Not sure if this belongs here or on the Home Country forum, so move it if I placed it incorrectly.

Over the years I've heard about how some US expats use Medicare in US on trips back, as opposed to moving back. Not useful for an acute emergency but if you have a condition that perhaps requires surgery that might cost millions of baht in Thailand if uninsured, I suppose it makes sense to try this.

Sometimes expats fly to Guam (particularly expats in the Philippines with a shorter flight), sometimes they go back to friends or family in the US, and sometimes i suppose they go to a random US city if they don't have a local support network in the US. Of course if you're not able to crash with family or friends, accommodation etc. is an added cost.

To keep this simple which conveniently applies to my situation. perhaps keep this limited to expats who have Part A (automatic) and also Plan B (optional for cost).

For those who have Medicare Advantage, that can't be used in Guam and those expats would need to travel to zip code associated with their Advantage plan. Such people are expats in reality, but U.S. residents as far as Medicare knows.

So back to basic Part A plus Part B question, how exactly does this work?

So you show up in Guam or somewhere in the US armed with your Medicare Card knowing you 're enrolled in A and B.

What exactly do you?

Start calling doctors that accept Medicare?

Or do you generally need to get that set up before you travel?

If so, how?

is it hard to find providers as a non-resident who just dropped out of the sky?

What about non covered costs?
As a rough example, a procedure that might cost 4 million baht in Thailand, would cost out of pocket about how much after the A and B cover?

Feel welcome to respond to me as if to a person who knows nothing about it, I won't be insulted, as that's basically where I'm at now.

Thanks in advance for any replies especially useful from people who have done this.

For myself, I use it when back in mainland US visiting family but I think would be the same wherever you go.

I set everything up before I go, though in an emergency could certainly go to an ER or Urgent Care.

To start with yes, you must find a provider who accepts original Medicare.

Personally I get all my preventive care done under Medicare, there is no co-payment for that. Annual wellness checks with labs, periodic colonoscopies, mammogram/bone density scans.

I also get skin cancer checks and treatment, these come under Part B so do entail a copay.

And last year I had thyroid surgery there as my international insurance has a thyroid exclusion. I did encounter some initial issues with some places insisting they needed a referral from a US Primary Care Physician -- not required under original Medicare but is required by some managed care plans, I think some places just make it a blanket rule rather than figure out in advance if you need it. Mostly it was individual specialist practices & clinics doing this, ultimately I switched to major hospitals and all was fine, was able to forward all my records, register as a patient and set up appointment at Sloan Kettering easily. (They are used to people self-referring). Wound up with about US $2,500 in copay.

it definitely helps to have a US phone number, I maintain one. Might be hard to do this otherwise, places want a US phone number and, usually, a US billing address.

I have no idea about Guam but it's pretty small and likely not much range or choice in health care. Hawaii probably better and likely not cost any more for the flight.

But if you have anyplace with a friend or relative who would let you use their address I'd go there.v

58 minutes ago, Jingthing said:

For those who have Medicare Advantage, that can't be used in Guam and those expats would need to travel to zip code associated with their Advantage plan. Such people are expats in reality, but U.S. residents as far as Medicare knows.

Well that's wrong. Your Medicare advantage works in all 50 states, just like medicare. Had a hip replaced in CA with a FL address on my advantage plan. Probably Guam too but I haven't checked.

7 minutes ago, gargamon said:

Well that's wrong. Your Medicare advantage works in all 50 states, just like medicare. Had a hip replaced in CA with a FL address on my advantage plan. Probably Guam too but I haven't checked.

Definitely not Guam.

I checked that.

Anyway, Advantage is private insurance and would likely be dependent on the specific Advantage insurer that you're with.

20 minutes ago, Sheryl said:

For myself, I use it when back in mainland US visiting family but I think would be the same wherever you go.

I set everything up before I go, though in an emergency could certainly go to an ER or Urgent Care.

To start with yes, you must find a provider who accepts original Medicare.

Personally I get all my preventive care done under Medicare, there is no co-payment for that. Annual wellness checks with labs, periodic colonoscopies, mammogram/bone density scans.

I also get skin cancer checks and treatment, these come under Part B so do entail a copay.

And last year I had thyroid surgery there as my international insurance has a thyroid exclusion. I did encounter some initial issues with some places insisting they needed a referral from a US Primary Care Physician -- not required under original Medicare but is required by some managed care plans, I think some places just make it a blanket rule rather than figure out in advance if you need it. Mostly it was individual specialist practices & clinics doing this, ultimately I switched to major hospitals and all was fine, was able to forward all my records, register as a patient and set up appointment at Sloan Kettering easily. (They are used to people self-referring). Wound up with about US $2,500 in copay.

it definitely helps to have a US phone number, I maintain one. Might be hard to do this otherwise, places want a US phone number and, usually, a US billing address.

I have no idea about Guam but it's pretty small and likely not much range or choice in health care. Hawaii probably better and likely not cost any more for the flight.

But if you have anyplace with a friend or relative who would let you use their address I'd go there.v

Thanks for that very good information from your personal experience.

Yes, I recall you posting about using Medicare on visits before.

Good point about Guam vs. Hawaii. The care there is limited and the flight from Thailand is already 14 hours.

In any case expats in the Philippines have shorter flights.

Too bad there isn't an American island off of Thailand, ha ha.

Yes another case which shows it's highly desirable for US expats to someone maintain a US address and phone number, even if as it probably usually is, a faux residence.

55 minutes ago, Jingthing said:

Yes another case which shows it's highly desirable for US expats to someone maintain a US address and phone number, even if as it probably usually is, a faux residence.

I keep a US phone using Tello.com. It's under $8 US/month and I use it just about ever day.

I also have a relative who lets me claim her address for home base and voter registration. This is of paramount importance if you want to vote overseas in US elections. I also keep a post office box with iPostal.com though I'm not thrilled with the service. I have all mail going to my relative's address forwarded to iPostal. I don't know how long that service will last - it's supposed to be for one year only but I understand you can extend for a year or two.

Edited May 27May 27 by HappyExpat57

1 hour ago, HappyExpat57 said:

I keep a US phone using Tello.com. It's under $8 US/month and I use it just about ever day.

I also have a relative who lets me claim her address for home base and voter registration. This is of paramount importance if you want to vote overseas in US elections. I also keep a post office box with iPostal.com though I'm not thrilled with the service. I have all mail going to my relative's address forwarded to iPostal. I don't know how long that service will last - it's supposed to be for one year only but I understand you can extend for a year or two.

Good, but to note that it not necessary to have a US address to vote. Any expat citizen can register and vote abroad based on the last address in the US before moving abroad.

Here's a twist.

My query was about people having Part A and Part B.

However, many expats don't pay for Part B.

For my example scenario where you're flying back for some defined major surgery. wouldn't the bulk of that expense be covered by Part A?

1 hour ago, Jingthing said:

Here's a twist.

My query was about people having Part A and Part B.

However, many expats don't pay for Part B.

For my example scenario where you're flying back for some defined major surgery. wouldn't the bulk of that expense be covered by Part A?

• Part A covers inpatient hospital stays and some home health care services.

• Part B includes outpatient care, preventive services, and durable medical equipment.

• Part A is premium-free for 99% of beneficiaries with 40+ quarters of coverage.

• Part B standard monthly premium is $202.90 with an annual deductible of $283.

• Original Medicare covers 80% of approved amounts; beneficiaries pay 20% with no out-of-pocket limit.

https://www.medicare.org/articles/what-is-the-difference-between-medicare-parts-a-b-c-and-d/

This YouTuber does a very good job at explaining Medicare.

1 hour ago, Jingthing said:

Here's a twist.

My query was about people having Part A and Part B.

However, many expats don't pay for Part B.

For my example scenario where you're flying back for some defined major surgery. wouldn't the bulk of that expense be covered by Part A?

The surgery itself part A but all the visits before and after, all the pre op teets etc, part B. Noeadsyd in US hospital stays are kept to bare minium, so a lot ends up on Part B.

On 5/27/2026 at 3:05 AM, Sheryl said:

For myself, I use it when back in mainland US visiting family but I think would be the same wherever you go.

I set everything up before I go, though in an emergency could certainly go to an ER or Urgent Care.

To start with yes, you must find a provider who accepts original Medicare.

Personally I get all my preventive care done under Medicare, there is no co-payment for that. Annual wellness checks with labs, periodic colonoscopies, mammogram/bone density scans.

I also get skin cancer checks and treatment, these come under Part B so do entail a copay.

And last year I had thyroid surgery there as my international insurance has a thyroid exclusion. I did encounter some initial issues with some places insisting they needed a referral from a US Primary Care Physician -- not required under original Medicare but is required by some managed care plans, I think some places just make it a blanket rule rather than figure out in advance if you need it. Mostly it was individual specialist practices & clinics doing this, ultimately I switched to major hospitals and all was fine, was able to forward all my records, register as a patient and set up appointment at Sloan Kettering easily. (They are used to people self-referring). Wound up with about US $2,500 in copay.

it definitely helps to have a US phone number, I maintain one. Might be hard to do this otherwise, places want a US phone number and, usually, a US billing address.

I have no idea about Guam but it's pretty small and likely not much range or choice in health care. Hawaii probably better and likely not cost any more for the flight.

But if you have anyplace with a friend or relative who would let you use their address I'd go there.v

I don't plan to give up my address, it's a paid service. Never been to that address or the location, and is far from where my US home is. I don't use my physical US address so I don't receive mail there while I'm here and don't have to change it back to my mail service location when I leave and come back. The mail service, scans to pdf and I can read or even ship to me, even if I'm here. Also deposits any checks into my bank (us banks). Same with a phone, I don't intend to give up my US number, and I also still have my original Thai number with same carrier but post-paid now. Address and phone number go with my passport, not something I would ever give up.

On 5/27/2026 at 7:16 PM, Jingthing said:

Good, but to note that it not necessary to have a US address to vote. Any expat citizen can register and vote abroad based on the last address in the US before moving abroad.

True for voting in my case. Registered voting is tied to my last US residence as I own/rent no property in the USA. As to Medicare ... I am going round and round with myself. I pay the monthly Part B premium. I also have a Medicare Advantage Policy from my last employer BUT.... They changed Advantage company and I do not think they will cover anything outside the US, perhaps even outside the "service area" (I say this because I read I am supposed to be a resident within their service area). I am about ready to cancel Part B (which means end of Advantage Policy). My greatest risk is heart attack (had one in CM 2015 and old Advantage company covered $5000 out of US for critical care). Not getting on a plane with heart attack ... thought of Medicare as catastrophic insurance but with the deductions/co-pays? Might be better off with the additional approx. $200 left in my SS. All, please note fully retired military must pay the monthly, Part B premium but they receive coverage around the globe.

2 hours ago, NedR69 said:

I don't plan to give up my address, it's a paid service. Never been to that address or the location, and is far from where my US home is. I don't use my physical US address so I don't receive mail there while I'm here and don't have to change it back to my mail service location when I leave and come back. The mail service, scans to pdf and I can read or even ship to me, even if I'm here. Also deposits any checks into my bank (us banks). Same with a phone, I don't intend to give up my US number, and I also still have my original Thai number with same carrier but post-paid now. Address and phone number go with my passport, not something I would ever give up.

Hmm, I have been retired in Thailand 16 years. /uS Passport renewed through the Consulate here in Chiang /mai. It lists my Thai address and mobile number as resident in Chiang Mai.

On 5/27/2026 at 2:13 PM, gargamon said:

Well that's wrong. Your Medicare advantage works in all 50 states, just like medicare. Had a hip replaced in CA with a FL address on my advantage plan. Probably Guam too but I haven't checked.

Fifty States, don't think Guam is included.

From my reading with Medicare, Advantage plans aren't private per say they must follow the guidelines of Medicare whether it is original medicare or an advantage plan the company one picks adminitrated the plan because the government can't reason every year one can switch their plans to be adminitrated by a different company.

If one wants to switch from an advantage to original it is tough due to pre-existing conditions and must go through underwriting. Whatever plan usually have previsions when traveling to be covered.

My own story in 2016 , when I signed up I was already living full time in Thailand, I was able to use a family member address and had a T-Mobile pay as you go account, I put in a 100 bucks minutes would be good for a year. I setup a message box, call back from time to time to see if I have any messages.

For my personal need, I selected a zero monthly plan high deductible of 4000 USD, offered by Anthem Blue Cross HMO, these plans are zip code related great if it is in a very dense populated zip, for me right in the heart of S.F. Chinatown, my mother former physician took this plan and me as a patient and knew I was living in Thailand.

Whenever, I knew I was coming home once a year, 2 weeks I called 2 months ahead arrange a yearly wellness examine got all my blood test, and recommended examines being an HMO, at time tough to schedule since all specialized doctors were also in Chinatown so months wait. but co-payment visits were like 5-10 bucks.

Then I had to stop using that zip, so with no pre-existing condition, underwriting I got accepted original medicare plan F, high deductible, 50 bucks a month and got a Plan D, pharmacy plan 5 bucks a month. Although you could see anyone you want without authorized paperwork from your main doctor you got to look around if those doctors are taking new Medicare patients.

Whatever your plan original or advantage a must, you log into www.meducare.gov and create a account when you do everything about you is there including your plans one can search for doctors anywhere, eye, nose, etc, will tell you if they are taking new patients and whether they do televisual consultations.

Based on your plan can find out possible cost.

I had this plan for two years in theory depending original if something like cancer comes up coverage is better? Original the government decides what to pay whereas Advantage the Insurance company that adminitrated your plan decides whether to pay for something like an experimental drug.

So , due to some other circumstances I switch back to an Advantage one it was nice to see any Doctor but getting one was a different story. So I heard from a friend who had this plan with Kaiser zero monthly, deductible I think is 4000 USD, sign up 2025, and so far I'm loving it, for 21.00 extra I get dental and eye.

For Everything is on their website, I pick from list of doctors, have personalized messaging, video appointments, appointments, it does take planning, on day of my appointment if it is at 9:00 I see the Dr. at 9, go down after to lobby grab a number register 30 minutes , blood test on the bus. By the end of day my test results Doctors notes about our visit right there once I log in.

It also covers me partially if I travel abroad to Thailand if on vacation but like most you pay out of pocket first. As an expat I might at best get away once but if one continues to submit claims from Thailand busted.

Expats like us for me I not ready to burn my bridges it is a gamble we get A, pay 205. for B, a month I'm 74, I got maybe at best another 10 years needing to go back once a year when I can't if still kicking I'll stop paying into part B?

Not for everyone?

On 5/27/2026 at 5:50 PM, HappyExpat57 said:

I keep a US phone using Tello.com. It's under $8 US/month and I use it just about ever day.

I also have a relative who lets me claim her address for home base and voter registration. This is of paramount importance if you want to vote overseas in US elections. I also keep a post office box with iPostal.com though I'm not thrilled with the service. I have all mail going to my relative's address forwarded to iPostal. I don't know how long that service will last - it's supposed to be for one year only but I understand you can extend for a year or two.

In Florida, for voting you do not to have a local address as long as you were previously a resident of FL before going to live abroad.

1 hour ago, placnx said:

In Florida, for voting you do not to have a local address as long as you were previously a resident of FL before going to live abroad.

That's for all of the US.

On 5/29/2026 at 1:51 AM, wwest5829 said:

Hmm, I have been retired in Thailand 16 years. /uS Passport renewed through the Consulate here in Chiang /mai. It lists my Thai address and mobile number as resident in Chiang Mai.

6 years or 16... wouldn't make a difference for many that think this way. I'll keep mine. That's great if you don't want or need any US contact info. But with both real and personal property in both place, it fits my situation.

On 5/29/2026 at 5:30 AM, thailand49 said:

I'm 74, I got maybe at best another 10 years

Not for everyone?

I hope you and I both have more than 10 left.

17 hours ago, NedR69 said:

I hope you and I both have more than 10 left.

What I mean is 10 years being able to travel back and forth to visit what remaining family and friends I have same visit get whatever test I need using my medicare as if I'm still living there and filing my taxes.

Right now I have no problem in paying the Part B, at some point something happens I can't I will stop paying Part B, save the 200 plus for medical here hopefully just visits.

On 5/30/2026 at 9:46 PM, NedR69 said:

6 years or 16... wouldn't make a difference for many that think this way. I'll keep mine. That's great if you don't want or need any US contact info. But with both real and personal property in both place, it fits my situation.

Did not say I did not need nor want. I only stated to clarify it is not needed to keep your US Passport.