US Medicare options for CNX residents

[1FinickyOne]

4 hours ago, Jingthing said:

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

Then how about approaching this from the other side though i doubt there is data...

 

Do you think the people who have returned are happier there, than here? Assuming they could have stayed? Do you think you would be happier if you had gone back?

 

one friend in Pa. bought a Fla. condo, lived there for a year and moved back to Pa... 

[Jingthing]

12 minutes ago, 1FinickyOne said:

Then how about approaching this from the other side though i doubt there is data...

 

Do you think the people who have returned are happier there, than here? Assuming they could have stayed? Do you think you would be happier if you had gone back?

 

one friend in Pa. bought a Fla. condo, lived there for a year and moved back to Pa... 

Start another topic.

Off topic bait ignored.

 

[wwest5829]

4 hours ago, Sheryl said:

 

I don't follow that.

 

You can enroll in Pasrt B wiht a foreign address, I did it.

 

it is only for MediGap and Medicare Advantage policies that you need a US address. And, for those, you need to be resident in the US at least 6 months of the year.  People have gotten around that by essentially lying, but this is fraudulent and if discovered could invalidate the policy.

I retired at age 64 1/2 in 2011 (regular age for my birth year group was 65). I sold all property in the USA and showed my youngest Son’s address as a mailing address. That address is registered with Social Security and Medicare, my USA financial institutions … although almost all communication is via email. When I retired, a Medicare Advantage Plan was (is) part of retirement. That Advantage Plan will pay up to $5000.00 USD annually for overseas care. It paid that $5000.00 in 2015, directly to RAM Hospital here in Chiang Mai. My Thai mobile number is also registered with institutions requiring a direct phone number. I have been (am) registered with the STEP program with the US gov’t - IRS (thus I do not believe there is any fraud involved).

 

I have viewed the Medicare Part B premiums as insurance against, say cancer but even there, I think that this is an increasingly false idea. The co-pays and deductibles (non-covered) expenses may well still ruin me financially. So, the Medicare monthly premiums are increasingly questioned as to value. In the decade in Thailand thus far, Thai medical care has been excellent at a fraction of what the costs would be in the USA. I will continue to lobby for equal treatment of retired workers under Medicare with those fully retired from the military. Currently, military retirees can get medical coverage globally while Medicare recipients cannot.

[malibukid]

it would be so much better if the U.S. government would extend Medicare to us expats abroad.  they would save the taxpayers millions.

[ClaySmc]

I was unofficial told that if I don't sign up for plan B etc. I would be liable for a penalty but if my income is under a certain limit I could sign up for Medicaid and the state would cover plan B and work out a deal between them and Medicare that since I would not be directly paying there would be no penalty. You might want to verify that if you choose to go down that road. 

 

[Sheryl]

1 hour ago, wwest5829 said:

I retired at age 64 1/2 in 2011 (regular age for my birth year group was 65). I sold all property in the USA and showed my youngest Son’s address as a mailing address. That address is registered with Social Security and Medicare, my USA financial institutions … although almost all communication is via email. When I retired, a Medicare Advantage Plan was (is) part of retirement. That Advantage Plan will pay up to $5000.00 USD annually for overseas care. It paid that $5000.00 in 2015, directly to RAM Hospital here in Chiang Mai. My Thai mobile number is also registered with institutions requiring a direct phone number. I have been (am) registered with the STEP program with the US gov’t - IRS (thus I do not believe there is any fraud involved).

 

I have viewed the Medicare Part B premiums as insurance against, say cancer but even there, I think that this is an increasingly false idea. The co-pays and deductibles (non-covered) expenses may well still ruin me financially. So, the Medicare monthly premiums are increasingly questioned as to value. In the decade in Thailand thus far, Thai medical care has been excellent at a fraction of what the costs would be in the USA. I will continue to lobby for equal treatment of retired workers under Medicare with those fully retired from the military. Currently, military retirees can get medical coverage globally while Medicare recipients cannot.

Advantage plans for the military may not be the same as those available to civilians. I am not aware of any Medicare Advantage Plans open to the general public that will cover care overseas.

[Sheryl]

1 hour ago, ClaySmc said:

I was unofficial told that if I don't sign up for plan B etc. I would be liable for a penalty but if my income is under a certain limit I could sign up for Medicaid and the state would cover plan B and work out a deal between them and Medicare that since I would not be directly paying there would be no penalty. You might want to verify that if you choose to go down that road. 

 

Before planning on that better check what that income limit is.

 

Slight variation by state but about $880 a month for a single person,  $1,300 for a couple.

 

Significantly less than the average Social Security payment for retirees in US.

 

So nto easily qualified for.

[ClaySmc]

53 minutes ago, Sheryl said:

Significantly less than the average Social Security payment for retirees in US.

I never followed up on it, but since you mention it; it is very low. Checking on California I find it is 1073.00 and that is a very expensive state.

[cmarshall]

11 hours ago, pablo el sueco said:

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.

You could be right, but I am unable to find the details of the penalty calculation online.  Do you have a link?

[meechai]

15 hours ago, Sheryl said:

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.

Hear Hear ! (but sadly most will not) It seems these days folks are educated by Sensationalized Media & have no real world experience

[wwest5829]

8 hours ago, Sheryl said:

Advantage plans for the military may not be the same as those available to civilians. I am not aware of any Medicare Advantage Plans open to the general public that will cover care overseas.

I address only the fully Retired Military able to receive global medical care while fully retired civilians are forbidden to use their Medicare on an equal basis. I am not aware of differences in any add-on insurance comparing the same groups of retirees. My additional medical policy came as part of my institution’s retiree package and does pay up to $5000 USD per year for foreign medical care. I have used it for my heart attack in 2015 and submitting medical bills for my quarterly checkups here in Chiang Mai. It is a publicly available company Seniors Plan for retirees. While I think it is an “advantage plan” it may be a “medigap plan”. I cannot seem figure out which.

[pablo el sueco]

3 hours ago, cmarshall said:

You could be right, but I am unable to find the details of the penalty calculation online.  Do you have a link?

https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/original-medicare-enrollment/medicare-part-b-late-enrollment-penalties  Read the paragraph -- How do you calculate your premium penalty?

 

Plus, I speak from the experience of paying 60% late penalties for the past 30 months.

 

[IAMHERE]

13 hours 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.

That 'no more' could work out to be real soon if you have to return for medical care.  I'd also guess that once you are all better you could quit part-B again.

[cmarshall]

1 hour ago, pablo el sueco said:

https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/original-medicare-enrollment/medicare-part-b-late-enrollment-penalties  Read the paragraph -- How do you calculate your premium penalty?

 

Plus, I speak from the experience of paying 60% late penalties for the past 30 months.

 

Ouch.  Was the non-enrollment inadvertant or a strategy?

[Jingthing]

12 hours ago, malibukid said:

it would be so much better if the U.S. government would extend Medicare to us expats abroad.  they would save the taxpayers millions.

When pigs fly.

[pablo el sueco]

43 minutes ago, cmarshall said:

Ouch.  Was the non-enrollment inadvertant or a strategy?

Uh-oh.  You got me started.  It was a strategy that was based on the hope that Thailand Immigration rules would remain fair and static.  I moved to Thailand 15 years ago knowing I was covered by my unlimited global health coverage (with deductible and out-of-pocket expenditures) provided by my pension arrangement.  So, for most of that time I didn't want or need Medicare Part B.  Then came stricter rules from Thailand Immigration; for example, I currently have to report to my local office 7 times every year (1--extension of stay, 4--address verifications, 2--bank book verifications...all on differing schedules). The official Immigration web application reports that I am on overstay by 381 days, and Immigration Officers laugh at me when I ask them to fix that.  Now there is the concern that I may be forced to increase my throw-away Thai health coverage to 3 million baht, which at my age will cost a considerable amount -- actually an amount I have earmarked to pay for the deductible and out-of-pocket expenditures on my global policy.  Thailand wants rich people to come and subsidize their economy in a big way.  I'm not poor, but am far from rich.   I thought I had it all planned out, but the rules are changing in a big way.  So I decided I needed to prepare for the eventuality that I would have to repatriate -- hence I enrolled in Medicare Part B almost 7 years late, and am paying 60% penalty.

[cmarshall]

13 hours ago, wwest5829 said:

I retired at age 64 1/2 in 2011 (regular age for my birth year group was 65). I sold all property in the USA and showed my youngest Son’s address as a mailing address. That address is registered with Social Security and Medicare, my USA financial institutions … although almost all communication is via email. When I retired, a Medicare Advantage Plan was (is) part of retirement. That Advantage Plan will pay up to $5000.00 USD annually for overseas care. It paid that $5000.00 in 2015, directly to RAM Hospital here in Chiang Mai. My Thai mobile number is also registered with institutions requiring a direct phone number. I have been (am) registered with the STEP program with the US gov’t - IRS (thus I do not believe there is any fraud involved).

 

You might be committing fraud.  The SSA will accept both a physical address for you and a mailing address.  If you provide only one address and that's within the US, then they will take that as your physical address.  

 

I provided the SSA with my BKK address as my physical address and my CMRA as my mailing address at the time that I claimed benefits.  The BKK address is the one that shows up in my profile on ssa.gov.  

 

If the the address that shows in your profile on ssa.gov is your son's US address then you may be defrauding the SSA.  If you had not been receiving the annual Form 7162 prior to 2020 then that would be consistent with the SSA's believing that you claim to live in the US.

[cmarshall]

3 minutes ago, pablo el sueco said:

 

Uh-oh.  You got me started.  It was a strategy that was based on the hope that Thailand Immigration rules would remain fair and static.  I moved to Thailand 15 years ago knowing I was covered by my unlimited global health coverage (with deductible and out-of-pocket expenditures) provided by my pension arrangement.  So, for most of that time I didn't want or need Medicare Part B.  Then came stricter rules from Thailand Immigration; for example, I currently have to report to my local office 7 times every year (1--extension of stay, 4--address verifications, 2--bank book verifications...all on differing schedules). The official Immigration web application reports that I am on overstay by 381 days, and Immigration Officers laugh at me when I ask them to fix that.  Now there is the concern that I may be forced to increase my throw-away Thai health coverage to 3 million baht, which at my age will cost a considerable amount -- actually an amount I have earmarked to pay for the deductible and out-of-pocket expenditures on my global policy.  Thailand wants rich people to come and subsidize their economy in a big way.  I'm not poor, but am far from rich.   I thought I had it all planned out, but the rules are changing in a big way.  So I decided I needed to prepare for the eventuality that I would have to repatriate -- hence I enrolled in Medicare Part B almost 7 years late, and am paying 60% penalty.

You have to have insurance coverage, because you are on an O-A visa?  Or for some other reason?  Those of us on Non-Imm O for retirement don't have to have insurance.

 

I think you made a smart move by enrolling even late to Part B, however painful.  Things change, especially for us expats who have chosen to fall between most of the cracks.

[pablo el sueco]

1 minute ago, cmarshall said:

You have to have insurance coverage, because you are on an O-A visa?  Or for some other reason? 

Yes, I entered Thailand 15 years ago on an O-A visa. 

[walt1]

15 hours ago, Jingthing said:

No penalty if you've been on qualifying insurance.

I think the conditions for the exception are very limited and private insurance you pay for is not covered. Must be linked to employment or a few other things that most people wouldn't qualify for.

[Jingthing]

1 minute ago, walt1 said:

I think the conditions for the exception are very limited and private insurance you pay for is not covered. Must be linked to employment or a few other things that most people wouldn't qualify for.

Yes, people that think they might qualify for that exception really need to confirm that. That said I'm not sure how exactly that could be done given that Part B enrollment is done through Social Security not Medicare.

[walt1]

I'm still 2 years out, but have been trying to get educated on the subject. It was discussed on the Medicare site or SS site. A lot to think about for sure.

[wwest5829]

1 hour ago, cmarshall said:

You might be committing fraud.  The SSA will accept both a physical address for you and a mailing address.  If you provide only one address and that's within the US, then they will take that as your physical address.  

 

I provided the SSA with my BKK address as my physical address and my CMRA as my mailing address at the time that I claimed benefits.  The BKK address is the one that shows up in my profile on ssa.gov.  

 

If the the address that shows in your profile on ssa.gov is your son's US address then you may be defrauding the SSA.  If you had not been receiving the annual Form 7162 prior to 2020 then that would be consistent with the SSA's believing that you claim to live in the US.

I fail to see a “fraud” case here. The one protection each small fish has is that we are not important enough to bother with. In my case, I report and pay my federal income taxes with my Thai address listed and have had conversations with the same noting I am currently in residence in Thailand. As to SS, my monthly payment is directly deposited into my US institution account and I then transfer monthly. In this time of Covid, mail services have been severely compromised. No way would I encourage not getting critical mail from the US here … I had to deal with getting Covid payment checks mailed again due to SS (they make direct deposits) not reporting my bank information to IRS. SS and Medicare send me email announcements.

[Jingthing]

33 minutes ago, walt1 said:

I'm still 2 years out, but have been trying to get educated on the subject. It was discussed on the Medicare site or SS site. A lot to think about for sure.

I was mailed a pamphlet entitled:

Welcome to Medicare

Information for people living outside the United States

[Jingthing]

14 minutes ago, wwest5829 said:

I fail to see a “fraud” case here. The one protection each small fish has is that we are not important enough to bother with. In my case, I report and pay my federal income taxes with my Thai address listed and have had conversations with the same noting I am currently in residence in Thailand. As to SS, my monthly payment is directly deposited into my US institution account and I then transfer monthly. In this time of Covid, mail services have been severely compromised. No way would I encourage not getting critical mail from the US here … I had to deal with getting Covid payment checks mailed again due to SS (they make direct deposits) not reporting my bank information to IRS. SS and Medicare send me email announcements.

It's not fraud to have ss payments direct deposited in the U.S. I do but ss, IRS, and Medicare know that I live abroad.

 

Here are some examples of fraud:

 

Claiming to ss that you live in the US when you don't to avoid proof of life letters.

 

Enrolling in and making claims during a trip to the US using any Medicare parts other than A and B including Advantage when you actually are an expat.

 

More complicated cases are snowbird type expats. There are rules for determining your primary residence country.

Edited December 1, 2021 by Jingthing

[cmarshall]

4 minutes ago, wwest5829 said:

I fail to see a “fraud” case here. The one protection each small fish has is that we are not important enough to bother with. In my case, I report and pay my federal income taxes with my Thai address listed and have had conversations with the same noting I am currently in residence in Thailand. As to SS, my monthly payment is directly deposited into my US institution account and I then transfer monthly. In this time of Covid, mail services have been severely compromised. No way would I encourage not getting critical mail from the US here … I had to deal with getting Covid payment checks mailed again due to SS (they make direct deposits) not reporting my bank information to IRS. SS and Medicare send me email announcements.

Please note that I am neither alleging that you have an intention to defraud the SSA nor that you are at any particular risk of repercussions, which is probably small.  However, SSA participants do have a specific obligation to notify the SSA when we move.  The SSA always wants to know our physical address, even if they sometimes allow us also to indicate a mailing address, which they then ignore as far as I can see.  Since as I gather, you live in Thailand and the physical address that the SSA has in your profile on ssa.gov is not your Thai address then you are possibly committing fraud.   Whatever information other parts of the US govt may have as to your whereabouts does not relieve you of the obligation to inform the SSA specifically.  

 

I don't care what you do or don't do about it, but it would be foolish to persuade yourself that you are in compliance when you are not.

[wwest5829]

12 minutes ago, Jingthing said:

It's not fraud to have ss payments direct deposited in the U.S. I do but ss, IRS, and Medicare know that I live abroad.

 

Here are some examples of fraud:

 

Claiming to ss that you live in the US when you don't to avoid proof of life letters.

 

Enrolling in and making claims during a trip to the US using any Medicare parts other than A and B including Advantage when you actually are an expat.

 

More complicated cases are snowbird type expats. There are rules for determining your primary residence country.

How would one “enroll in and make claims during a trip to the US using any Medicare parts other than A and B including Advantage when you actually are an expat”? I am confused in the meaning here?

[wwest5829]

6 minutes ago, cmarshall said:

Please note that I am neither alleging that you have an intention to defraud the SSA nor that you are at any particular risk of repercussions, which is probably small.  However, SSA participants do have a specific obligation to notify the SSA when we move.  The SSA always wants to know our physical address, even if they sometimes allow us also to indicate a mailing address, which they then ignore as far as I can see.  Since as I gather, you live in Thailand and the physical address that the SSA has in your profile on ssa.gov is not your Thai address then you are possibly committing fraud.   Whatever information other parts of the US govt may have as to your whereabouts does not relieve you of the obligation to inform the SSA specifically.  

 

I don't care what you do or don't do about it, but it would be foolish to persuade yourself that you are in compliance when you are not.

No, I would not claim to be in compliance. But “fraud” is another matter.

[cmarshall]

Just now, wwest5829 said:

No, I would not claim to be in compliance. But “fraud” is another matter.

Well, I wouldn't do it.  The SSA has a large role in my life these days which I would not want to jeopardize, even temporarily.  And then does the advantage of not reporting your physical address amount to?  So you don't get the annual are-you-alive letter.  That's a pretty small benefit that is not worth any risk in my mind.  The fact that the SSA has my correct information doesn't inconvenience me in the least.

 

Someday they could notice and give you a headache. 

 

[Jingthing]

23 minutes ago, wwest5829 said:

How would one “enroll in and make claims during a trip to the US using any Medicare parts other than A and B including Advantage when you actually are an expat”? I am confused in the meaning here?

Read it again. Note the word ENROLLED. If you're enrolled you could use during a trip. Expats are only allowed to enroll in A and B. If you're faking not being an expat you could fraudently enroll in other parts. If you enroll in other parts while a US resident and then become an expat you're supposed to CANCEL them.

Edited December 1, 2021 by Jingthing