US Federal Government annuitants (non-military), Medicare and FEHB health plans.

[Dogberry]

This is addressed to a limited audience for sure but I know you're out there…

I'm in the final quarter before turning 65. I elected SS at age 62 and according to the SSA I will be automatically enrolled in Medicare parts A and B (yes, a whole other topic ensues concerning SS and foreign address reporting. As far as the SSA knows my domicile is in Oregon).

The fact is Medicare provides no benefit it me in Thailand.

So what did you do (or plan to do) and why? PM is fine.

[Langsuan Man]

No, you will automatically be enrolled in Part A only @ 65

You must apply for Part B at 65 or pay a 10% penalty per year if you want it later on

Since I go back to the US every summer I have both, Medicare Part A and B and FEHB. Why ? because I prefer to be over insured than under insured

Just remember here in Thailand most hospitals will make you pay up front and then you can make a claim using your Federal Employee Health Benefits. If it is Blue Cross, they now allow you to submit overseas claims via email attachments and will reimburse you via direct deposit to a US bank if you want

[Pib]

You are automatically enrolled in part A and B in some cases and then you contact Medicare to opt out of part B. See below Medicare.gov Web page.

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html

[Dogberry]

No, you will automatically be enrolled in Part A only @ 65

You must apply for Part B at 65 or pay a 10% penalty per year if you want it later on

Since I go back to the US every summer I have both, Medicare Part A and B and FEHB. Why ? because I prefer to be over insured than under insured

Just remember here in Thailand most hospitals will make you pay up front and then you can make a claim using your Federal Employee Health Benefits. If it is Blue Cross, they now allow you to submit overseas claims via email attachments and will reimburse you via direct deposit to a US bank if you want

No big deal at all but as I mentioned I still maintain a domicile in Oregon and that's my SS address.

Quoting SSA web site: "If you live in one of the 50 states, Washington, D.C., the Northern Mariana Islands, Guam, American Samoa, or the U.S. Virgin Islands, we’ll automatically enroll you in Medicare Parts A and B. However, because you must pay a premium for Part B coverage, you can choose to turn it down."

And then I'm not sure about this either... Speaking with my FEHB Provider (GEHA) she said all claims must be submitted to Medicare first as primary provider. Medicare will then submit claims to GEHA after paying their portion (which would be $0 if in Thailand). Perhaps this is a difference related to living in a foreign country as well.

[Dogberry]

I think this is turning into SSA question of which there are many threads, some running even now. I sure don't want to get sideways with them so I'm thinking I need to change my address?

Anyway I looked at the OPM "life events" page and qualifying for Medicare is not listed. Can I change my FEHB coverage outside of open season?

I want to maintain FEHB coverage as you did Langsuan Man but want to change my policy...

Edited May 21, 2016 by Dogberry

[Langsuan Man]

PIP is correct if you are drawing SS they will start both A and B automatically so you have to opt out from B. In my case since I waited for full SS benefits at 66 they had no way of getting money out of me, other than billing me

I'm thinking I need to change my address?

Changing your address would open the window for changing your FEHB without waiting for open season so long as you are changing a US address. If you want to change it to a Thai address , Consider it long and hard before you do. Think about opening bank accounts in the future, getting new credit cards for lower interest rates, voting and drivers license renewal. Many people who retire here in Thailand fail to anticipate the ramifications of making Thailand an official address. Military retirees are different since they can obtain limited APO privileges , which effectively gives them a US address, in most cases

I have talked to other retirees who have health insurance from state or local governments as part of their retirement package and most report that they have to submit bills to Medicare first, who of course will issue a rejection letter since they will not cover you overseas , and they then make their claims. Since as far as Blue Cross is concerned I am just vacationing in Thailand they have no such requirement . So for me at least it is just one less step to get my money back

[ubonjoe]

If living outside the US when you turn 65 you have to request part B. You automatically get part A but not B. After I turned 64 I got a letter telling me I would get part A and would have to request part B to get it.

From: https://www.medicare.gov/people-like-me/outside-us/signing-up-for-part-b-outside-us.html

"Example

You're over 65, currently getting Social Security retirement benefits and Part A, and you didn't take Part B when you were first eligible. You may only apply for Part B from January 1–March 31 each year, and you may have to pay a late enrollment penalty for as long as you have Part B."

[lopburi3]

FEP Blue Cross offers online claim submission and direct payment to bank (including Bangkok Bank via ACH). But I am not drawing SS so have not opted for Medicare so can not answer questions on that. For me it is direct submission to FEP/Blue.

As for having overseas address don't need US credit cards beyond what I have and they were happy to change to my foreign address.

I have opened USAA bank account with my foreign address without issues.

I have voted in elections without issue using foreign address (address for voting remains last US address even after you leave).

I renewed DL for 20 years without issues - but new law is only one time without photo in person - having US address would not help.

That said if intent is maybe return or continued activity in US then having address and phone number might well be important.

[Dogberry]

If living outside the US when you turn 65 you have to request part B. You automatically get part A but not B. After I turned 64 I got a letter telling me I would get part A and would have to request part B to get it.

From: https://www.medicare.gov/people-like-me/outside-us/signing-up-for-part-b-outside-us.html

"Example

You're over 65, currently getting Social Security retirement benefits and Part A, and you didn't take Part B when you were first eligible. You may only apply for Part B from January 1–March 31 each year, and you may have to pay a late enrollment penalty for as long as you have Part B."

Yes that is absolutely correct Joe. However SSA knows nothing about me living here in Thailand so I will be enrolled automatically as if I were living in the USA.

But that begs the question being discussed here and in other threads; should I report my Thai address to SSA. It's a difficult question for sure and I really don't like "gaming the system".

I want to keep my US address for correspondence, credit cards, other insurance etc but I think I want to advise SSA and Medicare of my Thai address. I don't really see a problem with this unless someone can chime in with a reason why not.

[IMA_FARANG]

i retired in 2010 at age 64.

i recieve 75 percent of my full Social Security benefits beause i retired at age 64 rather than at age 65 (medical reasons forced my retirement at agr 64)

When i reached asge 65 I was automatically enrolled in Medicaid/Medicare....no one ever asked me if i wanted it.

Since my 65 birthday i have been paying $99 each month for Part B benefits i can not use here in Thailand.

Supposedly you can opt out of that.....but believe me if you try the Social Security will fight you all the way to not let you opt out of Part B

Their justification is that is a benefit to you IF you should return to the U.S....which may indeed be true.

However trying to tell them you don't intend to return to the U.S. .....they will treat you like you were a fool or even a traitor to your country for not wanting to accept their so-called Part B "benefits"....which they take out of your momthly benefits money.

The only way you are going to be able to opt out of Part B is to sit own with a supervisor who will lecture on thr benefit you sre getting from medicare/medicaid.

After 3 years gave up......i just look at that $99 monthly that is taken out of my SS benefits as anpther hidden tax like a Sales tax or a VAT tax you are forced pay when you buy sometihing in the U.S.

I am getting $1740 monthly anyhow....and i can survuve on that here in Thailand easily.

i say 4Q for their extra $99 a month. taken from my benefits

[lopburi3]

Actually it may indeed be a positive even living overseas as believe federal medical insurance does not require co-payments if you are enrolled - even if medicare is not paying anything.

[ubonjoe]

If living outside the US when you turn 65 you have to request part B. You automatically get part A but not B. After I turned 64 I got a letter telling me I would get part A and would have to request part B to get it.

From: https://www.medicare.gov/people-like-me/outside-us/signing-up-for-part-b-outside-us.html

"Example

You're over 65, currently getting Social Security retirement benefits and Part A, and you didn't take Part B when you were first eligible. You may only apply for Part B from January 1–March 31 each year, and you may have to pay a late enrollment penalty for as long as you have Part B."

Yes that is absolutely correct Joe. However SSA knows nothing about me living here in Thailand so I will be enrolled automatically as if I were living in the USA.

But that begs the question being discussed here and in other threads; should I report my Thai address to SSA. It's a difficult question for sure and I really don't like "gaming the system".

I want to keep my US address for correspondence, credit cards, other insurance etc but I think I want to advise SSA and Medicare of my Thai address. I don't really see a problem with this unless someone can chime in with a reason why not.

I was here when I applied for SS.

There is no reason I can think of not to change your address to here.

[ubonjoe]

i retired in 2010 at age 64.

i recieve 75 percent of my full Social Security benefits beause i retired at age 64 rather than at age 65 (medical reasons forced my retirement at agr 64)

When i reached asge 65 I was automatically enrolled in Medicaid/Medicare....no one ever asked me if i wanted it.

Since my 65 birthday i have been paying $99 each month for Part B benefits i can not use here in Thailand.

Supposedly you can opt out of that.....but believe me if you try the Social Security will fight you all the way to not let you opt out of Part B

Their justification is that is a benefit to you IF you should return to the U.S....which may indeed be true.

However trying to tell them you don't intend to return to the U.S. .....they will treat you like you were a fool or even a traitor to your country for not wanting to accept their so-called Part B "benefits"....which they take out of your momthly benefits money.

The only way you are going to be able to opt out of Part B is to sit own with a supervisor who will lecture on thr benefit you sre getting from medicare/medicaid.

After 3 years gave up......i just look at that $99 monthly that is taken out of my SS benefits as anpther hidden tax like a Sales tax or a VAT tax you are forced pay when you buy sometihing in the U.S.

I am getting $1740 monthly anyhow....and i can survuve on that here in Thailand easily.

i say 4Q for their extra $99 a month. taken from my benefits

You must of been in the states when you applied for Social Security and were using a US address when you turned 65. If you had been using an address here you would of not been enrolled in part B unless you asked for it.

[Dogberry]

i retired in 2010 at age 64.

i recieve 75 percent of my full Social Security benefits beause i retired at age 64 rather than at age 65 (medical reasons forced my retirement at agr 64)

When i reached asge 65 I was automatically enrolled in Medicaid/Medicare....no one ever asked me if i wanted it.

Since my 65 birthday i have been paying $99 each month for Part B benefits i can not use here in Thailand.

Supposedly you can opt out of that.....but believe me if you try the Social Security will fight you all the way to not let you opt out of Part B

Their justification is that is a benefit to you IF you should return to the U.S....which may indeed be true.

However trying to tell them you don't intend to return to the U.S. .....they will treat you like you were a fool or even a traitor to your country for not wanting to accept their so-called Part B "benefits"....which they take out of your momthly benefits money.

The only way you are going to be able to opt out of Part B is to sit own with a supervisor who will lecture on thr benefit you sre getting from medicare/medicaid.

After 3 years gave up......i just look at that $99 monthly that is taken out of my SS benefits as anpther hidden tax like a Sales tax or a VAT tax you are forced pay when you buy sometihing in the U.S.

I am getting $1740 monthly anyhow....and i can survuve on that here in Thailand easily.

i say 4Q for their extra $99 a month. taken from my benefits

You must of been in the states when you applied for Social Security and were using a US address when you turned 65. If you had been using an address here you would of not been enrolled in part B unless you asked for it.

That is exactly correct

I need some specific answers to some specific questions and the only way I'm going to get that is to call my provider. I will post their answers here after I've called in a couple days.

So... I have health insurance through my former employer. My question to them will be:

1. What is the the status of my coverage if I am LIVING in Thailand verses TRAVELING in THAILAND.

2. If I can continue coverage while living here do you need a Thai address or will my US address satisfy your requirements?

3. Can I continue coverage I refuse part B.

I think the answers might not only apply to me as a federal annuitant but to anyone who has employer provide coverage.

In the meantime anyone in a similar circumstance?

Edited May 21, 2016 by Dogberry

[Pib]

i retired in 2010 at age 64.

i recieve 75 percent of my full Social Security benefits beause i retired at age 64 rather than at age 65 (medical reasons forced my retirement at agr 64)

When i reached asge 65 I was automatically enrolled in Medicaid/Medicare....no one ever asked me if i wanted it.

Since my 65 birthday i have been paying $99 each month for Part B benefits i can not use here in Thailand.

Supposedly you can opt out of that.....but believe me if you try the Social Security will fight you all the way to not let you opt out of Part B

Their justification is that is a benefit to you IF you should return to the U.S....which may indeed be true.

However trying to tell them you don't intend to return to the U.S. .....they will treat you like you were a fool or even a traitor to your country for not wanting to accept their so-called Part B "benefits"....which they take out of your momthly benefits money.

The only way you are going to be able to opt out of Part B is to sit own with a supervisor who will lecture on thr benefit you sre getting from medicare/medicaid.

After 3 years gave up......i just look at that $99 monthly that is taken out of my SS benefits as anpther hidden tax like a Sales tax or a VAT tax you are forced pay when you buy sometihing in the U.S.

I am getting $1740 monthly anyhow....and i can survuve on that here in Thailand easily.

i say 4Q for their extra $99 a month. taken from my benefits

They do not "fight you all the way to opt out of Part B." They do try to inform you of what opting out can incur to insure you understand the re-enrollment cost and open windows to re-enroll. You can opt out easily "if you really want to" but it appears you do not. That's OK...It's your decision.

[Dogberry]

Actually it may indeed be a positive even living overseas as believe federal medical insurance does not require co-payments if you are enrolled - even if medicare is not paying anything.

I was in the hospital in Bohol, Philippines. I got the best care you can imagine at the Medical Training College in Tagbilaran. Days and days in intensive care, weeks of in-patient care. My bill was less than $5000 dollars. I was discussing my claim on the phone with a GEHA rep and she was flabbergasted. First she told me all care out of country meets preferred provider criteria, then she said she had to follow the rules to certain extent but ANY claim for 5000 bucks that would has been a hundred thousand in the USA had some leniency. No itemized receipts required. Paid in full.

The hospital was a Catholic facility called Holy Name Medical University. Being attended to by gaggles of pretty (and OK, handsome) student nurses made me feel A LOT better. HAHA

Edited May 21, 2016 by Dogberry

[Dogberry]

So, my new GF at GEHA (Crissy - not her real name) was perfect. FEHB and specifically my GEHA High Deductable Health Plan, are the same weather you in in the USA or LIVING as and EXPAT (as opposed to just traveling) in a foreign country.

The GEHA brochure mentions coverage while traveling but never living in a foreign country. Nevermind. Traveling or Living same same.

GEHA does't care about mailing addresses. All coordination between them and Medicare is based on SS Numbers. I intend to notify SSA of my foreign address. I'll keep my US address for every thing else including my FEHB Healh Plan.

Medicare is my Primary Provider weather I have just Part A or if I have B, or C, and D or any combination. All claims will submitted to Medicare FIRST. Medicare will will then submit unpaid claims to GEHA as my secondary provider. Essentially all my claims will be paid by GEHA as Medicare provides no coverage "out of the USA".

My FEHB coverage is mine for the remainder of my life. I can chose to elect part A or not. Or elect A and B or not. My FEHB plan remains the same regardless.

I will not elect part B as I have secondary coverage already.

Now my only concern is that since I'm in the final quarter before 65, if I mess around with address changes It might screw something up.

Anyway.... happy to share some concerns that are now resolved.

Edited May 24, 2016 by Dogberry

[Langsuan Man]

I can chose to elect part A or not.

Can you decline Medicare if you take social security?

The US Court of Appeals for the District of Columbia Circuit recently said no. A group of seniors, including former US House Majority Leader Dick Armey, had sued the federal government to be allowed to accept Social Security payments, but decline Medicare coverage. They preferred to keep their private coverage to being covered by Medicare. Unfortunately for them, the court concluded that the Social Security Act did not allow an individual to take Social Security payments without also accepting Medicare Part A coverage (although the individuals could not be forced to use the benefits). Eligible individuals can at times accept Medicare coverage without starting their Social Security benefits; the restriction runs in only one direction.

source: http://www.lexology.com/library/detail.aspx?g=395adff2-7f0c-4ef7-b0d9-cf98083b9385

[Pib]

https://www.opm.gov/healthcare-insurance/fastfacts/fehbmedicare.pdf

* Since I have FEHB coverage, do I need Medicare coverage? The decision to enroll is yours.

Medicare Part A - If you are entitled to Part A without paying the premiums, you should take it, even if you are still working. This may help cover some of the hospital related costs that your FEHB plan may not cover, such as deductibles, coinsurance, and charges that exceed the plan's allowable charges.

Medicare Part B - If you are retired and enrolled in a fee-for-service (F F S) plan such as: Blue Cross Blue Shield (BCBS), GEHA, and Mail Handlers, Part B and your plan may combine to provide almost complete coverage for all medical expenses. Refer to Section 9 of your plan’s brochure to see how your FEHB plan works with Medicare.

Edit: reinserted F F S with spaces within the parenthesis because ThaiVisa would automatically delete the acronym without the spaces. Strange.

That court ruling was really driven by someone trying to prevent their current coverage from being reduced because they were now Medicare eligible...some plans are like that to save costs. My sister in the U.S. who works for a county school system has a plan like that...once reaching 65 the plan reduces coverage because they say Medicare A can now cover some of the costs.

Edited May 25, 2016 by Pib

[Suradit69]

i retired in 2010 at age 64.

i recieve 75 percent of my full Social Security benefits beause i retired at age 64 rather than at age 65 (medical reasons forced my retirement at agr 64)

When i reached asge 65 I was automatically enrolled in Medicaid/Medicare....no one ever asked me if i wanted it.

Since my 65 birthday i have been paying $99 each month for Part B benefits i can not use here in Thailand.

Supposedly you can opt out of that.....but believe me if you try the Social Security will fight you all the way to not let you opt out of Part B

Their justification is that is a benefit to you IF you should return to the U.S....which may indeed be true.

However trying to tell them you don't intend to return to the U.S. .....they will treat you like you were a fool or even a traitor to your country for not wanting to accept their so-called Part B "benefits"....which they take out of your momthly benefits money.

The only way you are going to be able to opt out of Part B is to sit own with a supervisor who will lecture on thr benefit you sre getting from medicare/medicaid.

After 3 years gave up......i just look at that $99 monthly that is taken out of my SS benefits as anpther hidden tax like a Sales tax or a VAT tax you are forced pay when you buy sometihing in the U.S.

I am getting $1740 monthly anyhow....and i can survuve on that here in Thailand easily.

i say 4Q for their extra $99 a month. taken from my benefits

They do not "fight you all the way to opt out of Part B." They do try to inform you of what opting out can incur to insure you understand the re-enrollment cost and open windows to re-enroll. You can opt out easily "if you really want to" but it appears you do not. That's OK...It's your decision.

Yes. I never signed up for Part B and SS never made a fuss about it, nor have I ever had anything deducted from my SS monthly payments.