Signing up for US medicare as an expat

[ThaiFraiGai]

Does anyone know how to best deal with this middle-(uncomfortable)-ground situation: If you've started getting Soc Sec bennies >early<, say at 62, because you're broke because you were foolish enough to get scammed by a wily TH coyote (Lord, would never happen to me!, and you've got basic health and accident insurance but not for the cataracts operation that you were just told you need, are there any options available for 1) US coverage under any of these plans (without heading back to the US, as you're broke, remember), or 2) finding a way to head back and quickly get coverage before your eyes give out and you go blind, or 3) finding some fairly INexpensive, but not INeffective (so, I mean, it works and holds!) way to get the procedure done here, if you can scare up the money? (whew, long sentence -- I'm being oblique so as to not 'confess' too much)

Stan7444 sounds like he got a great deal (but only "as a Thai resident"? Official?); BKK Hosp suggests 40-70,000 TB PER EYE, but says it can be had for less at a public hospital; a BKK Hosp eye MD said there's some program for pennies or free for TH citizens, but probably not for farangs; Rutnin is preferred, but clearly out of $ range; and, if you've declared to both the IRS and SSA that you're living in TH, it makes for a potential mess to suddenly turn and run to the US on borrowed money, but might be the only option...and, I'm guessing the out-of-pocket costs for even homeless people ("you" would be one upon landing!) would be more than a cheap operation here. I'm hearing bank tellers in the US need food stamps, and they're mostly NOT 62, so getting a decent job sounds a bit unlikely. Add this to "your" scenario, and you see the ugliness: arrears owed on IRS loom (though it was supposedly clear!), long-deferrred school loans are coming due, as are credit card payments made to buy things for the business, as well as "the property" for it... (all of which were to be paid by earnings from the business the TH lady stole...serial, professional scammer meets another 'dumb ass trusting fahlang fooo, I know).

This would be a one-shot chance, and with no TH lady or great support network, quite a scary proposition for anyone. Sorry for the contortions, but, so it goes. Being broke sucks, but in TH, it might be worse, soon, if one can't see the cup for begging on Sukumvit, painted in Thai-colored shoe polish. THANKS!

[connda]

Thank you for your research and explanations, CaptHaddock. I feel more comfortable with decision (actually the reality) that Hubby must forego Medigap since he hasn't been back to the U.S. for years and doesn't plan to return anytime soon. And since we no longer own property there. Good to someone has a two month window to enroll upon return and no penalty like there is when you forego Part B (which he did get).

Now the next hurdle will be to figure out how to obtain an exemption from the mandatory requirement for younger people (like Hubby's child bride -- me) to have health insurance under Obamacare. That requirement becomes law in a a year or two, doesn't it. Oh well -- guess we'll start a new Thaivisa thread on that subject......

NancyL. As long as you are an expat, you will not be required to purchase insurance under the ACA if you meet the requirements below.

See http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision Topic 12:

12. Are US citizens living abroad subject to the individual shared responsibility provision?

Yes. However, U.S. citizens who are not physically present in the United States for at least 330 full days within a 12-month period are treated as having minimum essential coverage for that 12-month period. In addition, U.S. citizens who are bona fide residents of a foreign country (or countries) for an entire taxable year are treated as having minimum essential coverage for that year. In general, these are individuals who qualify for a foreign earned income exclusion under section 911 of the Internal Revenue Code. Individuals may qualify for this rule even if they cannot use the exclusion for all of their foreign earned income because, for example, they are employees of the United States. Individuals that qualify for this rule need take no further action to comply with the individual shared responsibility provision during the months when they qualify. See Publication 54, Tax Guide for U.S. Citizens and Resident Aliens Abroad, for further information on the foreign earned income exclusion.

Edited April 25, 2014 by connda

[Sheryl]

ThaiFraiGai: go to a government hospital, that is your only viable option. It will still cost but much less than the amounts you've heard from private hospitals.

BTW are you having a lot of trouble seeing? As the timing of a catarct operation is, basically, when they have gotten bad enough that it affects your everyday vision. Just wondering if you could wait it out for Medicare...just because you have cataracts doesn't in itself mean you have to have surgery now (though sooner or later, you will). There is no real rush if you are still able to function OK.

[NancyL]

ThaiFraiGai -- if I were you, I'd be worrying about way more than cataracts. As Sheryl said, you can probably tough them out until age 65 and Medicare. If I were you, in your situation, with what appears to be no savings for a medical emergency, I'd be more concerned about an accident. The accident rate in Thailand is about 20 times greater than in the west. And I'm not just talking about vehicular accidents. It's all the stupid obstacles on the sidewalks, the little steps in the buildings, the half steps in our homes, that trip us up here. If you can't afford health insurance here, you can afford a personal accident insurance policy. I don't know where you live, but here in Chiang Mai, Bangkok Bank sells one at all their branches, called PA Senior First that is dirt cheap -- about 6000 baht/year to anyone. You don't have to be a bank customer. The max payout is 60,000 baht for a broken bone (not real high), but you can use it any hospital and every hospital in CM recognizes their card and will admit and direct bill that policy -- for an accident. Which is what you're much more likely to suffer than a medical problem.

I'm not connected with Bangkok Bank and Sheryl is welcome to blow away this post if she thinks I'm promoting them too much. But, I assist elderly expats with Lanna Care Net, most of whom have had accidents and it's so sad that most (actually nearly all) haven't taken advantage of easy-to-purchase insurance insurance policy. The few that have the policy don't have to receive treatment in the crowded, un-air-conditioned gov't hospital ward rooms. They have a little extra "help" where they can be admitted into a nice room at a private hospital.

Edited April 25, 2014 by NancyL

[DogNo1]

I recently saw the Bangkok Bank brochure regarding accident insurance and it costs 5,800 per year for seniors but the accident payout is only 30,000 not 60,000. It didn't seem worth it to me but for those on very limited funds, it may be. Regarding a cataract operation, it may be possible to get a discount and pay over time for an operation at a good hospital. You could ask around.

[TallGuyJohninBKK]

It looks like the BKK Bank related accident insurance being mentioned above aimed at seniors actually has four different levels, with four different benefit structures, and four different premium levels dealing with both medical expenses for injuries and accidental death benefits in the event of a fatality.

See the BKK Bank website at the following link:

http://www.bangkokbank.com/BangkokBank/PersonalBanking/BuildYourWealth/Bancassurance/NonLifeInsurance/Pages/PA1st.aspx

The highest of the four levels does include up to 30K or 60K per accident in benefit, depending on the specific type of accident, but is also the level that has an annual premium at 5080 baht per year (not 5800 baht).

Accidents specifically involving broken bones under the highest policy level are the ones that qualify for up to the 60K in benefits, whereas other kinds of accidents have the lower 30K benefit cap under that same high level policy.

The website also states:

The insured person must have a good health record and not be disabled, already injured or have a serious sickness or chronic disease at the time of the application.

It might make sense for someone who doesn't have and/or can't afford regular local health insurance coverage, or even someone with a high deductible regular insurance policy.

But I have no idea of how BKK Bank's coverage and premium levels may compare to other comparable policies offered in the marketplace. I have the sense there are a lot of these kinds of policies marketed in Thailand.

Edited April 25, 2014 by TallGuyJohninBKK

[Langsuan Man]

DogNo1 I am still trying to understand why you pay $146 per month for Part B, while I only pay $104 ?

[Sheryl]

It looks like the BKK Bank related accident insurance being mentioned above aimed at seniors actually has four different levels, with four different benefit structures, and four different premium levels dealing with both medical expenses for injuries and accidental death benefits in the event of a fatality.

See the BKK Bank website at the following link:

http://www.bangkokbank.com/BangkokBank/PersonalBanking/BuildYourWealth/Bancassurance/NonLifeInsurance/Pages/PA1st.aspx

The highest of the four levels does include up to 30K or 60K per accident in benefit, depending on the specific type of accident, but is also the level that has an annual premium at 5080 baht per year (not 5800 baht).

Accidents specifically involving broken bones under the highest policy level are the ones that qualify for up to the 60K in benefits, whereas other kinds of accidents have the lower 30K benefit cap under that same high level policy.....

30 - 60K is a grossly inadequate level of coverage. Need 2- 5 million at a minimum or hardly worth getting. What good will a 30-60K payout do you if faced with a 3million baht hospital bill? As yo ueasily can be, even at a government hospital.

[TallGuyJohninBKK]

Sheryl, I wasn't recommending or endorsing the BKK Bank related policy, just providing the correct info about its coverage after the policy was broached by others earlier in this thread.

And clearly, it's an accident and accidental death policy -- not full-blown health/medical insurance. So it would do nothing for someone who simply gets ill. But I think that's pretty clear.

However, I can see the advantage of that kind of policy for someone here who either can't afford or isn't eligible for regular Thai medical insurance. For $100 to $175 per year, it's certainly better than nothing. And the fall-type, broken bone accidents it does cover can be a common risk for the elderly.

I'm in my mid 50s and currently pay about $1500 per year for my Thai medical insurance, inpatient and outpatient with a $1000+ annual deductible. 5 million per incident and 20 million lifetime caps. For me, that's an important coverage to keep and maintain. And it's only going to get more expensive as I get older. But I do understand, that not everyone is in a position to purchase that kind of coverage.

[sgtsabai]

I dropped Plan B after moving here full time. I also have an excellent free insurance plan from work retirement available in the states after re-enrolling in Plan B. It isn't any good here past the 1st 30 days in-country. I have no plans to ever return to the states. A serious illness would be a disaster for me, but there are no options. I would return to the states to use Medicare and pay penalty for dropping Plan B only if I could be assured of returning to full health and previous lifestyle. If I could not be assured I will just live life as fully as possible until the end. Then they can just pop me in the oven until well done. Speaking of cataracts, I have in a very early stage. Since moving here I have been using drops prescribed here. They have not worsened. If you are a Vet with service connected disability the VA Foreign Medical Program will re-pay any expenses related to that disability, including transportation and overnight lodging for tests/exams etc. There is at least one major hospital where I live that is enrolled with the Foreign Medical Program. It may be that FMP can pay them directly, not sure. If the VA can actually get it together enough to recognize a hospital for services here then so should Medicare, but I believe the money paid by big health to bribe politicians will prevent that from happening.

[ThaiFraiGai]

TallGuyJ, NancyL and others, Thank You...I appreciate the info. I do have an AXA/ACS insurance policy, not cheap but not terribly costly, AND the BKK Bank 5K/year one - but, neither, as I understand them (I'm investigating further) cover cataract surgery...only hospitalization and accident for the A/A one and "illness" for the BK B one. The former is a huge cost to me, given my status, and I didn't think I needed the vision part, RE surgery, nor had (or, have) the extra money for it...I'm actually considering dropping it for the BKB one...but, as you say, this might be foolish. The BKB person who sold it to me said, "No cover for motorbike accident; if have accident, go away and say not happen on motorbike." Um, with a bike registered in my name, don't think so.

GOVERNMENT Hospital sounds like my only option, if I can even raise funds for that...trying to sell things now & not doing well. Live on Koh Phangan, so it's harder/costlier to get anywhere, too. HOW/WHERE is Closest Gov't Hospital to me, that does cataracts, **how does one get in for service? I'm told Suratthanin Hospital is good, but still might be too much money for me. Spending on this will cut my emergency bailout card option, and make for even higher CCard paybacks. I'd like to "hold out" for Medicare, but I might be blind by then, if it progresses quickly...seems to have accelerated. Thanks!

(PS - Sorry for non-instant responses, I'm on/off 'Net...and, don't know why it says my posting is limited, or PM'ing.)

[lopburi3]

Have you actually been advised you need cataract surgery now by an ophthalmologist? People can have for many years and live with them until there eyesight is severely limited and then have operation to remove/replace lens. So you might be able to wait on this expense. If you have other eye issues that may require ongoing treatment (to control high pressure or such) make sure you take care of that as a priority. For most cataract removal can wait many years. I am 10 years older it seems and doctors are not in any rush to remove mine as long as I am not having difficulty in normal daily activities. But as mentioned suspect you are not in a good location for quality eye care so would make sure of the need first.

As mentioned a government hospital would be much less expensive than private as wife had done at 35k per eye at Venthani last year and nurse mentioned her mother could not afford that price and had done at government hospital as much cheaper (we did not ask the price - sorry).

[sgtsabai]

Agree with lopburi3, the need for cataract surgery is not always immediate. Make sure you go to a competent eye doctor with the right equipment. I've had for at least 5 years and they are not bad enough to operate. Just take the drops, am in a 'holding pattern'. I go to an eye specialist, trained in America-along with her sense of humor, several times a year for a check-up. There has been no change in 5 years. In fact up until just a couple of months ago I no longer even need glasses except for difficult reading. I had a severe bout with conjunctivitis that reoccurred in one eye after being cured. It somehow seems to have affected my vision and I will need to go back in a couple of months for a check-up and new glasses. My visits and meds even in a private hospital have not been expensive. If at some time I needed the surgery I would probably have to use the gov't hospital, I can have the 'Thai plan' if my wife ever gets over being pissed off at being asked for a bribe when she went for my 'yellow book'.

[Sheryl]

" .....HOW/WHERE is Closest Gov't Hospital to me, that does cataracts, **how does one get in for service? I'm told Suratthanin Hospital is good, but still might be too much money for me. Spending on this will cut my emergency bailout card option, and make for even higher CCard paybacks. I'd like to "hold out" for Medicare, but I might be blind by then, if it progresses quickly...seems to have accelerated. Thanks!"

Yes, Surathani is the closest government hospital.there is also a moderately priced private hospital in Surat town called Taksin hospital which is reported to be the best option in that region https://th-th.facebook.com/pages/Thaksin-Hospital/144792698904787. Would cost more than the provincial hospital but a whole lot less than the private hospitals in Bkk.

In either place, you just go and register, get a patient number and card and then go wait in the OPD area (being sure they know you need the opthalmologist). . Signs and instructions will all be in Thai so if you can, bring a Thai speaker. In the govt hospital will usually have to do all this first thing in the morning or risk being made to come back the next day. And only Mon-Fri, govt holidays excluded. May also be made to first see a GP before they let yo use the specialist, depends on the hospital. In the private hospital any day of the week will work and easy to go straight to specialist....though there may be specific hours. Often these are in the evening as the same doc may work at the govt hospital during the day.

It is unusual for cataracts to get that much worse that quickly so it is possible something else is going on. So a good opthalmologist exam is your first priority. Usually worsening vision due to cataracts is a very gradual occurrence.

[connda]

ThaiFraiGai: go to a government hospital, that is your only viable option. It will still cost but much less than the amounts you've heard from private hospitals.

BTW are you having a lot of trouble seeing? As the timing of a catarct operation is, basically, when they have gotten bad enough that it affects your everyday vision. Just wondering if you could wait it out for Medicare...just because you have cataracts doesn't in itself mean you have to have surgery now (though sooner or later, you will). There is no real rush if you are still able to function OK.

Cataract operation at Suan Dok government hospital in Chiang Mai is approximately 30K baht per eye with a simple IOL lens replacement.

Edited April 26, 2014 by connda

[connda]

DogNo1 I am still trying to understand why you pay $146 per month for Part B, while I only pay $104 ?

If you look at his original post, he indicated he didn't sign up until he was 70.

[DogNo1]

TallGuy is correct. The BB accident insurance benefit is 60,000 if you suffer broken bones. 30,000 otherwise.

The reason I pay $146 for my Medicare Part B and will have to pay more than the usual premium if and when I purchase Part D is because of the MAGI on my federal income tax return. See http://www.ssa.gov/pgm/medicare.htm and the publication "Medicare information for beneficiaries with higher incomes. " On page 8 it says, "Individuals with a MAGI above $85,000 up to $107,000: Standard premium + $42." According to your income, it goes all the way up to Standard premium + $230.

[joespnet]

DogNo1 I am still trying to understand why you pay $146 per month for Part B, while I only pay $104 ?

The higher premium for Part B is based on your MAGI (Modified Adjusted Gross Income). There is a sliding rate scale. Because it is based on your last filed return, they use your income from 2012 to determine your 2014 premium.

Basically if you are an individual filer with income under $85,000 (or a joint filer with income under $170,000) you will pay the normal rate of $104.90.

With higher income, it goes up in 4 steps with monthly premiums of $146.90, $209.80, $272.70, and $335.70. The highest of these steps would apply to individual filers with income over $214,000 (or joint filers with income over $428,000).

Here is a page from the Medicare.gov site that gives the details:

http://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html

[NeverSure]

I have medigap. I don't know how anyone gets it for $200 a month.

I have A which is free, B which costs $104 a month, RX (prescription drugs) which is about $30 a month, and all of that is deducted from my SS payment.

Medigap or "Medicare F" is purchased from a private insurance company but is heavily subsidized by the government. I have mine with Aetna and it costs about $140 per month. It picks up all deductibles and co-pays, so health care never costs me anything beyond paying for my insurance.

Add it up. $104 + $30 = $134 deducted from my SS. Another $140 for Medigap to Aetna = $274 per month.

[Langsuan Man]

DogNo1 I am still trying to understand why you pay $146 per month for Part B, while I only pay $104 ?

If you look at his original post, he indicated he didn't sign up until he was 70.

Yes and he never answered if he was paying $146 versus $104 because of the 10% per year penalty for late sign up or if this is the correct explanation :

The higher premium for Part B is based on your MAGI (Modified Adjusted Gross Income). There is a sliding rate scale. Because it is based on your last filed return, they use your income from 2012 to determine your 2014 premium.

Basically if you are an individual filer with income under $85,000 (or a joint filer with income under $170,000) you will pay the normal rate of $104.90.

With higher income, it goes up in 4 steps with monthly premiums of $146.90, $209.80, $272.70, and $335.70. The highest of these steps would apply to individual filers with income over $214,000 (or joint filers with income over $428,000).

Here is a page from the Medicare.gov site that gives the details:

http://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html

[ThaiFraiGai]

Lopburi, Sheryl, Sgtsabai, Thanks. Just reading now (as said, not on here often enough...way too late for earlier problems:). What "drops" do you take (SgtSabai/Lobpburi?)? I've been told that I have dry eyes (too much AC/fan - indoors, do computer stuff, still can't take heat after a few years here, tho I keep it at only 29/30•C!), so use TEARS-type drops. **What drops will counter-effect cataracts?

RE "don't have to get cataract surgery now," I've 'seen' distance vision going for a year+ (i.e., not clear, can't make out stuff as clearly, it's 'fuzzier' or 'blurrier' even at a few yards - but further, worse, whereas it used to be very clear except for reading, which went to glasses over 10 years ago. A supposed opthalmologist I saw then said the blurring was "seasonal stuff in air" and just ignore it, and, ironically, just gave me the tears, then. I've had Blepharitis (dry inner lids) for years, and haven't been aggressive enough about constantly 'washing' inner lids with hot water, so that's not helped.

But, last week, after a movie in a theater, I could not focus on people I was talking to 4-6 feet away, and felt unable to 'make' my eyes focus...and, then, going into a store, couldn't focus well on any signs or even faces very well, at many distances. Not IMpossible to do, but almost...and, I could see/function ... it's not like my vision just went, but it got bad enough to wonder if I was having a bigger issue (stroke?), etc. - totally scary. That's what I'm afraid is a "tipping point" of what's been the trend: going outside to "stretch" my eyes, doing focusing on different distances, I'm not as able to 'make' them do this...they "want or tend" to go to the lazy non-focus...very disturbing lack of control. I do think hours on the computer is bad, but I do it to try to eat, shall we say, and I'm a bit slow, so things take longer. NOTE to follow this might explain this - that night, I'd had only 1 drink, but a couple candy bars after; I'm told sugar can make the D and then the vision worse, like an "episode" I had.

RE other issues, I am likely at least borderline Diabetic, maybe Type 2, but try to control it through timely eating - mother had it, her dad, too. Heaven help me that the EnEssAy is not on this line, but what the hell: have severe sleep apnea, so take several things for that, Va and Za, shall we say...and, try to kick 'em, but can't sleep w/o. Irregular heart or A-fib for long time doesn't help, but that takes Ton$ to convert, meds didn't help for months. In short, I'm a mess and uninsurable in the US, a risk here.

RE hospital info, thanks, I do not have a TH lady or friend who'd go with, so it'd be tough at any place but the most expensive, which are out of reach...even the government ones are now, sadly...I'm walking the broke line and about to get worse...bad enough to think about return to US, but afraid it'd be worse there! Many payments, mentioned in original post about my friend, are about to come due, which will SAP all living monies.

Went back to the eye doctor, and he said, it's "nuclear cataracts", so that's not as bad as the one kind that only gives you a few months. But, that's what I worried about with 1) the bad incident, 2) his first meeting, where he said, "Get them done in 3-4 months" ... then, revised to "can do in 6-12 months" - still sounds a bit more rushed than, "wait until they're bad, is all." And, maybe it's just the dry eyes, but something just feels a bit different about the eyes, not quite a "discomfort", but a "hmm, there's something going on in there" feeling - not quite right.

I came here relatively "rich" in TH terms, "not bad" by most of your standards (as you sound well-set, by and large), but didn't do the right paperwork and paid cash for everything, now can't afford attorneys to recover, and might not gain by trying...they already said I'd need 1-200K TB, ha! The 300K I put down for a truck (yeah, cash: DAS [dumb ass syndrome]) could pay for this and more, but...could only get if an attorney wanted to go for a commission/5 deal. I had high hopes when a big lawyer saw she'd signed an agreement that I'd paid her over 1M TB, but terms of payback weren't in it, etc. And, tho another att'y said, "Clear case of verbal contract and business/house-mate reversal" - (all fake, while she's with another man, who's likely helping her cheat several men, as I'm told now) - verbals are iffy anywhere, cash is 'no paper trail,' etc.

She's done very well with the 1st biz, making into 2-3, kept truck, got car, 2nd car, maybe, maybe several homes...all on credit and leases. And, gave back some, but refuses a penny now, yada.OK, digressing, but you see my plight...escalating cah-rap, essentially.

**Q: Still don't know **if Laser or Knife is best" for this, though I think that Knife lasts longer, if I understand it. As I do a lot of reading and computer, I think IOL lens is best, right? Thanks again, All! -TFG

[DogNo1]

Funny about that Medicare.gov page. I'm pretty sure that I pay $146 exactly rather than $146.90. I'll have to look for my past communications from SSA. That will be a chore. I wish I'd used my Paperport software years ago and scanned everything. I'd be able to find anything in a flash. Most of my financial documents have been supplied in digital format for about four years ago so anything recent is easy to find.

[ThaiFraiGai]

TFG again, sorry for that long post. Yes, this is straying, but it goes back to "how can I pay for living, And eye surgery?"

Footnotes, as I know I'll get kicked for stupidly trusting, which is why I never posted here...been beaten up enough:

- How much should I worry about chemicals on foods here, that might cause vision issues? I use Reishi (CH: "lingzhu") and Astragalus ("pak-ki") mushrooms for health and to fight depression about all of this, and have been told they have "no chemi", but worry, still. Also read about "Formalin/Formaldehyde on veg/fruits" on here...try to eat fresh, for health.

- The "commission/5" was meant to be a ".../% deal" - most attorneys want cash, obviously. And, yes, I was getting ready to possibly "Ask the Attorney" about this, when the eyes issue flared up. Ironically, winning the case could pay for the fix, as said, but I'm a bit leary (and now, bleary;) about trying it...a couple prior attempts were clear scams set to get $ only.

- My overall investment was 2-3M TB, her earnings are now >3M TB/year...tho$e were supposed to pay my debts off, we agreed. I got all her teeth fixed, but she wouldn't pay 30K for some dental surgery, so no 60-200K is coming for eyes.

- There is some pittance of "paper trail", i.e., initial $ transfers from abroad to her account, emails about "we do business together", and many pix of the first small biz, which I then trebled in 2nd. I have 'confessions of debt,' but they might be tossed out. I thought I was tracking all, but was out-foxed x10, w/ her family/many in on it. Just saying...it's pretty thick. :-I

[lopburi3]

Normally one of the first checks on an eye exam, if for more than just prescription, is pressure check and mine has always been high and as have family history and systems of some glaucoma issues keeping that within the mid-teens has been a priority so eye drops are used for that (my father stopped taking in elderly years and indeed lost his vision). I don't know if you need for anything except the dry eyes you mention and indeed that condition is likely to cause a loss of focus and generally bad eyesight - much better vision when wet. I use Vislube during the day and although this is expensive do not need much as seems to last a long time. Morning and night use Genteal Gel. You might find something cheaper under a local brand name.

If it were me I would be considering a return to US when you may have family and even without can obtain services on the basis of your citizenship if there really is no plan or hope for local income.

[sgtsabai]

I use Alcon Quinax, available just about any pharmacy, plus Allergan Cellufresh MD for dry eyes. I was using Kary Uni, hard to find, but doctor said the Quinax was doing the same so stopped. The description of your problems does not sound like cataracts to me, but I'm no doctor. You need to get to a good eye doctor and have a thorough exam, cost isn't that much.

[ThaiFraiGai]

Thanks again, sgtsabai and lopburi3. I appreciate your kind info, and that of the others. I will check out these leads, try the drops, get to another doctor, etc. No open-hearted or open-doored family back home, but if you know a nice lady who'd have a guy who would clean house, run errands, cook (ex-chef), do massage (nuat TH folks say I'm good!), I'll take names, haha. Can do some of these things with limited vision, if it gets to that - the other stuff...they'll have apps for it all soon.

[Sheryl]

I would get a second opinion from another opthalmologist if I were you, and soon. What you describe does not add up for being cataract-caused and some of what you report the doc you saw saying also gives me pause.

As a diabetic you are at high risk of macular degeneration and other problems. This might not be a cataract issue.

And, I agree with those who suggest getting back to the US. Where you may be able to get on Medicaid. It is not a good idea to be here without enough funds to pay for medical care.

[sgtsabai]

I do not recommend the drops, except for the dry eyes, without consulting another doctor, and quickly. I totally agree with others here, your problem does not sound like cataracts. Do not take cataract meds. At least you are keeping a sense of humor, vital my friend. Don't know your exact age, but age makes a difference as much as we wish it didn't. Last year I was having a urinary problem, along with several others-high blood pressure for one and went to a Urologist. Had a sonogram, wow pretty doc and assistant, never mind-off subject, nothing unusual, i.e. no cancer. Went back into the Urologist, also pretty, who explained I had an enlarged prostrate, no big problem, just take meds. I indignantly said I never had problem with prostrate in my life. She took no back talk from me and said "You old man, all old men have problem". I was rightly put in my place and had to laugh. Took the meds and will the rest of my life. Get to a good doctor ASAP. Once you get a good diagnosis all the rest will fall in place.

[TallGuyJohninBKK]

She took no back talk from me and said "You old man, all old men have problem". I was rightly put in my place and had to laugh.

That's not exactly the kind of medical diagnosis of a supposed prostate problem that I'd expect to be hearing from a medical doctor, pretty or otherwise. Especially if it was the basis for a lifelong prescription of taking medication.

There are common tests for determining prostate issues -- the digital exam, which I'm sure you would have enjoyed, the PSA blood test and other methods. It's a bit concerning that you mention having had neither of those.

My elderly father some years back had a diagnosis of early prostate cancer by one doctor. So they did biopsies and had him going for regular blood tests every few months to monitor his levels. And the original doctor started talking about chemo and other such things. In the end, my father ended up seeing a specialist who did a more extensive, detailed series of biopsies, and the specialist judged him to NOT have prostate cancer. Gave him a clean bill of health. I was never able to get my father to explain to me just how the original doctor had come up with the wrong diagnosis.

Edited April 27, 2014 by TallGuyJohninBKK

[DogNo1]

Repatriation to America to get on Medicaid or emigration to a country that has low-cost generous health care insurance would seem to be a good solution for your various medical problems. For the sake of your health, sooner rather than later. If you can't afford health care in Thailand then you can't afford it. Dithering and worrying won't help you. I'm sorry that you got taken but sympathy won't solve your health problems. I suggest that you "bite the bullet" and get yourself to a country where the welfare system will allow you to be treated for your failing eyesight and incipient diabetes promptly. That would be the best use of your remaining funds. Good luck!