US Medicare options for CNX residents

[lopburi3]

25 minutes ago, CMBob said:

I can understand expats that truly believe they'll never go back to the US opting out of Part B of Medicare but for all others it could be foolish.

There is a group where it may not be foolish and I have opted many years ago not to pay for Medicare B for that reason.  I have worldwide FEHB insurance which I share payment for and really no intent to return to USA.

Quote

As a federal retiree, if you don't enroll in Medicare, your FEHB plan will act as your primary insurer and won't pay less because you qualify for Medicare.

 

[1FinickyOne]

3 minutes ago, PFV said:

it would be very expensive.

Any idea of the price here?

 

My Thai FIL had quadruple bypass and all the meds they might want to give him for 30 baht... 

 

But what would it cost us farang at a good private hospital?

[pablo el sueco]

4 hours ago, cmarshall said:

I didn't know that.  So, it compounds.  You pay penalties on the penalties.  Nasty.

I would not characterize it as paying penalties on the penalties.  That's not how it works.

 

Each year, the government announces the standard premium for the year.
If one has incurred no penalty, then one's annual payment is 100% of the standard premium.
If one has incurred a 10% penalty, then one's annual payment is 110% of the standard premium.

 

While a penalty due to late enrollment is applied year after year as long as one is enrolled in Part B, penalties do not compound upon each other from one year to the next.

[Sheryl]

16 minutes ago, 1FinickyOne said:

Why? Is there one main or top reason? I am talking about people with choice, not ones who can no longer get the liars letter and do not meet the visa qualifications.

 

USA, my beloved home country, seems like an angry, dangerous and expensive place... I have no desire to even visit there... 

 

Bear in mind that visa qualification / requirements for extensions of stay can and do change. And changes of late have been applied to people already here.

 

A visa entitles you to no more than to enter the country within a defined time period.

 

Extensions of stay entitle you to no more than 12 months more stay. No assurance of the same a year later.

 

This far, retirees and people married to Thais have been able to extend year after year (though the financial requirements for retirees have significantly increased) but that does not mean you can be certain it will always be the same going forward.

 

What the Thai government - and any future Thai governments - may decide to do is a wild card.

 

As is future political stability in Thailand.

 

Changes in either of these could force you to leave, perhaps permanently.

 

So might a serious change in health status.

 

Always have a Plan B.

 

 

BTW - The US might not seem so angry and dangerous if you did actually visit. Easy to get a distorted picture of any place when relying in media reports. Media everywhere reports only the unusual and sensational.

 

I now go back yearly and I can assure you that most people are going about their lives peacefully, people with differing political views are managing to come together for holidays and family gatherings without incident, crime rates in most areas aren't much increased, etc etc. As for expensive - I would actually say the gap in costs between Thailand and US has if anything narrowed over the years due to big increases in Thailand.

[IAMHERE]

16 minutes ago, lopburi3 said:

There is a group where it may not be foolish and I have opted many years ago not to pay for Medicare B for that reason.  I have worldwide FEHB insurance which I share payment for and really no intent to return to USA.

 

The FEHB ;  they know you are overseas?  I ask because I have the BCBS Fepblue and a bit afraid to declare my outside the states residence as more than travel.

[PFV]

15 minutes ago, Sheryl said:

...Or is there a time limit to apply for MediGap after enrolling in Part B?

That is exactly the point. You can enroll in MediGap without going through a medical screening process only during the initial 6 months after signing up for Part B, Folks with pre-existing conditions will either be denied coverage or required to pay a higher premium, depending on the condition.

There are a few exceptions such as having existing qualified insurance, a change in benefits, after a Medicare Advantage Trial period, or if you live in ME, CT, MA, or NY.

I suppose that I could sign up next summer, when I turn 65, and then move to Maine for Medigap. I have always liked Maine, but spending the winter there is not what I had in mind.

Do you really need to be physically present at least 6 months a year, or would it be sufficient to rent a place for 12 months and pay local and state taxes?

 

[lopburi3]

9 minutes ago, IAMHERE said:

The FEHB ;  they know you are overseas?  I ask because I have the BCBS Fepblue and a bit afraid to declare my outside the states residence as more than travel.

Yes - I lived and worked overseas.  FEP/Blue Cross Blue Shield is the international coverage program.  There are only a handful and some have employment restrictions.  But these are for those primarily living overseas.

Edited November 30, 2021 by lopburi3
add info

[jerrymahoney]

28 minutes ago, lopburi3 said:

There is a group where it may not be foolish and I have opted many years ago not to pay for Medicare B for that reason.  I have worldwide FEHB insurance which I share payment for and really no intent to return to USA.

Well as long as we're now dealing in arcane exceptions to the Part B enrollment penalty, I will offer this one:

 

Deficit Reduction Act of 2005
All CMS Provisions
As of February 28, 2006
5115 Waiver of part B late enrollment penalty for certain international volunteers.

 

Provides for the waiver of the Part B late enrollment penalty and establishment of a special enrollment period for beneficiaries who are volunteering outside of the U.S. through a 12 month or longer program sponsored by a tax-exempt organization defined under section 501(c)(3) of the Internal Revenue Code and who have other health insurance coverage.

Edited November 30, 2021 by jerrymahoney

[Srikcir]

"Return to the US permanently"

You also go to Guam which has substantial medical services due to US Naval population. 

 

[Sheryl]

1 minute ago, PFV said:

That is exactly the point. You can enroll in MediGap without going through a medical screening process only during the initial 6 months after signing up for Part B, Folks with pre-existing conditions will either be denied coverage or required to pay a higher premium, depending on the condition.

There are a few exceptions such as having existing qualified insurance, a change in benefits, after a Medicare Advantage Trial period, or if you live in ME, CT, MA, or NY.

I suppose that I could sign up next summer, when I turn 65, and then move to Maine for Medigap. I have always liked Maine, but spending the winter there is not what I had in mind.

Do you really need to be physically present at least 6 months a year, or would it be sufficient to rent a place for 12 months and pay local and state taxes?

 

You need to be physically present not just in US but specifically in the  plan coverage area.

 

In practicality, if you rented a place and paid local and state taxes, they would be unlikely to know, but it would still be a risk that could potentially invalidate the policy.

 

I wouldn't personally worry about being a few days under the  6 month mark from time to time, I don't think anyone is going to sit down and count the days if you do in fact live in the US and in the coverage area close to half time. But those who live full-time in Thailand and do no more than make a short visit to the US each year are on thin ice IMO.

[Sheryl]

6 minutes ago, jerrymahoney said:

Well as long as we're now dealing in arcane exceptions to the Part B enrollment penalty, I will offer this one:

 

Deficit Reduction Act of 2005
All CMS Provisions
As of February 28, 2006
5115 Waiver of part B late enrollment penalty for certain international volunteers.

 

Provides for the waiver of the Part B late enrollment penalty and establishment of a special enrollment period for beneficiaries who are volunteering outside of the U.S. through a 12 month or longer program sponsored by a tax-exempt organization defined under section 501(c)(3) of the Internal Revenue Code and who have other health insurance coverage.

It is also waived for those who lived and worked abroad and had health insurance there while doing so. I enrolled in Part B a year or two  later than Part A and was exempted on this ground.

[IAMHERE]

6 minutes ago, Srikcir said:

"Return to the US permanently"

You also go to Guam which has substantial medical services due to US Naval population. 

 

I like that option well enough. You think it a better option to go to Guam than Phillipinnes?

[Jingthing]

33 minutes ago, 1FinickyOne said:

Why? Is there one main or top reason? I am talking about people with choice, not ones who can no longer get the liars letter and do not meet the visa qualifications.

 

USA, my beloved home country, seems like an angry, dangerous and expensive place... I have no desire to even visit there... 

Use your imagination. I refuse to engage at the above level.

[Sheryl]

Just now, IAMHERE said:

I like that option well enough. You think it a better option to go to Guam than Phillipinnes?

If the idea is to be able to use Medicare coverage, inlcuding getting a Supplemental policy, Philippines is out. Guam or Hawaii (and I think American Samoa) are in.

 

Guam is  tiny and things are pretty expensive there. Hawaii is expensive too but much larger/more range of choice in where to live and things to do.

[Jingthing]

1 minute ago, IAMHERE said:

I like that option well enough. You think it a better option to go to Guam than Phillipinnes?

Guam is a U.S. territory. The Philippines currently is not. 

[connda]

23 hours ago, PFV said:

With eligibility for Medicare a few months away, I am trying to figure out if it is worth enrolling due to lack of coverage outside the US, or if it is even possible without a US address.

Like the rest of us - you're screwed. You've paid into Medicare all your life.  Now?  Well go ahead.  Enroll.
Then if you have an emergency then maybe you'll be able to be packed on an airplane.  Or not.  And then, unlike the Congressional super-plans and Tri-Care - you can die in Thailand with a Medicare policy that doesn't do <deleted>.

Me?  If I have a terminal disease, I'll go back while I'm still well and become a burden on the government.  As a Veteran, I'll embarrass them.

"Homeless Dying Veteran Can Not Obtain Hospice Care - Dies On Street."  

[Jingthing]

43 minutes ago, PFV said:

For me, getting MediGap is almost more important than Part B. Here in Chiang Mai, my cardiologist told be that I will probably need bypass surgery at some point in the future, given current calcification issues, and without MediGap it would be very expensive. At that point in time I would have no problem in moving back to the US, but would not want to move now just waiting for something bad to happen. So postponing enrollment in part B seems to be the only option for now.

I don't follow your logic at all! If you repatriate you will be in a better situation if you're already in B regardless. Are you getting that it can potentially take as long as 15 months to get on B upon repatriation?

[ifmu]

23 hours ago, Jingthing said:

Hmm.

I just signed up for Medicare B during the initial enrollment period to avoid a later penalty.

Because I had a current early social security claim I was automatically enrolled in the free part A.

If you're living abroad your ONLY options are A and B.

If you're living abroad and claim you're living in the US that is definitely fraud.

Every part other than A and B including advantage are based on zip code.

Expats don't have a US zip code.

You can enroll in A or A and B as an expat by emailing the FBU in the US embassy in Manila. The US embassy in Thailand can't help.

If repatriate there are ways to enroll in other parts but there are specific rules about that.

If you opt out of B it can take as long as 15 months to get enrolled in that upon repatriation on top of the severe penalties.

 

 

a lot of this is wrong  ... i am comparing it to my experience tho 

 

you can have medical a and b  and live in thailand   you can not use it for medical you only can pay for it      and have it ready if u need to go back 

 

you can have any mailing address you want     it will not affect a or b 

my medicare thinks i am on vacation .. i sort of am .. only covid idiots are keeping me from usa

now MAYBE  a fine print that says no vacation over 3 months  ... not confirmed for me yet  

 

you can fill out a form and STOP medical payments part B only  .. you will still have part a which is emergency medical in usa only   you will save money 

if you go this route  you can sign up for part B ONLY at signup time  

this will give you xtra money for thailand insurance .. and all the visa requirments 

 

if u sign up for part b again they will charge a nominal fee/penalty based on length of time out of country  ..... 

 

my opinion is that the manila SS is useless as a dgturd    even my ss in usa was useless  they had no idea how it worked  ..

SS is were you change your address  for medical ..

 

look at all info and check it out  

i am in california    and i am speaking for my experiences in my state only   

 

 

[Jingthing]

11 minutes ago, ifmu said:

a lot of this is wrong  ... i am comparing it to my experience tho 

 

you can have medical a and b  and live in thailand   you can not use it for medical you only can pay for it      and have it ready if u need to go back 

 

you can have any mailing address you want     it will not affect a or b 

my medicare thinks i am on vacation .. i sort of am .. only covid idiots are keeping me from usa

now MAYBE  a fine print that says no vacation over 3 months  ... not confirmed for me yet  

 

you can fill out a form and STOP medical payments part B only  .. you will still have part a which is emergency medical in usa only   you will save money 

if you go this route  you can sign up for part B ONLY at signup time  

this will give you xtra money for thailand insurance .. and all the visa requirments 

 

if u sign up for part b again they will charge a nominal fee/penalty based on length of time out of country  ..... 

 

my opinion is that the manila SS is useless as a dgturd    even my ss in usa was useless  they had no idea how it worked  ..

SS is were you change your address  for medical ..

 

look at all info and check it out  

i am in california    and i am speaking for my experiences in my state only   

 

 

I was speaking to actual expats.

If you're not a real expat or you're fraudently claiming that you're not I was NOT addressing that.

If you're living abroad you can ONLY enroll in A and B. That is FACT.

I never said you can actually use Medicare while living abroad!

You can't!

I recently used Manila FBU to sign up for Initial Enrollment Period part B.

I was already automatically enrolled in A at 65 because of an early social security claim.

If social security knows you live abroad they will not automatically enroll you in B.

I was pessimistic but it turned out Manila FBU processed my B application very quickly and it did take effect.

To add oddly enrollment in Medicare A and B is done through Social Security not Medicare.

Edited November 30, 2021 by Jingthing

[ifmu]

Just now, Jingthing said:

I was speaking to actual expats.

If you're not a real expat or you're fraudently claiming that you're not I was NOT addressing that.

If you're living abroad you can ONLY enroll in A and B. That is FACT.

I never said you can actually use Medicare while living abroad!

You can't!

i was only speaking for my experiences ..   as a yearly expat and future full time resident  over 65   

i think you should reread my post  .. i think you misunderstood  some of it  or i did not explain it well  

anyway OP check it out yourself   you need to get the correct info to proceed   .. take all this info and talk to someone  

[PFV]

19 minutes ago, Jingthing said:

I don't follow your logic at all! If you repatriate you will be in a better situation if you're already in B regardless. Are you getting that it can potentially take as long as 15 months to get on B upon repatriation?

I suppose that I could indeed sign up for B. Then, upon repatriating try to sign up for Medigap. If unsuccessful, go live in one of the 4 states that won't block me for pre-existing conditions, or be content with Medicare Advantage's limitations.

[Jingthing]

2 minutes ago, PFV said:

I suppose that I could indeed sign up for B. Then, upon repatriating try to sign up for Medigap. If unsuccessful, go live in one of the 4 states that won't block me for pre-existing conditions, or be content with Medicare Advantage's limitations.

Its my opinion that you should if nothing else to avoid a potential 15 month delay for B.

 

What are those four states?

[PFV]

16 minutes ago, Jingthing said:

...What are those four states?

Maine, New York, Connecticut, and Massachusetts. I understand that Massachusetts handles Medicare differently from other states.

[Jingthing]

1 hour ago, PFV said:

Maine, New York, Connecticut, and Massachusetts. I understand that Massachusetts handles Medicare differently from other states.

Oh. Cold and expensive. That said Buffalo may be the boom city of the climate change future.

[BKK57]

22 hours ago, Jingthing said:

You're forgetting the worse part of not taking B. It can take as long as 15 months to get enrolled in it upon repatriation. Thats what convinced me to pay for it more than penalties.

I have a good private insurance that I purchased many years ago that covers me both here in Thailand where live now AND in the US.  I know I need to sign up for Medicare A, but as I understand it, you can defer Part B as long as you show you have insurance during the deferral period. Then, if and when I decide to return to the US I can sign up for Part B with out penalty or medical underwriting.

 

Are you saying it could take 15 months regardless? If so, I still have the private insurance to cover me in the states, but I was unaware of this 15 month delay.  Part B doesn't require an US address, so why the possible 15 month wait?

 

So, given my situation, I don't really need to sign up for part B until I return to the US, right???

[My 2 baht]

7 hours ago, Jingthing said:

Extremely.

 

Plus of course the part B fee goes up every year anyway without the penalties.

 

Wait long enough and it could wipe out a lower level social security check.

I have plan B. It goes up about $2 per year

[My 2 baht]

4 minutes ago, BKK57 said:

 

 

So, given my situation, I don't really need to sign up for part B until I return to the US, right???

You can wait until you are ready to go back but there is a 10 % penalty per year until you are no more.

[Jingthing]

10 minutes ago, BKK57 said:

I have a good private insurance that I purchased many years ago that covers me both here in Thailand where live now AND in the US.  I know I need to sign up for Medicare A, but as I understand it, you can defer Part B as long as you show you have insurance during the deferral period. Then, if and when I decide to return to the US I can sign up for Part B with out penalty or medical underwriting.

 

Are you saying it could take 15 months regardless? If so, I still have the private insurance to cover me in the states, but I was unaware of this 15 month delay.  Part B doesn't require an US address, so why the possible 15 month wait?

 

So, given my situation, I don't really need to sign up for part B until I return to the US, right???

Yes you avoid the penalty.

I don't know if you are subject to the regular enrollment period or not in your situation. I would guess you'd be an exception though but you should research that.

The regular situation is there is a three month enrollment period. If an expat signed up for B just after that date they wouldn't be able to enroll until a year later adding up to a potential 15 month delay.

However yes expats can enroll during any open enrollment period including while living abroad.

Correct no US address needed for A or B.

[Jingthing]

15 minutes ago, My 2 baht said:

I have plan B. It goes up about $2 per year

Your post is not clear.

[Jingthing]

13 minutes ago, My 2 baht said:

You can wait until you are ready to go back but there is a 10 % penalty per year until you are no more.

No penalty if you've been on qualifying insurance.