How to sign up for Medicare Part B during initial enrollment period as a Thai addressed expat?

[Jingthing]

OK, this is a specific situation but it may be relevant to other people.

 

If you've made an early social security claim (before age 65), you will AUTOMATICALLY be signed up for Medicare Part A (if you qualify). 

 

If you have a MySSA account it will show you as enrolled.

 

If you use a U.S. address for social security I think you also will be automatically enrolled in Part B, although you can opt out because there is a cost (taken out of your social security check).

 

However, you will not be automatically enrolled in Part B if you use a non-U.S. address and that is the crux of the issue in this topic. 

 

The reason to pay for Part B as an expat is to avoid the 10 percent penalty per year for life for the time you didn't pay for it if you repatriate. This topic isn't about the often hard decision about whether to enroll in Part B or not (you might plan to be an expat for life but you never really know). 

 

Other Medicare part enrollments are irrelevant to expats with a foreign address (sign up upon repatriation). 

 

This period around your 65th birthday is called the INITIAL ENROLLMENT PERIOD. If you enroll for Part B later, it's called a SPECIAL ENROLLMENT PERIOD.  IEP and SEP. 

 

The INITIAL period is three months before your birthday and three months after.

For example birthday September 15, the actual deadline is December 31, not December 15.

 

Social Security (NOT Medicare) is involved in enrollment for Parts A and B.

Medicare is involved in the other parts.

 

This is my current situation. 

 

Early social security claim

Thai address

Automatically enrolled in Part A

 

My social security card and package never arrived at my Thai address so I didn't even have my Medicare Card Number (11 digits).  I've read elsewhere that they don't send the package abroad but I was at least expecting the card (with the number). Nope. 

 

So I logged onto my MySSA account and it showed me enrolled in Part A only (but advised that that should be further verified). 

 

So I called this Medicare number to verify that I was definitely enrolled in Part A and hoping to get my Medicare Number. With your Medicare Number you can open an online Medicare account, but I was told that you CAN'T enroll in Part B online on the Medicare site because Parts A and B enrollments are done by Social Security.

 

1-800-633-4227 MEDICARE

They were very helpful and easily without pulling teeth verified that I was definitely enrolled in Part A and I was even able to get my Medicare Number read to me over the phone. Of course if you were in the U.S. you would want the actual physical card which can be requested via Medicare or Social Security. 

 

So far, so good.

 

As I was told that I MUST go through Social Security (not Medicare) to enroll in Part B, I called this number.

 

410-965-0160

Social Security International Service

9:00am and 4:00pm Eastern U.S time

 

Called it several times with the message call back later and not even put in a call queue!

 

There is an 800 number meant for people living in the U.S. but I haven't tried that yet as I doubt they're geared to an expat issue like this.

 

1-800-772-1213 Social Security

 

You see, the problem here is that the information you're going to find online about this is NOT about enrolling in Part B during INITIAL enrollment, but rather about special enrollments later.

 

There is form referred to that doesn't support foreign addresses and instructions with it usually say you need to file an additional form regarding your employment situation (presumably to try to avoid the penalty of late sign up because if you qualify under certain insurance conditions you are exempt). 

 

CMS40B - Application for Enrollment in Part B | CMS

 

I'm not sure what to do with that form as an expat trying to enroll in Part B during INITIAL enrollment. Notice it does support people that live specifically in the colony of Puerto Rico but appears to explicitly exclude expats. 

 

So what to do?

 

I'll keep trying to call the international number but it doesn't sound promising.

 

Other than that, there is always the dreaded Manila FBU, but I'm very hesitant to go there. Like many, I've found the service wanting. 

 

I perhaps recall a member here saying they could sign up for Medicare Part B online from their online Medicare account (Medicare number needed to create) but I was told very strongly by a Medicare rep that that is not true.

 

If any brave, generous, or masochistic soul, has made it this far, can you offer any advice?

 

In a way I'm finding this darkly funny. I want to pay the government money for something I can't use while living abroad, but they seem to making this very hard!

 

 

 

 

 

 

 

[Jeffr2]

Excellent information! Following.

[Jingthing]

5 hours ago, Jeffr2 said:

Excellent information! Following.

Well it's a work in progress.

I'm not sure I'm actually going to manage to get enrolled in Part B before the IEP deadline. 

Especially if I have to resort to the black email hole of Manila FBU.

[Jeffr2]

4 hours ago, Jingthing said:

Well it's a work in progress.

I'm not sure I'm actually going to manage to get enrolled in Part B before the IEP deadline. 

Especially if I have to resort to the black email hole of Manila FBU.

I'll be 65 next August. I missed a lenter a few years ago for my mother. Just never arrived. Confirming she was still alive. They stopped her SS payments and it took me over a year to get it resolved. Too many early phone calls. It was horrible.

[Jingthing]

21 minutes ago, Jeffr2 said:

I'll be 65 next August. I missed a lenter a few years ago for my mother. Just never arrived. Confirming she was still alive. They stopped her SS payments and it took me over a year to get it resolved. Too many early phone calls. It was horrible.

Wow.

It took a whole year?

That's horrible.

I've heard it's a hassle but not that bad.

A delay that long could lead to killing off many financially marginal people in which case they wouldn't need to fix it anymore.

[AgMech Cowboy]

11 hours ago, Jingthing said:

If any brave, generous, or masochistic soul, has made it this far, can you offer any advice?

Not yet. I am planning to re-enroll this December, so maybe in the same boat.

It took me 5 months last year to disenroll (they started charging me $500/month due to taking a lump sum on my pension the year before, which was all spent on my son's international school). They basically drained the last of my savings, but I need to get back on it since I'll probably return to the states next year.

 

Keep us informed. Since I'm here, I'll probably use Manila. They are the office that finally got me off of Part B last year. Good Luck

[pablo el sueco]

I understand you wish to enrol during your IEP, and that you're concerned about the processing involved with having to go through Manila.  It was many years after my IEP, but I  enrolled in Part B in 2019 by going through Manila. I couldn't find any other way to do it as an expat in Thailand.  Manila and Baltimore handled my enrollment swiftly and smoothly.  I realise my case is different from yours, but I wanted to  share my positive experience with enrolling through Manila.  Good luck in your endeavor.

[Tony125]

6 hours ago, Jingthing said:

Well it's a work in progress.

I'm not sure I'm actually going to manage to get enrolled in Part B before the IEP deadline. 

Especially if I have to resort to the black email hole of Manila FBU.

Do you not have any family/friend in US that you could have listed as living at or listed as a mailing address that could have forwarded the card to you?  Get a MagicJack  Google it. Device which plugs into computer port or router that gives you a US phone number and alows free calls to the US and Canada for a yearly charge of $45.  Friends can call you in Thailand for no charge to them. I use it when calling 800 numbers in US and can stay on line for hours untill  they answer the phone  with no cost to me.

[Jingthing]

10 minutes ago, Tony125 said:

Do you not have any family/friend in US that you could have listed as living at or listed as a mailing address that could have forwarded the card to you?  Get a MagicJack  Google it. Device which plugs into computer port or router that gives you a US phone number and alows free calls to the US and Canada for a yearly charge of $45.  Friends can call you in Thailand for no charge to them. I use it when calling 800 numbers in US and can stay on line for hours untill  they answer the phone  with no cost to me.

That isn't my issue.

I have a U.S. phone number.

The issue is that I'm recorded as living abroad by social security so I wasn't automatically enrolled in Part B.

Personally I don't think expats should lie about that to Social Security. It's actually fraud to so.

 

[KClark]

Actually I've just done this very thing.  Send an email to FBU Manila telling them you want an enrollment request form for Medicare Part B.  You should receive one in a few days.  Fill it out and send it back to them.  A few days letter they will acknowledge they have received it.  All this is over email as the Soc Sec Office in MNL is closed due to COVID restrictions.  It's rather painless.  r, KC

[Almer]

OMG, the Uk way is far simpler, if you dont live in the Uk you get  big zero, with regard to health as an expat, if you live overseas for more than 90 days you are classed as gone, if/when you return you must register and wait for 6 months before being afforded hospital or and medical help. 

That said you can go Bangkok to France, public transport to Calais , hide in a lorry or hitch a lift on a boat when you arrive Blighty do a non comprehend after ditching your passport  and look forward to several months of hospitality in a upmarket hotel and any ailments will be sorted, i think this is how it works.

[BKK57]

20 minutes ago, Tony125 said:

Do you not have any family/friend in US that you could have listed as living at or listed as a mailing address that could have forwarded the card to you?  Get a MagicJack  Google it. Device which plugs into computer port or router that gives you a US phone number and alows free calls to the US and Canada for a yearly charge of $45.  Friends can call you in Thailand for no charge to them. I use it when calling 800 numbers in US and can stay on line for hours untill  they answer the phone  with no cost to me.

Microsoft Skype lets you purchase a Skype number. Cost is $52/year.  No dongle needed. The Skype number is a USA phone number that any one in the States can use to call you in Thailand or for that matter where ever you are in the world. They dial it just like any USA number and it will ring on your computer, smart phone or both, whenever you have Skype installed.  You can also received a SMS on the number which is VERY useful when businesses in the USA what to send a code to your phone via SMS to verify your identity. The person calling you will only be charged local call rates and they can can leave a voice mail if you don't answer.  You can pick the are code and the country of the Skype number.  Also with the Skype account (no Skype number needed) you can call 800 and other toll-free numbers in the states for free, other numbers are charged about 2 cents per minute. You can also can numbers in other countries as well.  I have used this for many years and find it immensely useful.

[Jingthing]

18 minutes ago, KClark said:

Actually I've just done this very thing.  Send an email to FBU Manila telling them you want an enrollment request form for Medicare Part B.  You should receive one in a few days.  Fill it out and send it back to them.  A few days letter they will acknowledge they have received it.  All this is over email as the Soc Sec Office in MNL is closed due to COVID restrictions.  It's rather painless.  r, KC

That's interesting.

My previous email encounters with Manila FBU have been  very unsatisfactory involving multiple sends of the same email, actions asked for but never done with no explanation of why not. That was about my initial signup for social security which I ended up doing without any help from Manila FBU whatsoever. 

 

That said for this issue it may indeed make sense to try with them.

 

To add had this pushback from them before.

 

Must provide all this to get a response.

Is this still their policy?

 

‐---

 

However, we are not able to assist you with your inquiry without the following information:

 

-      Last Name:

-      First Name:

-      Middle Name:

-      Date of Birth:

-      Place of Birth:

-      Last four digits of Social Security Number (SSN):

-      Address:

-      Contact Number:

[Jingthing]

2 hours ago, pablo el sueco said:

I understand you wish to enrol during your IEP, and that you're concerned about the processing involved with having to go through Manila.  It was many years after my IEP, but I  enrolled in Part B in 2019 by going through Manila. I couldn't find any other way to do it as an expat in Thailand.  Manila and Baltimore handled my enrollment swiftly and smoothly.  I realise my case is different from yours, but I wanted to  share my positive experience with enrolling through Manila.  Good luck in your endeavor.

Yes. Thank you. Based on my previous experience I thought it would more efficient to deal directly with Baltimore. But as they aren't answering their phone maybe not anymore. 

[Jingthing]

22 minutes ago, Almer said:

OMG, the Uk way is far simpler, if you dont live in the Uk you get  big zero, with regard to health as an expat, if you live overseas for more than 90 days you are classed as gone, if/when you return you must register and wait for 6 months before being afforded hospital or and medical help. 

That said you can go Bangkok to France, public transport to Calais , hide in a lorry or hitch a lift on a boat when you arrive Blighty do a non comprehend after ditching your passport  and look forward to several months of hospitality in a upmarket hotel and any ailments will be sorted, i think this is how it works.

It's not very different. US national expats can enroll in Medicare  part A is free and part B costs about 150 dollars a month minimum but it's useless unless you're physically in the U.S.

 

If you opt out of Part B there is a similar limited window of enrollment and waiting time upon repatriation. 

 

Part A only is very inadequate. 

Plus there are other parts not available for enrollment to expats. 

[KClark]

Sorry--make that "a few days later" they will acknowledge.......................  I live in Thailand and my local address here is what's registered with Soc Sec.  I'm retired Army and our insurance program, Tricare, requires we sign up for Part B at age 65 to maintain Tricare coverage.  So while I essentially had no choice, I concur with your notion that signing up at 65 regardless is the prudent thing to do.  Anyway, sounds like your situation is the same as mine, so the email to FBU MNL should do the trick.  Happy hunting.  

[KClark]

However, we are not able to assist you with your inquiry without the following information:

 

-      Last Name:

-      First Name:

-      Middle Name:

-      Date of Birth:

-      Place of Birth:

-      Last four digits of Social Security Number (SSN):

-      Address:

-      Contact Number:

 

 

I sent them all my relevant data in my initial email to them.  Didn't seem to matter as they simply sent me a very short enrollment request back.  I think just the mention of name, address, medicare nbr and your intent would be sufficient for first salvo.  The form they'll send back ask for:

medicare nbr

name

address

phone nbr

check the box that says you want part B.  

 

That's about it.  When they respond they'll acknowledge your request and state "Action was taken to enroll you in Medicare Part B."  

[Jingthing]

22 minutes ago, BKK57 said:

Microsoft Skype lets you purchase a Skype number. Cost is $52/year.  No dongle needed. The Skype number is a USA phone number that any one in the States can use to call you in Thailand or for that matter where ever you are in the world. They dial it just like any USA number and it will ring on your computer, smart phone or both, whenever you have Skype installed.  You can also received a SMS on the number which is VERY useful when businesses in the USA what to send a code to your phone via SMS to verify your identity. The person calling you will only be charged local call rates and they can can leave a voice mail if you don't answer.  You can pick the are code and the country of the Skype number.  Also with the Skype account (no Skype number needed) you can call 800 and other toll-free numbers in the states for free, other numbers are charged about 2 cents per minute. You can also can numbers in other countries as well.  I have used this for many years and find it immensely useful.

Off topic but interesting. 

Is Skype technically VOIP or not?

You may know that many US financial institutions require sms authentication codes.

Some accept VOIP numbers and some don't. 

Yes they can tell.

I recently heard some major news that eventually all US banks will be requiring this and only US based mobile phones in your name will be accepted. Definitely no VOIP. So your Skype solution unfortunately may be short lived..

[KClark]

One last thing--if you haven't yet looked at how Medicare computes how much your Part B premiums will be, you should give that a look.  Plenty of info via internet, but pay attention to the Modified Adjusted Gross Income (MAGI) part.  Essentially, they add most of those deductions (other than standard deduction) you might have taken from your AGI to file your Fed Taxes, and ADD them back in for your MAGI.  I know, sucks.  That percentage of your Social Security Retirement you don't have to pay taxes on--you guessed it, gets added back in as part of your MAGI.  They'll use your tax filing from two years previous, as that's what the IRS gives them.  So if you've worked hard, deferred gratification or fun things, saved and invested to build up a nest egg, you'll want to strategize how you bleed it down.  $1 over on MAGI and you're into the next higher Part B premium charge (which run from the minimum of $148.50 to the max of $356.40 per month, with 4 interim rates between those bottom and top nbrs.)

[BKK57]

Not everyone is aware of this but you can DEFER medicare Part B without penalty. I plan to do this while I live in Thailand as I have good health plan that will pay everything in Thailand.  Don't want to pay Medicare Part B AND my health insurance premium.  To do this you need to have an existing health plan for the period you want to defer. See the link below to check if this works for your situation.

 

https://www.healthline.com/health/medicare/how-to-defer-medicare

[Jingthing]

1 hour ago, BKK57 said:

Not everyone is aware of this but you can DEFER medicare Part B without penalty. I plan to do this while I live in Thailand as I have good health plan that will pay everything in Thailand.  Don't want to pay Medicare Part B AND my health insurance premium.  To do this you need to have an existing health plan for the period you want to defer. See the link below to check if this works for your situation.

 

https://www.healthline.com/health/medicare/how-to-defer-medicare

Yes. Definitely not my situation but you are certainly correct.

[statman78]

Jingthing,

 

I’m surprised that you did not receive your Medicare card.  I am collecting social security using my Thai address.  This past February I turned 65 so was automatically enrolled in Medicare part A.  I received my Medicare card in the mail here in Thailand in March.  I did not sign up for part B.

[wwest5829]

I encourage all USA Expat citizens to lobby for equal treatment for retirement medical coverage. Earned military retirement medical care is global (Tricare) . Earned civilian retirement medical care (Medicare) is limited to those on US territory. Currently, I have not only paid for the Medicare coverage but additionally, pay a monthly premium and all without equal coverage with military retirees. Reasonable to have equal treatment on the same conditions as the retired military.

[Jingthing]

3 minutes ago, statman78 said:

Jingthing,

 

I’m surprised that you did not receive your Medicare card.  I am collecting social security using my Thai address.  This past February I turned 65 so was automatically enrolled in Medicare part A.  I received my Medicare card in the mail here in Thailand in March.  I did not sign up for part B.

I was not so surprised. If it was even sent then there are real issues with mail service these days. I think I read something about being able to print out your own card from your Medicare online account. Of course you need your Medicare number to open that account. 

[BKK57]

2 hours ago, Jingthing said:

Off topic but interesting. 

Is Skype technically VOIP or not?

You may know that many US financial institutions require sms authentication codes.

Some accept VOIP numbers and some don't. 

Yes they can tell.

I recently heard some major news that eventually all US banks will be requiring this and only US based mobile phones in your name will be accepted. Definitely no VOIP. So your Skype solution unfortunately may be short lived..

Yes, somewhat off topic but Tony125 was talking about MagicJack to talk cheaply with Social Security and Medicare outside of Thailand. True, they can tell, and true, some do and some don't. Not sure how this will be affected by bank regulations. But at the moment SMS from banks and other institutions to my Skype number works. Just another option available so I can identify myself in the States while living in Thailand. Adding in email, and authentication such as google authentication I'm good almost all the time. If, in the future, I'm unable to receive SMS from banks Skype will still be very worthwhile.

[ericthai]

6 hours ago, Jeffr2 said:

I'll be 65 next August. I missed a lenter a few years ago for my mother. Just never arrived. Confirming she was still alive. They stopped her SS payments and it took me over a year to get it resolved. Too many early phone calls. It was horrible.

yes, you need to be careful as they do send out letter to verify you're still alive. Also Medicare advantage plans will send out letter to verify you're still at your address. Rules state you cant be out of your service area for more than 6 month or you'll be dropped. I've worked in the Medicare industry if you need help you can PM me.   For Social Security I use the 1-800-772-1213 Typically you have 30min-40 min wait.   Note: Be careful reading stuff on the internet, there is allot of miss information on medicare.

[ChristianBlessing]

I suggest continuing to call Medicare or visit/correspond with Manila. I'm nearly certain you will not be automatically enrolled in part B. Two years ago I returned to the US from abroad at age 68 and visited a local Social Security office to ascertain my status as MySS only showed me enrolled in Part A. Despite having a US address I had not been enrolled. Thankfully I was able to demonstrate coverage for the previous 3 years and the 3 month window (from the date at which my private coverage ended) so as to avoid the penalty.

 

I did not apply for Part D until a year later, and believe me, it's painful being stuck with the ensuing penalty.

 

Good luck.

[ericthai]

2 hours ago, KClark said:

Sorry--make that "a few days later" they will acknowledge.......................  I live in Thailand and my local address here is what's registered with Soc Sec.  I'm retired Army and our insurance program, Tricare, requires we sign up for Part B at age 65 to maintain Tricare coverage.  So while I essentially had no choice, I concur with your notion that signing up at 65 regardless is the prudent thing to do.  Anyway, sounds like your situation is the same as mine, so the email to FBU MNL should do the trick.  Happy hunting.  

Thank you for your service.  Nice you have Tri-care that is the best you can have!! 

[ericthai]

2 hours ago, KClark said:

One last thing--if you haven't yet looked at how Medicare computes how much your Part B premiums will be, you should give that a look.  Plenty of info via internet, but pay attention to the Modified Adjusted Gross Income (MAGI) part.  Essentially, they add most of those deductions (other than standard deduction) you might have taken from your AGI to file your Fed Taxes, and ADD them back in for your MAGI.  I know, sucks.  That percentage of your Social Security Retirement you don't have to pay taxes on--you guessed it, gets added back in as part of your MAGI.  They'll use your tax filing from two years previous, as that's what the IRS gives them.  So if you've worked hard, deferred gratification or fun things, saved and invested to build up a nest egg, you'll want to strategize how you bleed it down.  $1 over on MAGI and you're into the next higher Part B premium charge (which run from the minimum of $148.50 to the max of $356.40 per month, with 4 interim rates between those bottom and top nbrs.)

If you're living in the USA at least 6  months out of the year then you should look into Medicare advantage plans. Some of the plans in some areas in the USA have a part B refund. These plans work with Tri-care too. 

[Jingthing]

1 hour ago, ericthai said:

yes, you need to be careful as they do send out letter to verify you're still alive. Also Medicare advantage plans will send out letter to verify you're still at your address. Rules state you cant be out of your service area for more than 6 month or you'll be dropped. I've worked in the Medicare industry if you need help you can PM me.   For Social Security I use the 1-800-772-1213 Typically you have 30min-40 min wait.   Note: Be careful reading stuff on the internet, there is allot of miss information on medicare.

Well let's get specific. 

Social Security doesn't send the proof of life letters to people on record with U.S  addresses. Only expats.

The letters were suspended last year for expats because of Covid-19 and there is strong evidence they will be suspended this year as well.

Many expats lie to Social Security and Medicare and fake being a U.S. resident at least partly to avoid those letters. That can backfire.

Medicare Advantage is not available to honest expats because it's zip code based. Good info there that they send out letters.

The only Medicare parts available to honest expats are A and B.

Snowbird  type part time expats can more legitimately claim US residence.