Medicare Coverage In Chiang Mai

[realthaideal]

Serious Questions here folks. I need to know if anyone in Chiang Mai has any experience getting medical and or nursing care here in Chiang Mai that was covered by Medicare/ Medicaid back in the USA. Do those organizations reimburse n cover for expenses when we choose to come here for treatment ? Specifically for CM, does anybody out there have experience with nursing care facilities around town ? Even between here n Chiang Rai even ?

[Dustoff]

Serious Questions here folks. I need to know if anyone in Chiang Mai has any experience getting medical and or nursing care here in Chiang Mai that was covered by Medicare/ Medicaid back in the USA. Do those organizations reimburse n cover for expenses when we choose to come here for treatment ? Specifically for CM, does anybody out there have experience with nursing care facilities around town ? Even between here n Chiang Rai even ?

Sorry to have to tell you but, nope, nada. Even the Veterans Admin provides no coverage for American vets over here and you can't even get it in the Philippines. My Thai wife gets medical coverage here from the VA but I cannot. Go figure, eh?

[Jingthing]

Medicare stops at the border. Write your congressman.

[Dustoff]

Medicare stops at the border. Write your congressman.

Agreed. I have been paying well over 3000B/mo for more than ten years for Medicare coverage and they provide nothing outside of the country..

Guvmint takes lots, gives little back.

[swain]

Seems like a stupid policy, when it would be so much cheaper to treat people over here than there. Saving money isn't one of Americas strong points.

[mcgriffith]

Totally sucks. I just googled this very question a week ago.

I found a Thai health insurance policy with similar coverage, but cheaper than what I am paying now to Bupa (Thailand). I'm up for renewal in 3 weeks.

Unfortunately, the policy doesn't cover after age 65. I'm 56. So I thought- ahah....Medicare!

I was shocked to find out that Medicare coverage stops at the border.

[Mapguy]

Yes, the national health care plan for retired people stops at the border in America as do health care plans for "senior citizens" in other countries. It is not unusual. There is a certain limited logic to the argument in the case of expatriate citizens abroad in developing countries that, after all, the "home" governments are getting a great deal because wonderful medical care is available at less cost, but this unfortunately is an argument that does not necessarily hold up. For example, there is no control over quality of care. And there is more to it than that.

There are certain treaty arrangements and other exceptions for certain countries that bypass this provision. Never mind what countries. That will start a veritable firestorm on TV that would probably close down this thread.

Best advice? In the USA, write your representative. Expectation of success? Sorry! Less than zero.

In the future, there might be success in "internationalizing" government plans more liberally. After all, private firms do it now, but be sure to read the fine print. If you are truly interested beyond simple grousing about it all, I suggest you do some comparison pricing on health insurance to see what you find. Oh yes, you can get health insurance beyond the age of 65! Anyone want to share quotes and conditions of the plans?!

The TV website seems predominately Anglophile let alone Anglophone. I'd be interested in hearing from others outside of America, UK, and Australia on this topic.

In the meantime, I invite all to share their experiences with at least two hospitals in Chiang Mai: Sriphat at Maharaj and Chiang Mai Ram (both already available by thread on this site). If someone would open threads on other hospitals that generally serve the expatriate community, that would also be very welcome.

[PeaceBlondie]

True, US Social Security and the VA pay virtually nothing overseas. But some plans do pay here. For retired civil service, the Federal Employees Health Benefit Plans cover you overseas. CHAMPUS pays retired military until Medicare kills the coverage at age 65. Some civilian private coverage may work here.

[Dustoff]

Totally sucks. I just googled this very question a week ago.

I found a Thai health insurance policy with similar coverage, but cheaper than what I am paying now to Bupa (Thailand). I'm up for renewal in 3 weeks.

Unfortunately, the policy doesn't cover after age 65. I'm 56. So I thought- ahah....Medicare!

I was shocked to find out that Medicare coverage stops at the border.

Sucks indeed. I have just now posted a long email to Senator Daniel Akaka of Hawaii, who I have met several times and is the Chairman of the Veterans Affairs Committee in Congress, about this very issue.

While this may not seem like a Thailand issue, there are many, many elderly American expats here who likely are wondering about this and would like to see something done by our government about our welfare while we are out-of-country.

I would strongly encourage any and all expats of any country living here in Thailand to petition their governments that supposedly supply health coverage to ensure that they are insured even while living in Thailand or anywhere else!

Make some noise...

[realthaideal]

Good work going right to it Dustoff. Would you care to pass on the address(es) to those of us willing to write but too lazy at this moment to search out whom to write to (Like this fellow Akaka)?

And then the other question still stands about nursing care in the local and greater CM area, anybody have any knowledge who, where, how much ?

[Viceroy]

"Sorry to have to tell you but, nope, nada. Even the Veterans Admin provides no coverage for American vets over here and you can't even get it in the Philippines. My Thai wife gets medical coverage here from the VA but I cannot. Go figure, eh?"

Actually, Dustoff, the Foreign Medical Program of the VA covers all costs of treatment of service-connected conditions.

[Viceroy]

True, US Social Security and the VA pay virtually nothing overseas. But some plans do pay here. For retired civil service, the Federal Employees Health Benefit Plans cover you overseas. CHAMPUS pays retired military until Medicare kills the coverage at age 65. Some civilian private coverage may work here.

The program formerly known as CHAMPUS, now called TRICARE, generally covers 75% of allowable costs outside the USA for all military retirees and dependents, including those aged 65 and above. There are annual deductibles and, for the older beneficiaries, rules with respect to payment of MEDICARE Part B. Information is available on TRICARE websites.

[retiredusn]

I have used Tricare several times here in Thailand and have been very pleased. They will even send the checks to me in Thai baht from the US so there is little or no delay in cashing them.

[PeaceBlondie]

Thanks for the clarification about service-connected VA disabilities; maybe I can see Dr. Rachada after all, for free.

At my 65th birthday, I understood that to remain covered under TRICARE, I had to pay about $100 per month Medicare premiums, so I passed on that.

[Dustoff]

"Sorry to have to tell you but, nope, nada. Even the Veterans Admin provides no coverage for American vets over here and you can't even get it in the Philippines. My Thai wife gets medical coverage here from the VA but I cannot. Go figure, eh?"

Actually, Dustoff, the Foreign Medical Program of the VA covers all costs of treatment of service-connected conditions.

Yes Viceroy, I am very much aware of that since I am a disabled American veteran but this thread is primarily about Medicare and I didn't want to go into needless detail. The VA offers full medical coverage for disability-rated veterans whether service connected or not while in-country but Foreign Medical will not reimburse for anything other than service connected here in Thailand or any other country including the Philippines.

As the webweaver for our local Chiang Mai Post of the American Veterans of Foreign Wars, I would encourage any and all American veterans or retirees to contact us for further information about your benefits and how retired vets are receiving covered health care in local hospitals. There is never, ever any charge for information or services from the VFW.

vfw-chiangmai.org

Regards brothers.. Ken

Edited July 25, 2008 by Dustoff

[Dustoff]

Good work going right to it Dustoff. Would you care to pass on the address(es) to those of us willing to write but too lazy at this moment to search out whom to write to (Like this fellow Akaka)?

It would be easier for you to google for the Senatorial representatives of your particular state than for me to provide an entire list of them all. They pay way more attention to residents of their own states and are more likely to respond.

Good luck!

Ken

[JimGant]

At my 65th birthday, I understood that to remain covered under TRICARE, I had to pay about $100 per month Medicare premiums, so I passed on that.

So, are you now self-insured -- or did you find a better deal?

With Tricare Standard (which is what we get over here in lieu of Tricare For Life after age 65), the deductible is still $150/yr and 25% co-payment. Congress keeps dicking with raising the deductible by considerable amount, which could make monthly premium not cost effective. But for now, it seems -- at least to me -- a pretty good deal. Plus, by paying those Medicare premiums -- and if ambulatory -- I can hop back to the States for certain medical procedures.

What am I missing in this analysis?

[PeaceBlondie]

At my 65th birthday, I understood that to remain covered under TRICARE, I had to pay about $100 per month Medicare premiums, so I passed on that.

So, are you now self-insured -- or did you find a better deal?

With Tricare Standard (which is what we get over here in lieu of Tricare For Life after age 65), the deductible is still $150/yr and 25% co-payment. Congress keeps dicking with raising the deductible by considerable amount, which could make monthly premium not cost effective. But for now, it seems -- at least to me -- a pretty good deal. Plus, by paying those Medicare premiums -- and if ambulatory -- I can hop back to the States for certain medical procedures.

What am I missing in this analysis?

I seriously doubt I will be heading back to the States for medical treatment. Anyway, I am covered by the FEHBP, which costs me about $105 per month and my former employer (a little outfit you may not know ) pays the remaining $316 per month.

[JimGant]

Anyway, I am covered by the FEHBP, which costs me about $105 per month and my former employer (a little outfit you may not know smile.gif ) pays the remaining $316 per month.

I hadn't caught the fact that your primary insurance was FEHBP. Obviously, then, Tricare, as just a secondary insurance, becomes too expensive, especially over here, where co-pays (and the reason for secondary insurance) are considerably less than in the States.

Nice to have such options....

[PeaceBlondie]

Yes, nice to have such options, and I truly feel sorry for the uninsured. My big sister, who used to earn far more than I did, was let go early. For many years, she has had to work temp jobs and then fall back on COBRA and then work again. She simply cannot live abroad.

[mcgriffith]

Bottom line is, Medicare no go for US expats.

I'm shopping insurance now as we speak.

I currently have Bupa Platinum 1M outpatient coverage.

I'm up for my 3rd yr renewal; because my age tier increased, my premium jumped 20% over last year. Zero claims ever.

Anyone, US citizen, not covered by a generous public-sector retirement medical benefit plan, have any insights on group plans that don't end at 65?

Post here, and get a beer on my tab at Tuskers, if I buy the plan, and it saves me money!

[Mapguy]

Yes, Medicare is a no go. In fact, if you return to the USA, enrollment is not automatic when you want it. In other words, if you have coverage now from a private insurer, be careful about when the policy lapses. You'll have to check this out if interested, but my recollection is that you have to wait for an "enrollment period" to sign up for Medicare and that the period might be something up to six months after you return to America. Medicare rules are available on line, and I think administrators might answer individual questions by email.

In the meantime, not all people are fortunate to have health insurance coverage from their former employers, military or civilian. Some people have private policies. Considering balancing premium costs (especially with increases due to advancing age) against medical care needs and costs in Thailand, I wonder why no one has spoken about the advantages of self-insurance.

Edited July 26, 2008 by Mapguy

[dclaryjr]

The program formerly known as CHAMPUS, now called TRICARE, generally covers 75% of allowable costs outside the USA for all military retirees and dependents, including those aged 65 and above. There are annual deductibles and, for the older beneficiaries, rules with respect to payment of MEDICARE Part B. Information is available on TRICARE websites.

So from the "65 and above" comment may I assume that the "tricare-for-life" program works overseas as well?

[Viceroy]

The program formerly known as CHAMPUS, now called TRICARE, generally covers 75% of allowable costs outside the USA for all military retirees and dependents, including those aged 65 and above. There are annual deductibles and, for the older beneficiaries, rules with respect to payment of MEDICARE Part B. Information is available on TRICARE websites.

So from the "65 and above" comment may I assume that the "tricare-for-life" program works overseas as well?

Yes, it does; it functions like TRICARE Standard. But you must be subscribed to MEDICARE Part B.

[dclaryjr]

The program formerly known as CHAMPUS, now called TRICARE, generally covers 75% of allowable costs outside the USA for all military retirees and dependents, including those aged 65 and above. There are annual deductibles and, for the older beneficiaries, rules with respect to payment of MEDICARE Part B. Information is available on TRICARE websites.

So from the "65 and above" comment may I assume that the "tricare-for-life" program works overseas as well?

Yes, it does; it functions like TRICARE Standard. But you must be subscribed to MEDICARE Part B.

Thanks! This is going to get interesting for me real soon. I'll be 57 in Dec but my wife turned 63 this past May. I'm not sure what her status is when she turns 65, AND I have to take into account we are retiring in Thailand when I'm 62. Decisions...decisions!!

[PeaceBlondie]

Sixteen irrelevant, bickering, political, nationalistic posts have been deleted. Please stay on topic. Thank you.

[Viceroy]

WPS website

The program formerly known as CHAMPUS, now called TRICARE, generally covers 75% of allowable costs outside the USA for all military retirees and dependents, including those aged 65 and above. There are annual deductibles and, for the older beneficiaries, rules with respect to payment of MEDICARE Part B. Information is available on TRICARE websites.

So from the "65 and above" comment may I assume that the "tricare-for-life" program works overseas as well?

Yes, it does; it functions like TRICARE Standard. But you must be subscribed to MEDICARE Part B.

Thanks! This is going to get interesting for me real soon. I'll be 57 in Dec but my wife turned 63 this past May. I'm not sure what her status is when she turns 65, AND I have to take into account we are retiring in Thailand when I'm 62. Decisions...decisions!!

Use of TRICARE is relatively straightforward, once you understand the system, although the performance of the TRICARE contractor, Wisconsin Physicians Service (WPS), can sometimes be frustrating. Visit the WPS website for additional information.

[JimGant]

I'll be 57 in Dec but my wife turned 63 this past May. I'm not sure what her status is when she turns 65, AND I have to take into account we are retiring in Thailand when I'm 62.

If she's now Tricare enrolled via DEERs (and you're retired, not active duty), she'll get a notice from DEERs 3-months prior to her 65th birthday walking her thru what she needs to do, which is mainly enrolling in Medicare B. This will begin her Medicare coverage at age 65, plus her Tricare For Life (TFL) coverage (which picks up virtually all that Medicare does not, including Medicare's annual deductible). You, however, will still remain under Tricare Standard/Prime until your 65th b'day.

When you move to Thailand, her nice Medicare/TFL coverage will end, and you and she will fall under Tricare Standard rules in terms of coverage, deductibles, and co-pays -- tho' she'll be officially under TFL, thus still paying the monthly Medicare B premium (currently $96.80, but promising to rise substantially). You too will get to pay when you turn 65.

my recollection is that you have to wait for an "enrollment period" to sign up for Medicare and that the period might be something up to six months after you return to America.

Annual enrollment period is Jan-March, with Medicare B benefits not starting until July. And, if postponing signing up for Medicare B even tho' eligible, your premiums could rise as much as 10% per every 12-months of being late.

[mcgriffith]

I knew I shoulda gone to the Nam....had I survived, I'd have had health insurance!

Somehow, I'll muddle through this.

It does seem unfair (I know fairs have clowns and cotton candy) that I paid thousands, yes thousands of dollars a year into Medicare deductions, that I will never see a dime of benefit as a citizen, just because I'm living overseas.

[PeaceBlondie]

I knew I shoulda gone to the Nam....had I survived, I'd have had health insurance!

Somehow, I'll muddle through this.

It does seem unfair (I know fairs have clowns and cotton candy) that I paid thousands, yes thousands of dollars a year into Medicare deductions, that I will never see a dime of benefit as a citizen, just because I'm living overseas.

mc, you made good money in the States, but the Medicare portion was (if I recall exactly) only 2.45% of your gross wages. But in any event, yes, you and your employer paid into a fund that pays expatriates less than two satang per decade now.