Medicare While Living Abroad

[painai2]

I've searched and can't find the exact answer to my question. I'm 63 and in two years I can receive part A and part B of medicare (I've paid into Medicare through my working career in the states). My question is: "Am I able to receive Medicare treatment if I return to the states to receive it?" I retired from the airlines, so the airfare is minimal. I am questioning whether I'm required to maintain a US address in order to receive medical benefits on a return visit to the USA. I am fully aware Medicare won't pay any benefits abroad. I appreciate any help on this matter.

[noise]

Short answer is yes, you can use it when you return. They do not take your premium but refuse treatment because you were over seas XXXX number of days or years. I know of one fellow that did that for his hip replacement.

I do not know know for sure about the address, but my immediate reaction is to say having a Thailand address makes no difference, i.e., you do not have to keep a U.S. address of record.

[TerryLH]

"Short answer is yes, you can use it when you return. They do not take your premium but refuse treatment because you were over seas XXXX number of days or years."

Is that contradictory, or am I just having another old guy moment?

[noise]

"Short answer is yes, you can use it when you return. They do not take your premium but refuse treatment because you were over seas XXXX number of days or years."

Is that contradictory, or am I just having another old guy moment?

What I was trying to say was SS would not cheat you by happily taking your money and refusing treatment. Say, through ignorance, you tried to apply for medicare part B at age 60. They do not just say, "OK, pay $155/month" and then when you try to get treated say "Sorry, you are too young."

That is why I mentioned the friend who lived here for 5 years, had only a Thailand address with SS, did all the preliminary diagnostics for a hip replacement, transferred the info to the U.S., and then returned there for the actual operation.

[Wrong Turn]

"Short answer is yes, you can use it when you return. They do not take your premium but refuse treatment because you were over seas XXXX number of days or years."

Is that contradictory, or am I just having another old guy moment?

What I was trying to say was SS would not cheat you by happily taking your money and refusing treatment. Say, through ignorance, you tried to apply for medicare part B at age 60. They do not just say, "OK, pay $155/month" and then when you try to get treated say "Sorry, you are too young."

That is why I mentioned the friend who lived here for 5 years, had only a Thailand address with SS, did all the preliminary diagnostics for a hip replacement, transferred the info to the U.S., and then returned there for the actual operation.

Noise,

The OP is asking about Medicare, not SS.

[Thot]

Short answer is yes, but! For full Medicare coverage you need Part A and B. Part A is free. Part B has a premium and can be declined. To insure that you can return to the U.S. at any time to receive treatment you must keep the Part B and pay the premiums. If you don't then you can only sign up for Part B at certain times of the year and it will not take effect until months later. There is more to Medicare, drug coverage, etc.

If you have health coverage from your retirement you should check how it interacts with Medicare. You may even have coverage overseas from your employer's plan.

Go to http://www.medicare.gov/default.aspx which should answer your concerns.

[painai2]

Thanks for responding to my question about Medicare. Put's my mind at ease.

Edited October 19, 2011 by painai2

[Lopburi99]

Short answer is yes, but! For full Medicare coverage you need Part A and B. Part A is free. Part B has a premium and can be declined. To insure that you can return to the U.S. at any time to receive treatment you must keep the Part B and pay the premiums. If you don't then you can only sign up for Part B at certain times of the year and it will not take effect until months later. There is more to Medicare, drug coverage, etc.

If you have health coverage from your retirement you should check how it interacts with Medicare. You may even have coverage overseas from your employer's plan.

Go to http://www.medicare.gov/default.aspx which should answer your concerns.

This year I have been paying for Part B and also a Medicare Advantage HMO plan with Blue Care Network including prescription drugs. I first qualified for the Medicare Advantage on 1/1/11 and thank god I signed up for it. I had just come back from 3 years in LOS and was living in Michigan at the time. I wanted my BCN coverage so I could get a stress test done to see if my heart disease had increased since I had an angiogram in 2007. The first HMO primary care physician I chose, after my telling him I wanted the complete preventative exam offered new Plan B enrollees, gave me a quickie 15 minute superficial physical then even refused to order a stress test for me. He said it wouldn't be OKed by BCN. I had told him my complete history, plus mentioned my Dad had a triple bypass at 60 (I am 64) and the s.o.b. still wouldn't write one up for me. I couldn't get home quick enough to call BCN and change my HMO primary care physician. I selected an older polish female doctor from a list having a hunch she might be more understanding and committed. Sure enough, she immediately ordered a nuclear stress test. This proved to save my life.

Guess what? The test along with a followup angiogram revealed my 30% occlusion in '07 had progress to 99%! This was on the main LAD ("widow-maker") artery! I was sent in a lights-flashing, siren-blasting ambulance to the medical center for immediate treatment. I received a double (concatenated) DES stent. My cardiologist told my daughter a heart attack could have happened at any time and it would have been massive and fatal.

Now I am back in LOS and hope to stay here for the long term. I plan on keeping the Plan B (indefinitely) and my Medicare Advantage plan for 2012 even though I will be here. If my health becomes a problem and requires expensive treatment, I will return to the states for the treatment then hopefully come back here. I don't intend to keep the prescription coverage since I don't consider that important. I can get all my meds in Thailand, except Ranexa which I don't think I need anyway.

Now my question, apologies for the lengthy background info, is: I need to decide whether to continue on Plavix by name or switch to Apolets, it's generic equivalent (only 900 baht/month here). Several people have remarked they have shied away from the generic because it was "buffered differently", whatever that means. On the Apolets box reads: "Each tablet contains 98.0 mg of clopidogrel bisulfate equivalent to 75 mg of clopidogrel base". Equivalent? This means not the same I assume. Has this worried anybody or have you been assured Apolets are a true generic for prescription Plavix?

Until reading your post, I didn't realize Plan B could be started and stopped. That might have been worth considering if my anticipated health issues weren't so serious and could come without warning, but I don't dare go there or even consider not enrolling again for Medicare Advantage coverage. Obviously I am not in the financial condition to self-insure and get all future care done here, unfortunately.

[thaiorchidsource]

Short answer is yes, but! For full Medicare coverage you need Part A and B. Part A is free. Part B has a premium and can be declined. To insure that you can return to the U.S. at any time to receive treatment you must keep the Part B and pay the premiums. If you don't then you can only sign up for Part B at certain times of the year and it will not take effect until months later. There is more to Medicare, drug coverage, etc.

If you have health coverage from your retirement you should check how it interacts with Medicare. You may even have coverage overseas from your employer's plan.

Go to http://www.medicare.gov/default.aspx which should answer your concerns.

This year I have been paying for Part B and also a Medicare Advantage HMO plan with Blue Care Network including prescription drugs. I first qualified for the Medicare Advantage on 1/1/11 and thank god I signed up for it. I had just come back from 3 years in LOS and was living in Michigan at the time. I wanted my BCN coverage so I could get a stress test done to see if my heart disease had increased since I had an angiogram in 2007. The first HMO primary care physician I chose, after my telling him I wanted the complete preventative exam offered new Plan B enrollees, gave me a quickie 15 minute superficial physical then even refused to order a stress test for me. He said it wouldn't be OKed by BCN. I had told him my complete history, plus mentioned my Dad had a triple bypass at 60 (I am 64) and the s.o.b. still wouldn't write one up for me. I couldn't get home quick enough to call BCN and change my HMO primary care physician. I selected an older polish female doctor from a list having a hunch she might be more understanding and committed. Sure enough, she immediately ordered a nuclear stress test. This proved to save my life.

Guess what? The test along with a followup angiogram revealed my 30% occlusion in '07 had progress to 99%! This was on the main LAD ("widow-maker") artery! I was sent in a lights-flashing, siren-blasting ambulance to the medical center for immediate treatment. I received a double (concatenated) DES stent. My cardiologist told my daughter a heart attack could have happened at any time and it would have been massive and fatal.

Now I am back in LOS and hope to stay here for the long term. I plan on keeping the Plan B (indefinitely) and my Medicare Advantage plan for 2012 even though I will be here. If my health becomes a problem and requires expensive treatment, I will return to the states for the treatment then hopefully come back here. I don't intend to keep the prescription coverage since I don't consider that important. I can get all my meds in Thailand, except Ranexa which I don't think I need anyway.

Now my question, apologies for the lengthy background info, is: I need to decide whether to continue on Plavix by name or switch to Apolets, it's generic equivalent (only 900 baht/month here). Several people have remarked they have shied away from the generic because it was "buffered differently", whatever that means. On the Apolets box reads: "Each tablet contains 98.0 mg of clopidogrel bisulfate equivalent to 75 mg of clopidogrel base". Equivalent? This means not the same I assume. Has this worried anybody or have you been assured Apolets are a true generic for prescription Plavix?

Until reading your post, I didn't realize Plan B could be started and stopped. That might have been worth considering if my anticipated health issues weren't so serious and could come without warning, but I don't dare go there or even consider not enrolling again for Medicare Advantage coverage. Obviously I am not in the financial condition to self-insure and get all future care done here, unfortunately.

[thaiorchidsource]

To the question about Apolets verses Plavix. I also have had the balloon angioplasty and stints. The hospital pharmacy substituted my Plavix for Apolets without asking me or my cardiologist, and I think this might have sent me back into the hospital the 2nd time. Stay with Plavix in my opinion for atleast one year after your proceedure, and take one baby aspirin with it daily. Sure the Plavix is expensive, but is it worth the risk to use Apolets with a know higher incidents of problems? I think it would not be sound judgement to risk your life for the lower costs unless your simply destitute and have no other choice.

[Lopburi99]

To the question about Apolets verses Plavix. I also have had the balloon angioplasty and stints. The hospital pharmacy substituted my Plavix for Apolets without asking me or my cardiologist, and I think this might have sent me back into the hospital the 2nd time. Stay with Plavix in my opinion for atleast one year after your proceedure, and take one baby aspirin with it daily. Sure the Plavix is expensive, but is it worth the risk to use Apolets with a know higher incidents of problems? I think it would not be sound judgement to risk your life for the lower costs unless your simply destitute and have no other choice.

I agree with you although I did not know Apolets had a known higher incidents of problems! Do you remember how you found out about this? By chance did your cardiologist remark about Apolets one way or the other?

Before reading your post I was leaning toward staying on prescription Plavix until 1/1 when my drug coverage ends, that would be a full 9 months after my procedure. Then switch over to Apolets for at least another 3 years. Now I am not sure. What makes you suspect of the Apolets? Thanks for your input, I know others are watching this thread.

[BEENTHEREDONETHAT]

My wife and I decided to spend the summers in Idaho and the winters in LOS. We had been full time in LOS for 5 years and prior to that Australia for 15+ years. To get Medicare part B coverage we had to apply between January and March. It then became effective in June. But my wife advises me that when you first qualify (reach age 65 ) you can apply then regardless of date. For us supplemental was the same price as the Medicare.

It covers us for two months for emergencies after leaving the country. So we pay year around for about 6 months of coverage. But you can't spend time in the US without medical insurance or it could take everything you have. Very Very expensive.

In my opinion you are making a good move by taking it out. For every year after 65 that you don't have it they penalize you 10% of the premium. I waited 12 years to take it out and pay a 120% premium.

But should I get sick I would prefer to be in LOS for the treatment, even though it would be free in the US.