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US Medicare options for CNX residents


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25 minutes ago, wwest5829 said:

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

Its fraud. For example if ss discovers they can freeze your payments and put you through a ringer to get restored. They even have the power to prosecute for that.

 

As far as Medicare I guess it wouldn't be actionable fraud unless you actually used the non A or B benefit.

Edited by Jingthing
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20 minutes ago, Jingthing said:

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.

Thanks, I am enrolled only in Parts A (automatic when you turn 65) and Part B (paying the monthly premium out of my SS). I have not enrolled nor use any other Medicare. I do have the additional insurance policy that pays for some covered care outside the USA. Not sure if it is “advantage” or “medigap”.

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22 minutes ago, Jingthing said:

Its fraud. For example if ss discovers they can freeze your payments and put you through a ringer to get restored. They even have the power to prosecute for that.

 

As far as Medicare I guess it wouldn't be actionable fraud unless you actually used the non A or B benefit.

Yes, had an Expat here who did not receive the letter here in Chiang Mai and was cut off. Mail services between the US and Thailand have been interrupted for the past two years. I am still awaiting a credit card mailed from the US over a month ago. 

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32 minutes ago, Jingthing said:

Its fraud. For example if ss discovers they can freeze your payments and put you through a ringer to get restored. They even have the power to prosecute for that.

 

As far as Medicare I guess it wouldn't be actionable fraud unless you actually used the non A or B benefit.

And were not enrolled. I continue to pay the monthly Part B premium as a worse case, (for example cancer). My next hoped for trip would be in 2023. Hopefully without Covid issues. If I had the opportunity I might have the annual physical allowance visit but probably not. Fraud, I believe by definition would be, “wrongful or criminal deception intended to result in financial or personal gain”. At any rate, I will continue to lobby for those retired with Medicare to be treated equally with retired military who can have medical coverage, at least reimbursement through Tricare.

Edited by wwest5829
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8 minutes ago, wwest5829 said:

Yes, had an Expat here who did not receive the letter here in Chiang Mai and was cut off. Mail services between the US and Thailand have been interrupted for the past two years. I am still awaiting a credit card mailed from the US over a month ago. 

The requirement for the letter has not been in effect for this or last year because of the pandemic.

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2 minutes ago, wwest5829 said:

And we’re not enrolled. I continue to pay the monthly Part B premium as a worse case, (for example cancer). My next hoped for trip would be in 2023. Hopefully without Covid issues. If I had the opportunity I might have the annual physical allowance visit but probably not. Fraud, I believe by definition would be, “wrongful or criminal deception intended to result in financial or personal gain”. At any rate, I will continue to lobby for those retired with Medicare to be treated equally with retired military who can have medical coverage, at least reimbursement through Tricare.

 I never said enrolling in A or B or using them in the US while still an expat is fraud. I said the opposite.

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16 minutes ago, wwest5829 said:

Thanks, I am enrolled only in Parts A (automatic when you turn 65) and Part B (paying the monthly premium out of my SS). I have not enrolled nor use any other Medicare. I do have the additional insurance policy that pays for some covered care outside the USA. Not sure if it is “advantage” or “medigap”.

Expats are not eligible to enroll or use Medigap or Advantage. Using either while still in expat status is fraud.

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4 minutes ago, jerrymahoney said:

This is a typical Medicare-related application:

 

 

 

 

2021-12-01_13h13_17.png

Good example.

Because all parts other than A and B are based on US zip code RESIDENCE.

That said a snowbird that went to Mexico every winter can still legitimately use all parts.

Edited by Jingthing
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47 minutes ago, Jingthing said:

 I never said enrolling in A or B or using them in the US while still an expat is fraud. I said the opposite.

Sorry, I was addressing not using my Thai residence address with SS as being told it was fraud.

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46 minutes ago, Jingthing said:

Expats are not eligible to enroll or use Medigap or Advantage. Using either while still in expat status is fraud.

Hmmm, my policy as part of my retirement package paid RAM Hospital directly the $5000 it states it will pay for foreign medical care. I’m thinking you are incorrect as it depends on the company contract, Mine continues currently as an Expat.

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21 minutes ago, wwest5829 said:

Sorry, I was addressing not using my Thai residence address with SS as being told it was fraud.

If you're living abroad and telling ss that you live in the US that is fraud.

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26 minutes ago, wwest5829 said:

Hmmm, my policy as part of my retirement package paid RAM Hospital directly the $5000 it states it will pay for foreign medical care. I’m thinking you are incorrect as it depends on the company contract, Mine continues currently as an Expat.

Without knowing the details the question would be is the policy covering claims abroad based on you being a US resident that travels or for an actual expat. I suspect the former in which case making claims abroad when you are not a US resident is insurance fraud.

 

How about this? Why don't you call your company and ask them explicitly? If a policy holders residence status is no longer in the US as opposed to just traveling can you still make valid claims? Until you do that this has become pointless.

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7 hours ago, wwest5829 said:

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.

If you think it might possibly allow foreign medical care and be open to the general public please provide the name.

 

But I suspect it is a special plan for ex-military. For the general public, MediGap and Medicare Advantage Plans are region-specific (state or even county).

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1 hour ago, Jingthing said:

Expats are not eligible to enroll or use Medigap or Advantage. Using either while still in expat status is fraud.

Basically correct UNLESS you spend no more than 6 months a year in Thailand. So many "snow birds" can qualify. Just have to be in US 6 months of the year.

 

Also unless you are ex-military, they seem to have special Medicare Supplemental plans available to them.

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32 minutes ago, Jingthing said:

Without knowing the details the question would be is the policy covering claims abroad based on you being a US resident that travels or for an actual expat. I suspect the former in which case making claims abroad when you are not a US resident is insurance fraud.

 

How about this? Why don't you call your company and ask them explicitly? If a policy holders residence status is no longer in the US as opposed to just traveling can you still make valid claims? Until you do that this has become pointless.

Agree, it is moot. Had the company had any residency question it would have been asked at the time of my heart attack bill payment that they made in 2015. Thanks for the exchange of views.

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42 minutes ago, Jingthing said:

If you're living abroad and telling ss that you live in the US that is fraud.

 

I don't think it is an issue if getting only Part A and B Medicare.  The SS forms do not ask if you live full-time at the address you supply. Lost of people move around, within the country or between countries etc, and supply whatever mailing address is most convenient for them. This is not a representation that you live there unless that is specifically asked, which it is nto for Medicare Part A and B. Nor does benefit eligibility vary with where you live. (You can only get benefits for care in the USA, obviously).

 

Many expats use a  US address for Medicare. As it does not affect benefit eligibility I don't see how it could be considered fraud.

 

But for Medicare supplemental plans, where benefits are tied to residence and there is a 6 month minimum stay per year, and you are asked specifically to state you live there year round or else provide exact details of how much of the year you spend there -- yes, it would be fraud.

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4 minutes ago, wwest5829 said:

Agree, it is moot. Had the company had any residency question it would have been asked at the time of my heart attack bill payment that they made in 2015. Thanks for the exchange of views.

No that does not prove what you say it does.

Are you ex military?

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1 minute ago, Jingthing said:

No that does not prove what you say it does.

Are you ex military?

Not ex military. My understanding is that fully retired military get global healthcare coverage through Tricare. Unlike fully retired civilians under Medicare.

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9 minutes ago, Sheryl said:

 

I don't think it is an issue if getting only Part A and B Medicare.  The SS forms do not ask if you live full-time at the address you supply. Lost of people move around, within the country or between countries etc, and supply whatever mailing address is most convenient for them. This is not a representation that you live there unless that is specifically asked, which it is nto for Medicare Part A and B. Nor does benefit eligibility vary with where you live. (You can only get benefits for care in the USA, obviously).

 

Many expats use a  US address for Medicare. As it does not affect benefit eligibility I don't see how it could be considered fraud.

 

But for Medicare supplemental plans, where benefits are tied to residence and there is a 6 month minimum stay per year, and you are asked specifically to state you live there year round or else provide exact details of how much of the year you spend there -- yes, it would be fraud.

You misunderstood the issue being addressed.

I was responding only to the ss aspect there.

Not medicare A B enrollment.

Many expats present to SS as US residents to avoid the proof of life letter.

That is fraud.

If discovered they will freeze payments.

 

Also yes of course US residents that live abroad part time but not long enough to change their residency status like snowbirds don't have an issue with non AB Medicare parts. I previously mentioned that.

Edited by Jingthing
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1 minute ago, wwest5829 said:

Not ex military. My understanding is that fully retired military get global healthcare coverage through Tricare. Unlike fully retired civilians under Medicare.

Are you afraid to call them and ask the question?  I would be because its almost definitely meant for US residents. But ignorance is bliss I guess.

Edited by Jingthing
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26 minutes ago, Jingthing said:

Are you afraid to call them and ask the question?  I would be because its almost definitely meant for US residents. But ignorance is bliss I guess.

Ignorance is bliss in the view of some. Not rocking a bureaucratic boat is wisdom for others.

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43 minutes ago, Sheryl said:

If you think it might possibly allow foreign medical care and be open to the general public please provide the name.

 

But I suspect it is a special plan for ex-military. For the general public, MediGap and Medicare Advantage Plans are region-specific (state or even county).

Open to a PM from you but I am worn out from relating my personal experience as a US Expat in Thailand for over a decade.

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1 minute ago, wwest5829 said:

Ignorance is bliss in the view of some. Not rocking a bureaucratic boat is wisdom for others.

I think you're fooling yourself if you think its actually meant for non US residents without actually knowing that. But up to you.

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When I applied for Social Security at age 62 I gave them a US address (my mailing address) and the next question most certainly was : Do you live at this address.

 

I checked NO and then gave them my PO Box in Thailand.

 

I then received this email:

 

Good Morning.  My name is xxx zzz and I am a Claims Representative with the Office of International Operations with the Social Security Administration in Baltimore, Maryland.  According to our records, you have filed an application for Retirement benefits.  We would like to speak with you and ask some follow-up questions regarding your application.  Please contact us so we can continue to process your application.  Thank you and have a great day.
 
xxx zzz
Foreign Claims Representative
SSA-OCO-OIO-IBO
410-965-nnnn

_______________

 

So when I turned 65 I was automatically enrolled in Medicare using my Thai address.

Edited by jerrymahoney
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13 minutes ago, jerrymahoney said:

When I applied for Social Security at age 62 I gave them a US address (my mailing address) and the next question most certainly was : Do you live at this address.

 

I checked NO and then gave them my PO Box in Thailand.

 

I then received this email:

 

Good Morning.  My name is xxx zzz and I am a Claims Representative with the Office of International Operations with the Social Security Administration in Baltimore, Maryland.  According to our records, you have filed an application for Retirement benefits.  We would like to speak with you and ask some follow-up questions regarding your application.  Please contact us so we can continue to process your application.  Thank you and have a great day.
 
xxx zzz
Foreign Claims Representative
SSA-OCO-OIO-IBO
410-965-nnnn

_______________

 

So when I turned 65 I was automatically enrolled in Medicare using my Thai address.

Yes.

Currently those of us with SS claims that SS knows to not be US residents are automatically enrolled in Medicare part A at 65 but not part B. 

 

So if that was the policy when you turned 65 you would need to enroll in Part B yourself if you want it.

Edited by Jingthing
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This topic comes up time after time.

 

A couple of things to consider.

 

None of us knows what might happen to us health wise as we age. All we do know is that the likelihood increases  exponentially after 60 that the sh&&t will hit the fan

 

Now will be able to afford private health insurance in Thailand, or will you be able to get it at any price? 

 

Medicare may not be perfect, but assuming you have somewhere back home and haven't burnt all your bridges, it's the ultimate safety net!

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15 minutes ago, Jingthing said:

Yes.

Currently those of us with SS claims that SS knows to not be US residents are automatically enrolled in Medicare part A at 65 but not part B. 

 

So if that was the policy when you turned 65 you would need to enroll in Part B yourself if you want it.

Yes but I qualify for Part B penalty waiver as I posted earlier this topic

Edited by jerrymahoney
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