Enroll in ObamaCare?

[Guest siamjourney]

From what I've read US citizens who live here most of the year aren't required to join ObamaCare. I'm curious to hear from anyone living in Thailand who has actually joined it and what the pro and cons are. If you join will the program cover medical bills here?

If ObamaCare isn't the best option for medical coverage for US citizens living here what is?

[onthedarkside]

Let's try this in the health section, although not really Thailand related.

[Jingthing]

Bona fide expats are not required to have U.S. based health insurance. In other words, they are EXEMPT from the Obamacare MANDATE.

U.S. based health insurance is useless in Thailand.

If you are not a bona fide expat, you are obligated to obtain U.S. based health insurance or face penalties.

Based on my understanding, any year that you spend more than THIRTY DAYS in the USA would put you OUT of the bona fide expat category.

ObamaCare is not a SPECIFIC insurance product. It's just an alternative name for the Affordable Care Act.

For private health insurance in Thailand there are lots of options but keep in mind health exclusions for preexisting conditions apply and not everyone would even be insurable at all, just as in the pre-Obamacare USA.

Edited February 20, 2014 by Jingthing

[hellodolly]

I was wondering what it would take to get there medicare if I was to move there. I am receiving a SS payment. I chose not to join it as I was not living there even though I am US citizen.

Is it based on the amount of SS you receive?

[Jingthing]

I was wondering what it would take to get there medicare if I was to move there. I am receiving a SS payment. I chose not to join it as I was not living there even though I am US citizen.

Is it based on the amount of SS you receive?

I'm sure it's not linked to the amount of SS you receive.

In reference to this topic, this might raise an interesting point.

In the case of a person eligible for old age medicare who never enrolls and ALSO is not a bona fide expat (spends too many days in the USA) would they also be subject to Obamacare mandates/penalties?

Edited February 20, 2014 by Jingthing

[MMan]

I bought insurance from BUPA when I first moved to Thailand, though after turning 50 the premiums increased so much I decided I would forgo insurance (after weighing the premium costs, the coverage limits and how little quality health care costs here). The situation might be different for you depending on your financial situation. BUPA and a few others have worldwide coverage that will cover you in most countries though they usually have a disclaimer for the USA.

I once came close to buying from AIA (which I think once stood for American International Assurance), though was turned down because I am an American. Scared the crap out of me when my agent called to say I was refused by AIA..Two days earlier I had gone to the AIA head office for a physical exam and required blood tests. Greatly relieved when she explained it was only because I was on American.

[Mrjlh]

I was wondering what it would take to get there medicare if I was to move there. I am receiving a SS payment. I chose not to join it as I was not living there even though I am US citizen.

Is it based on the amount of SS you receive?

What you are talking about is Medicare Part B.

When you are eligible for Part B, which is one year after you start receiving social security benifits (65, 66, or 67 which ever one applies) you have 6 months to accept it. It is currently $104.90 a month, period. If you don't sign up you are penalized 10% for every year you do not sign up. So if you never plan on returning no problem, but if things change and you do, You suffer the consequences. How would they know? Simply go to a doctor when you return. If you have private insurance they too have the option of billing medicare. So you get caught there too. Plus yo might even get caught in good old Bamacare.

Your best source of information is http://www.ssa.gov/

[Sheryl]

Most Americans living in Thailand obtain local insurance. I have BUPA Thailand platinum, which also covers me worldwide except in the US. When I go back to the US for a visit, I buy travel insurance from world nomads.

As JT noted, "ObamaCare" is not a specific insurance plan. It is a system to facilitate people in obtaining a private (US) policy, including for those with incomes below a certain level financial assistance, coupled with a requirement to have insurance (which expats are exempted from) and some regulations to curb abuses by insurance companies....the most significant of these being not letting them exclude people with pre-existing conditions as used to be common practice.

You can certainly make use of the govt website to obtain a US policy but it is very unlikely to cover you in Thailand and in any case would cost more than a local policy. Get a local policy if you are settled in Thailand permanently or for the forseeable future. If you go home for a visit, get travel insurance.

[Lefty]

I was wondering what it would take to get there medicare if I was to move there. I am receiving a SS payment. I chose not to join it as I was not living there even though I am US citizen.

Is it based on the amount of SS you receive?

Go to medicare.gov--you can enroll on line.Has nothing to do with the amount of your social security payment. Cost around $120/mo for part B.

Lefty

[hellodolly]

I was wondering what it would take to get there medicare if I was to move there. I am receiving a SS payment. I chose not to join it as I was not living there even though I am US citizen.

Is it based on the amount of SS you receive?

What you are talking about is Medicare Part B.

When you are eligible for Part B, which is one year after you start receiving social security benifits (65, 66, or 67 which ever one applies) you have 6 months to accept it. It is currently $104.90 a month, period. If you don't sign up you are penalized 10% for every year you do not sign up. So if you never plan on returning no problem, but if things change and you do, You suffer the consequences. How would they know? Simply go to a doctor when you return. If you have private insurance they too have the option of billing medicare. So you get caught there too. Plus yo might even get caught in good old Bamacare.

Your best source of information is http://www.ssa.gov/

Thanks for the web site.

[Thanyaburi Mac]

Jingthing

You said: "U.S. based health insurance is useless in Thailand."

Totally incorrect! I have U.S. based med insurance, have had this since I returned 20+ years back. Submit my receipts and am reimbursed at about 80%, higher in some cases. Note, this is not TriCare related which is for U.S. military retirees.

All depends on your U.S. insurance company and I've been with this one for perhaps 30 years.

Mac

[Jingthing]

In my experience, U.S. based health insurance is for U.S. RESIDENTS. In fact aren't you required to have any actual U.S. STATE residence? Are you talking about U.S. based insurance that covers you on TRIPS? If not, please supply much more detail. Thank you.

In any case, why would an EXPAT in Thailand want to spend MUCH MORE MONEY for full time U.S. based coverage if they LIVE in Thailand, even if they could purchase it? OK, well, I can think of one reason. Now with Obamacare, you can get U.S. based insurance with preexisting conditions but I still think you would need a REAL U.S. state residence to buy that. That would be interesting to an expat in Thailand who is UNINSURABLE in Thailand.

Edited February 20, 2014 by Jingthing

[TallGuyJohninBKK]

It is an interesting question.

I do know, when I was working in the U.S., I had an employment related medical insurance thru Blue Cross that did include coverage at some selected hospitals in Thailand. So yes, some regular U.S. health insurance policies do include coverage when traveling abroad/outside the U.S.

However, I believe obtaining those kinds of policies from stratch would require residence in some particular U.S. state. Now, what kind of "residence" would suffice is an interesting question. A mail address? A family address?? I'm not sure.

My concern about that approach would be paying premiums over time, and then at some point, the insurance company coming to the conclusion that you're not really insurable under their rules. Or you start having medical claims all outside the U.S. and none in your designated home state... Is that going to catch someone's attention at some point?

[Jingthing]

Exactly. There's no point in paying for that unless you're clear they don't require actual U.S. residence, in which case, I am highly doubtful that kind of thing is even generally available.

[Genericnic]

Jingthing

You said: "U.S. based health insurance is useless in Thailand."

Totally incorrect! I have U.S. based med insurance, have had this since I returned 20+ years back. Submit my receipts and am reimbursed at about 80%, higher in some cases. Note, this is not TriCare related which is for U.S. military retirees.

All depends on your U.S. insurance company and I've been with this one for perhaps 30 years.

Mac

Correct Mac.

I worked for the State of Texas before I retired. Since I retired early, my coverage doesn't kick back in until I turn 65 this coming October. Before I retired I checked to see if I would be covered living in Thailand and was assured I would be. They indicated they already had a number of retirees living here not to mention all over the world. Most, if not all, U.S. based health insurance for retirees is not restricted in terms of locality. The main difference is that instead of the healthcare provided submitting the paperwork, the person covered by the policy has to do so. Not a particularly big deal these days with electronic communications and all.

David

[NeverSure]

When a US citizen turns 65 he is automatically enrolled in Medicare part A which is free. (Well, he has to return a form they send.) Part A covers only overnight stays in a hospital and any procedures they do. There is a deductible and a co-pay.

Real health insurance is when you buy part B which covers doctor visits and procedures they day. It's just under $105 per month and has deductibles and co-pays.

Better yet is part C instead of B which is called Medicare Advantage. It covers even more including prescription drugs. It is bought from a private insurance company and the government sends that company money every month to underwrite it. I think it's just over $1,000 a month. The government then washes its hands of you and all payments are from the private insurer. On average this costs about $150 a month.

I have, instead, part F which is called Medigap. It is part A, B, and F, and has absolutely no deductibles or co-pays. I pay for part B, for prescription drug coverage, and for part F and altogether it costs me about $270 a month but that's it. Never again a charge for anything no matter.

Because I have an expensive medical issue, it more than pays for itself.

None of this insurance is good outside the US. Because I am otherwise very healthy and this expensive issue I have isn't life threatening, I go to Thailand uninsured (or more like self-insured) knowing I can always return to the US for checkups with my expensive issue which needs very expensive monitoring about once a year. I go to a big medical university and teaching hospital and stay (in a motel) a couple of days and get tests. It costs about $10,000 and I pay nothing.

No one has to buy medicare. A is free, B is not required, and seniors 65 or older are exempt from Obamacare.

[TallGuyJohninBKK]

The situation Genericnic is talking about, though, is one where there was a pre-existing relationship or policy or commitment when you WERE living and employed in the U.S., just like a pension or a previously issued medical policy.

In the current discussion, I believe, we're talking about the prospect of someone looking to apply from starters for U.S. health insurance coverage under ObamaCare. Doing that without a state-based address I believe would be very difficult and problematic.

But if someone knows of an ObamaCare provider who would write new policies for someone officially living outside the U.S., I'd be happy to be proven wrong.

Edited February 20, 2014 by TallGuyJohninBKK

[Jingthing]

The situation Genericnic is talking about, though, is one where there was a pre-existing relationship or policy or commitment when you WERE living and employed in the U.S.

In the current discussion, I believe, we're talking about the prospect of someone looking to apply from starters for U.S. health insurance coverage under ObamaCare. Doing that without a state-based address I believe would be very difficult and problematic.

But if someone knows of an ObamaCare provider who would write new policies for someone officially living outside the U.S., I'd be happy to be proven wrong.

Indeed!

The OP clearly is talking about something he can buy right now, not as long term state worker somewhere, or any other SPECIAL CASE involving some commitment a company made to you long ago.

BTW, I'm pretty sure you are not going to be proven wrong.

Edited February 20, 2014 by Jingthing

[mania]

I read on a website folks saying to be exempt from Obama Care

you need to remain out of the USA & not return more than X days per year

No problem...But they also said after 2014 you will have had to file your taxes using your foreign address?

Has anyone else heard of this or found verification of such a rule?

While I do remain out of the US my mailing address remains in the US due to credit cards billing requirements etc.

As such I have always used my US address on my tax returns & wondered about this years filing which I am about to do.

[Jingthing]

I read on a website folks saying to be exempt from Obama Care

you need to remain out of the USA & not return more than X days per year

No problem...But they also said after 2014 you will have had to file your taxes using your foreign address?

Has anyone else heard of this or found verification of such a rule?

While I do remain out of the US my mailing address remains in the US due to credit cards billing requirements etc.

As such I have always used my US address on my tax returns & wondered about this years filing which I am about to do.

Interesting. I think your claim of being a bona fide expat might realistically be questioned. It's 30 days a year. I've been filing with a Thai address for many years.

Edited February 20, 2014 by Jingthing

[lanny]

For an expat to be exempt from Obamacare, he or she must meet the requirements for claiming the Foreign
Earned Income Exclusion -- not actually claim the exclusion, just meet the basic requirements. If they had to take the exclusion on their tax return, a person on a pension and/or social security, or otherwise without a salary, etc., would not be exempt.

If an otherwise qualifying person spends an extended time in the US, they would be required to have insurnce or to pay the penalty tax for any month that they did not ualify for the exclusion.

Income tax regulations for claiming the exemption from Obamacare have not been established yet, IRS will not be concerned until we file our returns for 2014, a year from now. Presumably, however, IRS will require taxpayers claiming the expat exemption from Obamacare to file Form 2555, or an equivalent, to prove that they qualify.

Edited February 20, 2014 by lanny

[Jingthing]

I'm so not looking forward to that!

[lanny]

I read on a website folks saying to be exempt from Obama Care

you need to remain out of the USA & not return more than X days per year

No problem...But they also said after 2014 you will have had to file your taxes using your foreign address?

Has anyone else heard of this or found verification of such a rule?

While I do remain out of the US my mailing address remains in the US due to credit cards billing requirements etc.

As such I have always used my US address on my tax returns & wondered about this years filing which I am about to do.

Interesting. I think your claim of being a bona fide expat might realistically be questioned. It's 30 days a year. I've been filing with a Thai address for many years.

Using a foreign address on your tax return has never been a requirement for claiming the Foreigh Earned Income Tax Exclusion. Many taxpayers use accomodations addresses in the US. You establish the right to claim the exclusion by including Form 2555. Presumably, you will need to file this form (or it's equivalent) to avoid having to pay the penalty for not having US based health care insurance.

[Jingthing]

The whole enforcement thing seems to be a work in progress. Stay tuned.

[mania]

Interesting. I think your claim of being a bona fide expat might realistically be questioned. It's 30 days a year. I've been filing with a Thai address for many years.

Shouldn't be questionable as I have my passport showing I have not been in the USA for a few years.

Also for Foreign Earned Income Tax Exclusion I do not claim any income here in Thailand as I have none

so no problem there.

But like I said I leave my mailing address as US because of various other reasons.

It would not be a problem this year to write in my Thai address & I guess I may do just that.

I was just curious as I read a year from now it will be noted where you lived the previous year based on

that address on return. I have no idea why it would be but then again I have no idea about any

of the reasons the US requires the forms we are required to file in or out of the USA

[VegasVic]

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It is an interesting question.

I do know, when I was working in the U.S., I had an employment related medical insurance thru Blue Cross that did include coverage at some selected hospitals in Thailand. So yes, some regular U.S. health insurance policies do include coverage when traveling abroad/outside the U.S.

However, I believe obtaining those kinds of policies from stratch would require residence in some particular U.S. state. Now, what kind of "residence" would suffice is an interesting question. A mail address? A family address?? I'm not sure.

My concern about that approach would be paying premiums over time, and then at some point, the insurance company coming to the conclusion that you're not really insurable under their rules. Or you start having medical claims all outside the U.S. and none in your designated home state... Is that going to catch someone's attention at some point?

Just as jingthing said most major U.S. insurance companies will reimbrse you if while traveling overseas you have a medical emergency, but if they find out you are living overseas full time they will stop paying in a heartbeat! I don't know why anyone would pay for private medical insurance in the states when they are living over in Thailand, since Thai medical insurance is so much cheaper and you wouldn't have to submit for reimbursement ?

[VegasVic]

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When a US citizen turns 65 he is automatically enrolled in Medicare part A which is free. (Well, he has to return a form they send.) Part A covers only overnight stays in a hospital and any procedures they do. There is a deductible and a co-pay.

Real health insurance is when you buy part B which covers doctor visits and procedures they day. It's just under $105 per month and has deductibles and co-pays.

Better yet is part C instead of B which is called Medicare Advantage. It covers even more including prescription drugs. It is bought from a private insurance company and the government sends that company money every month to underwrite it. I think it's just over $1,000 a month. The government then washes its hands of you and all payments are from the private insurer. On average this costs about $150 a month.

I have, instead, part F which is called Medigap. It is part A, B, and F, and has absolutely no deductibles or co-pays. I pay for part B, for prescription drug coverage, and for part F and altogether it costs me about $270 a month but that's it. Never again a charge for anything no matter.

Because I have an expensive medical issue, it more than pays for itself.

None of this insurance is good outside the US. Because I am otherwise very healthy and this expensive issue I have isn't life threatening, I go to Thailand uninsured (or more like self-insured) knowing I can always return to the US for checkups with my expensive issue which needs very expensive monitoring about once a year. I go to a big medical university and teaching hospital and stay (in a motel) a couple of days and get tests. It costs about $10,000 and I pay nothing.

No one has to buy medicare. A is free, B is not required, and seniors 65 or older are exempt from Obamacare.

Neversure, You seem to have hit all the highlights, the only thing that I would add is that there are many medicare advantage plans that cost $0/mo and have very reasonable copays, all one does is sign their medicare benefits over to a private insurer and accept the plan. My wife is on such a plan and outside of the $104 taken out of SS for part B, she pays nothing to Humana and her primary care physician visits area at a $0 copay and specialists are $25 copay. She is in relatively good shape so she hasn't used this insurance for anything like heart bypass or cancer, but she has seen an eye specialist 3 or 4 times and they have done many tests, and she has had blood work and radiological work done and never has had to pay anything other than her copay, her prescriptions are also very cheap and some like her bone density medicine are free.

[CaptHaddock]

I was wondering what it would take to get there medicare if I was to move there. I am receiving a SS payment. I chose not to join it as I was not living there even though I am US citizen.

Is it based on the amount of SS you receive?

What you are talking about is Medicare Part B.

When you are eligible for Part B, which is one year after you start receiving social security benifits (65, 66, or 67 which ever one applies) you have 6 months to accept it. It is currently $104.90 a month, period. If you don't sign up you are penalized 10% for every year you do not sign up. So if you never plan on returning no problem, but if things change and you do, You suffer the consequences. How would they know? Simply go to a doctor when you return. If you have private insurance they too have the option of billing medicare. So you get caught there too. Plus yo might even get caught in good old Bamacare.

Your best source of information is http://www.ssa.gov/

This is not correct. You are eligible for Medicare at age 65 if you have worked long enough, i.e. 40 quarters, to qualify for Social Security. You do not have actually to be collecting SS nor do you have to wait until Full Retirement Age or any other age. Under certain circumstances you could be eligible before age 65, but you never have to wait longer than age 65.

[TallGuyJohninBKK]

NeverSure and VegasVic, you both talk above about participating in the Medicare program, NeverSure for himself and VegasVic for his wife.

NeverSure, you seem to be saying you're paying for MediCare while living all or most of the time in Thailand. Did you enroll in Medicare before moving here, or after moving here? And, have you had any difficulties with being enrolled while living here?

Vegas, you talked about your wife, but don't seem to say if you're living in the U.S. or Thailand while using Medicare?

Afterall, the thread here is about the potential for expats to enroll in ObamaCare or things like Medicare.

[TallGuyJohninBKK]

BTW, if anyone knows the answer to this, I'd appreciate it:

Starting with 2014 under the ObamaCare law, U.S. residents cannot be DENIED health insurance coverage by private insurers because of pre-existing conditions. That means, you still can get health insurance.

But, does it also mean that the insurers cannot EXCLUDE pre-existing conditions from coverage? Or just that they have to provide an insurance policy, but still can exclude specific conditions from coverage under that policy?