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

[Jingthing]

17 hours ago, meechai said:

I recently did this process in reverse...

Meaning they automatically gave me Part B & I wanted out

 

They said just return card checking off part saying you opt out but it never went thru

 

So after contacting SS I found the easiest sure fire way was to file form CMS 1763

Again for my case of Opting out of Part B

 

The reason I am telling you this even though you want the opposite is I live in the USA & after speaking a long time with a nice lady at SS she said always on these cases the surefire way is fill the appropriate form & send to SS

 

Reasoning that SS is so backed up it is the only way to assure your covered or opted out with no penalties as you have proof

My Medicare starts Nov 2021 so I had time to re-file it

 

 

In your case just fill in form CMS40B which is the request for part B & send it to SS before your medicare starts

At least that way your protected from any interest/penalty etc

You will have your medicare # well in advance of starting medicare so no problem filling it out

 

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

 

 

 

 

I get what you're saying but all the instructions I've read about dealing with this an expat are very clear -- deal with your FBU (in Thailand's case Manila) or perhaps the international service number which is probably in Baltimore (which is how I made my social security claim).

Also the mail service is pretty awful these days. I don't trust it at all. 

Also I mentioned before that form you mentioned doesn't support foreign addresses. 

[Jingthing]

I have a question maybe someone can answer. 

If an expat does NOT enroll in Part B during their Initial Enrollment Period, they can still sign up during the General Medicare Enrollment Period (January 1–March 31) to start coverage July 1 even if they still live abroad, correct?

As I mentioned before a worse case scenario of someone repatriating without B in April and having to wait until July of the NEXT year to begin coverage, alternatively an expat that knows well in advance that they will repatriating would still be able to avoid that nightmare even if they didn't enroll during the IEP. 

[pablo el sueco]

 

6 hours ago, Jingthing said:

If an expat does NOT enroll in Part B during their Initial Enrollment Period, they can still sign up during the General Medicare Enrollment Period (January 1–March 31) to start coverage July 1 even if they still live abroad, correct?

You are correct.  Almost 7 years after my IEP ended, I enrolled in Part B during the General Medicare Enrollment Period in 2019.  My monthly premium, including the 60% late enrollment fee, was first withheld from my Social Security benefit July 3, 2019.  I did this not because I had any plan to repatriate, but because, like you, I was wary of being forced to return to the US due to some unforeseen event -- and not having proper and complete medical coverage immediately upon arrival.  At the time, in 2019, I was unaware that Thailand would soon force me to buy unwanted and unneeded insurance due to my O/A retirement.  Now I consider myself over-insured due to having

• Global HealthSelect Secondary Insurance through my pension provider
• Medicare Part B
• Unwanted Thai insurance

 

On 9/22/2021 at 5:39 PM, KClark said:

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.

I also wanted to take this opportunity to thank KClark for his alert about MAGI.  My Medicare premium would have increased beyond the standard rate in a couple of years if I hadn't seen his alert and taken action to reduce my investment in municipal bonds.

 

[Jingthing]

3 hours ago, pablo el sueco said:

 

You are correct.  Almost 7 years after my IEP ended, I enrolled in Part B during the General Medicare Enrollment Period in 2019.  My monthly premium, including the 60% late enrollment fee, was first withheld from my Social Security benefit July 3, 2019.  I did this not because I had any plan to repatriate, but because, like you, I was wary of being forced to return to the US due to some unforeseen event -- and not having proper and complete medical coverage immediately upon arrival.  At the time, in 2019, I was unaware that Thailand would soon force me to buy unwanted and unneeded insurance due to my O/A retirement.  Now I consider myself over-insured due to having

• Global HealthSelect Secondary Insurance through my pension provider
• Medicare Part B
• Unwanted Thai insurance

 

I also wanted to take this opportunity to thank KClark for his alert about MAGI.  My Medicare premium would have increased beyond the standard rate in a couple of years if I hadn't seen his alert and taken action to reduce my investment in municipal bonds.

 

Thanks for that.

 

I'm trying to better understand the penalty mechanics. 

 

Perhaps you can answer this.

 

For an example using these sample numbers.

 

Suppose a person has not had Part B for 5 years before signing up in a year where the fee is 200 dollars resulting in a 50 percent penalty of 100 dollars. 

 

So presumably the first year fee would be 300 not 200.

 

But what about subsequent years? Is the penalty set at 100 or is it recalculated every year based on the current fee based on their income formula plus the expected annual increase?

[shortstop2]

I enrolled in Part B before I started collecting SS.  Manila sets up a telephone appointment and calls you at your Thai number.

 

Earlier this year I decided to collect SS and again Manila again set up a phone appointment and called me at my Thai number. 

[pablo el sueco]

11 minutes ago, Jingthing said:

But what about subsequent years? Is the penalty set at 100 or is it recalculated every year based on the current fee based on their income formula plus the expected annual increase?

The penalty is recalculated every year based on the new rate.  If the new rate is 240 monthly, then the rate plus 50% penalty would be 360 monthly.

[Jingthing]

1 minute ago, pablo el sueco said:

The penalty is recalculated every year based on the new rate.  If the new rate is 240 monthly, then the rate plus 50% penalty would be 360 monthly.

Ouch!

[shortstop2]

On 9/25/2021 at 3:42 AM, Jingthing said:

This might be a better reason to pay for Part B than even avoiding the penalties. 

 

The enrollment window and delay in starting coverage. 

 

Here's a worst case scenario.

 

Suppose you repatriate due to a medical crisis in April 2022.

 

Then you would need to wait until January 2023 to enroll in Part B and then wait for the coverage to start in July 2023.

 

That's well over a year!

 

https://www.medicare.gov/blog/medicare-part-b-enrollment-sign-up-now

 

Of course the best case scenario would be about a four month wait IF you arrived in March 2022.

This is the main reason why I enrolled in Part B.    

[Jingthing]

23 minutes ago, shortstop2 said:

This is the main reason why I enrolled in Part B.    

It's pretty compelling!

[bendejo]

Not on topic but possibly pertinent:

https://www.reuters.com/world/us/us-postal-service-finalizes-plan-slow-some-mail-deliveries-2021-08-06/

 

 

[Jingthing]

Update on this.

Having masochistic tendencies, I kept trying calling the international number in the U.S. Absolutely nothing. Never even put into a queue. Told the office was closed when their hours were saying open. Rung through occasionally to get the same snarky message, everyone is busy, call again at a later time. I did. I did. I did.

This is pretty bad. Another example of our "clout" as expats. Who are we supposed to complain to about this non service? 
Anyway I broke down and called the 1 800 number not expecting much and my expectations were met. Put on hold for 40 minutes. I didn't mind that as there was an end to it but they really should give an estimated wait time message.

The lady was sincerely trying to help but she didn't know much. 

I did learn some things that are probably true though:

The form is indeed https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf

The format doesn't support foreign addresses or phone numbers and she couldn't offer any advice on that.

She was pretty definite that the ONLINE application using that same form was NOT for people like me trying to enroll during the Initial Enrollment Period. It's for Special Enrollment period people and Puerto Ricans.

The idea of filling out the form and mailing it would mean mailing it to your local Social Security office. As expats, we don't have one, unless you count Manila FBU.

The 1 800 number can't enroll over the phone.

I don't know if the Baltimore number could have though. 

As far as I can tell now, it's work through Manila FBU or nothing, so I am trying to work through Manila FBU.

Manila FBU or bust it is. 

 

Edited October 1, 2021 by Jingthing

[Bubbha]

A friend recently turned 65 y/o enrolled in Part B through the Manila FBU.

This was accomplished primarily using email.

She later enrolled her husband 70 y/o using the same system (late enrollment penalties applied).

 

 

 

[Jingthing]

Perhaps someone can help me.

Communicating with Manila but the info they send is limited.

 

They sent me PDF attachment of CMS-40B.pdf APPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE) and said send it back by email but there are some issues.

 

APPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE) (cms.gov)

 

I did ask them about the foreign address and phone number not being supported on the form and they didn't bother to answer. 

 

Well, I'll just figure out a way to get the information in there and note they are foreign in the remarks section.  If that isn't OK, they can tell me later.

 

As the form needs to be SIGNED (it's not an online filing) I assume that I need to print it out sign it, and then I can scan the finished form and attach by email. Sounds right?

 

The form is four pages. Only page two is actually fit it out stuff. The first page is intro and page three and four are messages and instructions? Can I send back only page two or do I need to send back all four? 

 

Is it OK if it's four separate PDF scans or does it need to be a PDF scan including all four pages?

 

Thanks for any help. 

Edited October 5, 2021 by Jingthing

[Jingthing]

For future reference this is what FBU Manila is asking for these days in email communcations:

Quote

 

So that we can locate your records and assist you with your inquiry, please provide the identifying information listed below.  Providing this information is optional; however, we may not be able to assist you accurately without referring to your records.

 

-      Complete Name (first name, middle name, last name):

-      Other Names Used:

-      Date of Birth:

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

-      Address:

-      Contact Number:

 

 

[pablo el sueco]

11 hours ago, Jingthing said:

I did ask them about the foreign address and phone number not being supported on the form and they didn't bother to answer. 

In 2019, I simply downloaded the form, CMS-40B-E, filled it in, signed it, and sent it to Manila.  I did not communicate with Manila in any other way.  In the phone number field, I entered my land line; for the area code I entered 662, and completed the field with the last 7 digits of my land line.  In the Mailing Address field, I entered the standard first line info followed by the Tambon and Amphoe.  In the City field, I entered my province, the postal code, and Thailand.  I sent the form to Manila on 2 February.  On May 19, Baltimore sent me a letter informing me that my Part B coverage would start in July.

 

12 hours ago, Jingthing said:

As the form needs to be SIGNED (it's not an online filing) I assume that I need to print it out sign it, and then I can scan the finished form and attach by email. Sounds right?

Sounds right.

 

12 hours ago, Jingthing said:

The form is four pages. Only page two is actually fit it out stuff. The first page is intro and page three and four are messages and instructions? Can I send back only page two or do I need to send back all four? 

I only sent page two

[Jingthing]

1 hour ago, pablo el sueco said:

In 2019, I simply downloaded the form, CMS-40B-E, filled it in, signed it, and sent it to Manila.  I did not communicate with Manila in any other way.  In the phone number field, I entered my land line; for the area code I entered 662, and completed the field with the last 7 digits of my land line.  In the Mailing Address field, I entered the standard first line info followed by the Tambon and Amphoe.  In the City field, I entered my province, the postal code, and Thailand.  I sent the form to Manila on 2 February.  On May 19, Baltimore sent me a letter informing me that my Part B coverage would start in July.

 

Sounds right.

 

I only sent page two

Thank you very very much.

 

That was quite helpful especially the detail that you only sent Page 2 and that was accepted. Now I don't have to worry about merging multiple scans into one PDF file. I need to use the email method as I've procrastinated on this and can't risk physically mailing. I don't know about other people but I've found the international pandemic mail service here to be very unreliable, in some cases nonexistent.

 

What gets me about the communication with the FBU is that you know they've been dealing with these forms for many years. Why don't they have a template text to send people to give them technical guidelines? I guess it's a do the minimum kind of thing.

Edited October 6, 2021 by Jingthing