enroll in a Part D drug plan within two months of returning to the United States, your coverage will start on the first day of the month after you enroll and you will not be liable for late penalties."

 

https://www.aarp.org/health/medicare-qa-tool/medicare-if-living-outside-united-states/

This is true and I was aware of it prior to applying here for part D. However they also expect you to have had a creditable insurance coverage prior to your return or they will penalize you. I am sure ericthai who has commented on this tread can explain it better. I am just trying to give a heads up. I have been aware of all the information others have shared on this thread, as I said I do my homework.

[ericthai]

23 hours ago, BobTH said:

I looked at all the plans and met with someone who was independent to explain all the different plans and companies. I knew what I wanted and it was covered by the plan G that I opted for. Yes I pay a monthly premium but I can go to any doctor anywhere in the country that takes Medicare. And the coverage if you become seriously ill long-term is much better. I recently had surgery that was billed at $86,000 US, I paid $179 out of pocket. The plans can get confusing, but I did my homework and got the plan that fit me.

Don't get me wrong, I wasn't trying to say a supplement is not good. They are great, you can go anywhere that accepts medicare, never have to worry about networks or payments. However, they can get expensive.

 

It's good you spoke with an independent agent, check with him yearly as plans change each year. If you think you've been told something untrue you can always PM me.

[ericthai]

17 hours ago, cmarshall said:

Do you have a reference for this?  I don't believe it is true, because expats are not eligible for Part D at all, unlike part B.

Sorry for the confusion. The poster spoke about part be late enrollment in general not as an expat. I was was pointing out the part D too.

 

you are correct, as an expat living outside the USA you are not eligible for part D so there would be no penalty. Only people that are eligible to enroll and dont will be hit with the penalty. 

[ericthai]

On 5/15/2020 at 5:32 AM, Dwig said:

Have you been using any part of your Medicare A or B?  When I return for a visit I always go in for a wellness checkup under Humana.  Never had a problem.  They deduct part A B from SS check each month.  I even get a 3 months supply of drugs while there.    I am not sure why they would insist on me being covered while out of county.  

Be careful, dont let humana know you are living outside your service area for more than 6 months. If they find out they could terminate your plan. Read your policy you must live in the service area. 

[ericthai]

23 hours ago, wpcoe said:

Do you have to have Medicare Parts B & D to subscribe to a Medicare Advantage plan?  

No, You dont need part D, you only need to have Parts A and B to be illegible to enroll in an Medicare Advantage plan. 

 

Typically an Advantage plan includes part A,B and D however their are some Advantage plans that only have Part A and B (no part D - Drug coverage).

 

Another thing to beware of, allot of time a Medicare Advantage plan is referred to as "C" so this helps to the confusion. If anyone says they have part C this is medicare advantage plan.

 

When looking for a medicare advantage plan you need to make sure it includes parts A,B and D. 

 

Plan rates change by company and location. You can have the same company offer different plans in different counties in the same state.  

If you PM your ZIP code I can pull up some plans for you to review. 

Edited May 16, 2020 by ericthai
spelling

[ericthai]

16 hours ago, wwest5829 said:

Thanks, confirms my understanding. I doubt any cost benefit studies have been done concerning savings in Medicare coverage here in Thailand versus returning for coverage in US. My heart attack here in 2015 (stent + 2 angioplasties and mini stroke) cost a total of $11,000.00 USD. Critical care for a week so no return to US possible. I have a BC/BS Core supplemental policy that pays up to $5,000.00 USD annually so the billing was $6,000.00 out of pocket. With US deductibles/co-pays, I am not sure what a US bill would have looked like. I would be well pleased to have the same as Tri-care coverage here. Thought about keeping the Part B Premium to enhance my SS but ... look at it as a backup should something major develop (that would allow the flight home).

The same out of pocket costs for surgery under a Medicare advantage plan could be anywhere from $2500 USD up to $10,000 USD.  All Medicare advantage plans have a Max out of Pocket (called MOOP) this prevents major loss. Every month you get a statement how much you spent on medical care, once you reach you max out of pocket you stop paying and the plan pay 100%. I've had several clients with cancer that with surgeries, extended stays in the hosp, chemo etc end up paying a total of $2500 USD and that's it. The MOOP resets every January 1st. 

Hope this helps! Any questions dont hesitate to ask I'm here to help if I can.