For US expats - Obama Care or Medicare?

[smo]

I'll receive my early (at age 62) retirement Soc Sec starting in December. Am going back next week to the States for a 2-month family visit. Just wondering what kind of free medical coverage I can apply stateside. Obama care started after I had left the us so I don't really have a handle on it. Basically I would need a general checkup of all sorts, from top; eye, teeth, etc, to bottom: my next colondoscopy is due (the last one was about a decade ago.)

Hopefully SheryL and others (us expats) with experience in this area can give some advice/pointers.
Thank you much in advance.

ps - I'm from California, which also has MediCAL, though I had never been qualified for it prior to the time I left the US 3 years ago.

[Jingthing]

Medicare eligibility starts at age 65.

You will want to seek health insurance.

What you can get depends on your actual income.

If it's under a certain amount, you can apply for expanded Medicaid (an "Obamacare" thing but only in some states but California is one of them).

If over that amount (and under what I'm guessing you make) you will likely be eligible for SUBSIDIES of your insurance fee, again depending on income.

Your income includes social security plus other income, plus withdrawals from IRAs etc.

To figure your exact situation best to logon to a government website and punch in your projected income level.

It might be a good idea to do some of those things (or all of them) on your list in Thailand even without coverage here BEFORE repatriating. 

 

Edited September 7, 2016 by Jingthing

[gk10002000]

fair warning that applying for obamacare through the health dot gov websites can be challenging.  They check information across several databases, TSA, Social Security, IRS, DMV, etc.  and if a name, or address or middle initial is different it can be a while.  Not sure what you would use as an address but since you are moving back to the States, it probably won't match up with some things.

 

     And don't forget how the whole darn things works.  In year 0 you state your income, and your cost with or without subsidies is based on that. Now when you file taxes the next year, your actual income is checked to see if you paid too much or too little for your insurance!  You may owe more, or you may get a refund/credit.  I have private insurance through FL Blue Cross Blue shield that luckily is "grandfathered" so I was able to keep the plan albeit with 28% increases every year!  I don't have to use the Obama care websites.  All my co-workers are direct salary people and they go through the company plan.  I honestly don't know anybody who is an independent such as me, (or you) that uses the health dot gov websites or plans.    My Mom is 87 and has medicare , part B and whatever so she never dealt with obamacare directly either.  I thought there was some sort of "bridge" insurance out there that can tide you over until you hit 65 and qualify for medicare and stuff.  I am 6 years from that so if things don't change I will keep my current insurance until then.

[Jingthing]

I don't think there is this "bridge" insurance you speak of.

You're right, repatriating, you need to establish state residency in the state if you don't already have it.

 

I'm sorry but I just reread the OP and it sounds like he isn't actually MOVING back to the U.S. and only going for a two month visit. To get on insurance there for such a short period without actually repatriating ... I'd say that is not possible. 

 

More bad news ... staying for two months the OP MAY be subject to an IRS PENALTY for not having U.S. medical insurance.

Edited September 7, 2016 by Jingthing

[Sheryl]

As others have explained, so-called "Obama Care" is not a system of free health care it is a system that helps people get private health insurance. This includes providing subsidies for people below a certain income threshold to help them pay the premiums.  The insurance one can get through this will in turn pay all or most health care costs (depending on the plan you select) but you do have to pay an insurance premium.

 

Medi-Cal on the other hand is aimed at very low income people and costs either very little or nothing depending on income level.

 

Both are applied through through the same process and website: www.coveredca.com  During the application process your eligibility for either Medi-Cal or subsidized private insurance will be ascertained.

 

That you live abroad does not preclude your obtaining either Medi-Cal or private insurance, though of course you will only be able to use these while in the US. The US considers every citizen to be domiciled in one state or another and as long as you have maintained a Ca address, even though you physically are somewhere else, should be OK - but if you for example have a driver's license issued by a different state, or registered to vote in a different state, might cause some difficulty. 

 

Whether or not to enrol now I think depends on whether you have good health insurance in Thailand, sufficient to cover a major illness and would be prepared to have a major illness treated here rather than go back to the US for it (if able).  If you do, then I would just get travel insurance to cover your stay in the US (will not cover medical check-ups, only urgent or emergency care, but still essential to have). If you are not set up to be able to handle medical bills in the millions of baht in Thailand and/or if you think that you would prefer to go back to the US for treatment if you, for example, needed major elective surgery (joint replacement, etc) or treatment for cancer (surgery, chemo etc) or other expensive chronic disease then you should enroll now. It might not be in place by the time you go back but on the other hand you can use your trip back to complete the enrolment process if you ran into any snags doing it online - there are counsellors you can go talk to face to face to help you through the red tape.

 

There is a member on this board right now, younger than you and until now in the peak of health, who just learned they have stage IV cancer and has no insurance, and is struggling to get coverage so they can go back to Ca for treatment. This is adding greatly to what is already a stressful situation, as you can imagine, and as there is an urgent need to start treatment at once this person may be faced with a choice of spending a million baht or more out of pocket here (and possibly not getting access to the very latest state of the art chemo) or increasing the risk of dying by delaying treatment while waiting to get covered in Ca. Something to think about as it could happen to you. Had this person already been enrolled they would have been on a plane weeks ago and already getting the needed care in the US.

 

If you decide not to enroll now, do get travel insurance for your stay. I use IMG as unlike many insurers they will cover US citizens who live abroad and are visiting the US - but only if they have insurance in their country of residence. (Pretty much all travel insurance policies require this - that is why travel insurance is so relatively inexpensive, they count on only having to cover treatment tat can't wait and only up to the point that you can get back home).

 

If you have no insurance in Thailand and do not have at least a few million baht put away for health emergencies, then you need to quickly fix that.

[smo]

I just spent some time doing enrollment on coveredca website. MediCAL that will be. Enrollment is pending awaiting proof of income, which is the confirmation letter from SSA which timely arrived last week. btw that will be my sole income for the future, not counting the few dollars that the bank pays for my saving account interest each year

Since I will be there in a week's time, I rather just show up in person at the local SSA office to complete the process. Medical does not cover vision, might as well I don't  have to rush (I will simply go to CostCo and buy new glasses). I hope that I would get something out of it during the 2 months of my home visit. While there I will also shop around for my coverage for Thailand in the long run....

Thank you all so much for your inputs, especially SheryL (as always) and also a big thank to Jingthing too. Will definitely give an update/report from the US.
In the meantime wish everybody a nice day, much appreciated.

[chubby]

in california is medical, elsewhere it's medicaid, and contracted out then to various pseudonyms,  depending on the company. 

 

you need to decided which state, and probably then be a resident, many states opt-ed out of the expansion of medicaid, so you'd have to be very low income, like < $11,000/year to get "free" medicaid, and then your subject to even finding doctors whom will take medicaid. 

 

then again, technically to NOT be legally required to buy a plan, you must be out of country a certain number of days,  i guess 2 months, might not make it so you aren't legally forced to "buy" a plan. 

 

then the insurance ain't gonna kick in till the next 1st of the month,  basically a lot of it turns into a tax question, if you 'disqualify' for medicaid, then the combination of tax credits and "cost sharing' makes it so you should try to make sure you get the 'cost sharing' which doesn't have to be paid back , when it gets reconciled on your taxes. 

 

and if you have any accountant friends, they seem to be about the only ones, whom might help you.......