I’m turning 65 next year and must decide my Medicare setup…

I’ve lived here in Thailand for 10 plus years and plan to continue but do not want to burn my bridges as I can see moving back to the US as I get older.

I definitely plan to sign up for Part A and B… (Will pay the Part B premium)…

My quandary is what supplement or Medicare Advantage if any should I get?…

 

I don’t really want to buy a part C & D supplement as these have a monthly premium that can be expensive and will most likely get more expensive as time goes on… So If I just go with A & B and nothing else and nothing else and in a few years return to the US I could only get medigap & Part D with medical underwriting (which I doubt I could pass)  so this is not really an option for me…

 

The other option would be a Medicare Advantage Plan… I have no problem with a zero dollar Medicare Advantage plan but understand I would not be eligible as I must live in the US in the insurer’s area… So initially ((At 65 living in Thailand) I could not sign up - But I could at some time in the future return to the US and be eligible for a “Special Enrollment Period” to sign up for a  Medicare Advantage Plan within the first two months of return with no premium or medical underwriting.

https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods

My preference right now would be to get A & B and pay the B premium and forgo any other supplement… If in the future I do return I will opt for Special Enrollment Period and apply for a Medicare Advantage Plan upon return… This seems to be prudent and cost effective… What is your thoughts?

 

 

Supplemental plans are far better than Advantage Plans, the latter limit your choice of doctors considerably and usually place roadblocks in treatment pathways (pre-approval to see a specialist, pre-approval for surgery etc...which may be denied). 

 

HOWEVER both Medicare Advantage and Medicare Supplement Plans require that you live in the specified coverage area at least 6 months per year. So really not an option for you.

 

In addition, since the main point of a supplemental is to pay the deductibles and copays (or part of them), you are very unlikley to get your money's worth while living overseas even if you were otherwise eligible. 

 

I have Parts A & B but no supplemental or Advantage Plan. Recently had treatment that included specialized surgery in the US, my copays came to a total of about  $2,200 out of a total bill of about $28,500.  A good Medicare supplement would have cost me at least that, probably more, per year.

 

One big advantage to Medicare is that, while there are copays in the absence of a supplemental insurance, the copay pertains only to the Medicare approved amount, which is always much less than the provider will otherwise charge. 

 

You can easily add a supplemental later if/when you start to live in the US at least half time.