(US) Medicare for Dummies

smo · January 12, 2017

I got on Obamacare (Medical revisited) based on my lack of income while on my home visit in Southern California. Been putting my newfound medical benefits to all sorts of use (from teeth to colon). Today I went to my CVS pharmacy to drop off my prescription erythromycin 500mg,anti-biotic given by my dentist to keep infection/inflammation at bay after she made 3 fillings on my front teeth.

The pharmacist told me that Medical won't pay for this, and this is a pricey drug. I said to him, lemme ask my dentist to give me something generic. He said that this is already generic as it can be, but still in the high price bracket. In fact too high he doubted I would want to get it. Since I'm flying back to Thailand this weekend, his comment got me deadly curious. Okay, tell me how much does it cost? Answer: 456 dollars for 30 tablets (3 tablets a day for 10 days). I burst out laughing at this insanity. I can't wait to get back to Thailand and check out the prices of similar drug at my BKK corner drugstore. In the meantime I called my friend Diane in Hawaii, who used to be a SSI recipient (MediCaid beneficiary) to express my disbelief. Before you know it she and I got into a serious argument about Medicare (I'm still blue in the face and she is too, I'm sure ).

While she was using MediCaid she got similar prescription drug sticker shock. That aside, SSA told her that when she gets to the age of 65, she won't be able to apply for Medicare because she has not worked much her whole life. I disagreed and said that your work history has nothing to do with your Medicare eligibility. But before she ever gets to 65 (she's still not there yet), she inherited family money and as a result lost all her SSI/Mecicaid benefits and it's strictly out of pocket from now on. And then she disclosed that her brother who also inherited a big chunk is now a millionaire and still get Medicare, and according to Diane that is because his long work history. In fact his friends ("all millionaires") also get Medicare (she emphatically stressed "free as opposed to buying it") because of their work history as well.

Since I'm not 65 yet this is an area that I have not done much research. But I've been living in Little Saigon (ie Camp Pendleton revisited - for those who remember the VN war era) and most of the VNmese seniors are thriving (for lack of a better word) health-wise thanks to Medicare. But the buzz words around here are: "If you live in a big house you better move to a smaller one... Or if you have more than one house you better deed it onto your kids before Medicare sniffs you out..." In other words you can be too rich to receive Medicare.

So Diane's argument: If you are 65 up and rich and have work history - yes you can get Medicare. " But I (Diane) won't get Medicare ever because I don't have a work history, doesn't matter whether I'm rich or not." She said has researched this high and low.

My argument: Diane's wrong. Her brother and other millionaires must have a work-around something to get free Medicare and I doubt if they have honestly declared their assets (this got Diane foaming at the mouth). Also the point is moot now because she's no longer poor (enough) to get (free) Medicare.

So any TV members with their expertise on this subject please speak up and help us settle our argument (we're still friends and nobody slammed down their phone at the end of our decidedly genteel conversation ). Thank you much in advance.

Suradit69 · January 12, 2017

Quote
- You qualify for full Medicare benefits at age 65 or older if:
- You are a U.S. citizen or a permanent legal resident who has lived in the United States for at least five years; and
- You or your spouse has worked long enough to be eligible for Social Security or railroad retirement benefits — usually having earned 40 credits from about 10 years of work — even if you are not yet receiving these benefits; or
- You or your spouse is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working.

And more info here: http://www.aarp.org/health/medicare-insurance/info-04-2011/medicare-eligibility.html

Quote

If you do not qualify on your own or your spouse's work record

Provided that you're a U.S. citizen or have been a legal resident for at least five years, you can still get full Medicare benefits at age 65 or older by:

Paying premiums for Part A (hospital insurance). If you have fewer than 30 work credits, you pay the maximum premium, $411 in 2016. If you have 30 to 39 credits, you pay less, $234 a month in 2014. If you continue working until you gain 40 credits, you will no longer pay these premiums.

Paying the same monthly premiums for Part B, which covers doctor visits and other outpatient services, as other enrollees pay.

Paying the same monthly premium for Part D prescription drug coverage as others enrolled in the drug plan you choose.

Emster23 · January 12, 2017

If you are coming to live here in Thailand, it won't matter. Medicare won't cover expats. I paid into it all my working life, and they ding retired me for $109 a month (in case I get something really nasty & go to states for treatment). How do they get away with that? Simple. Expats have zero political clout.

If you are not coming here to live, I wonder why you made this post on TV. Seems there would be more appropriate sites in the USA to raise your issues.

curtklay · January 12, 2017

Diane is correct.

So are Suradit and Emster.

elgenon · January 12, 2017

3 hours ago, Emster23 said:

If you are coming to live here in Thailand, it won't matter. Medicare won't cover expats. I paid into it all my working life, and they ding retired me for $109 a month (in case I get something really nasty & go to states for treatment). How do they get away with that? Simple. Expats have zero political clout.

If you are not coming here to live, I wonder why you made this post on TV. Seems there would be more appropriate sites in the USA to raise your issues.

You are kind of wrong. Depends on the Medicare you chose. I have Medicare Advantage and it covers hospital visits including the drugs prescribed. As an outpatient there is a $75 deductible as an inpatient no deductible.

thailand49 · January 12, 2017

Diane, in the heat of your discussion is right and wrong. First you can't mix ObamaCare with Medicare! And you can't mix Medicare with Medi-Cal.

Yes, it is true and I think one of the above poster posted the information. You got to have so many credits as they call it and that translate into years one has worked. If one goes to Social Security office or website and you create a account I believe you can get your status?

I might be wrong on this part? Although you might not qualify for all of Medicare Part A, with enough credit for free? One just has to pay a certain amount since one doesn't have full credit. The individual who posted he pays 109 a month for his Social Security draw is basically buying Part B...

With Part A/B you are basically covered 80% for Doctor visits and hospitalization. Now you got to buy C/D to cover the other 20% and for drugs.

In general, to qualify for Medi-Cal, you can't have more than $2,000 in the bank. And if you do, you basically get all the medical coverage, plus a lot more like housing subsides? If you get declare Disable, you generally get the maximum Social Security payment and all the benefits like Medicare/Medi-Cal. Medi-Cal has some type of equation to figure out how much benefits is paid. Not some people believe that your home is protected from Medi-Cal, if it is your primary. It is, but if you have more than 2,000 in the bank but not enough to pay for all the long term care and medical cost Medi-Cal will pay first but when you die they will come after the asset unless you have protected it legally. That is where a Will especially a Trust is needed.

I'm not going to get into all the 65 years of age stuff, that is your job to do the homework. But as noted above as a Expat, if you live in Thailand, Medicare doesn't coverage you outside of the country unless you are in American Somoa? There is one other place can't remember? If you got Part C/D, it does cover but you got to pay up front and they will refund you later when you put in the claim. The coverage will be based on 50% of the price index since you are most likely going out of network. But the coverage is better than nothing. As for your Anti-botics certainly it won't even come close here it might be 600 baht at best.

Good luck, but I suggest you do spend some time reading the material yourself! Log on don't be so lazy.

muffy · January 12, 2017

In the USA you pay more for drugs so the rest of the world can get them cheaper .Thanks

thailand49 · January 12, 2017

33 minutes ago, elgenon said:

You are kind of wrong. Depends on the Medicare you chose. I have Medicare Advantage and it covers hospital visits including the drugs prescribed. As an outpatient there is a $75 deductible as an inpatient no deductible.

He isn't wrong. Everyone gets Part A/ if they have the credits. Then you buy B or you can defer but if you do it is basically around $109.00 per month. Part A/B covers 80% of Doctor and Hospital. What you refer to as Medicare Advantage is purchased by you to cover Part C/D. Depending what company/package determines the Deductible. Part A/B is not covered outside of the United States but you can get partial coverage for your Medicare Advantage but you got to go to a Certified/Accredited Hospital to make the claim to get your money back.

Edited January 12, 2017 by thailand49

BruceMangosteen · January 12, 2017

"Today I went to my CVS pharmacy to drop off my prescription erythromycin 500mg,anti-biotic given by my dentist to keep infection/inflammation at bay after she made 3 fillings on my front teeth.

The pharmacist told me that Medical won't pay for this, and this is a pricey drug. "

That particular antibiotic has been around for decades and is very cheap, I thought even in the USA. I'm sure it's less than 10 Baht a capsule at just about any pharmacy in Bangkok or Pattaya.

Pib · January 12, 2017

In the U.S. even the generic erythhomycin is pricey. The U.S. probably has the highest drug prices in the world thanks to drug company lobbyists who keep Congress from passing laws which would lower prices of drugs.

For example see below link regarding U.S. price

https://www.goodrx.com/erythromycin/medicare-coverage

See below link for Thailand price (quite a bit cheaper)

http://buy-thailandrx.com/buy-erythromycin-thailand.html

Edited January 12, 2017 by Pib

Acharn · January 12, 2017

4 hours ago, Emster23 said:

If you are coming to live here in Thailand, it won't matter. Medicare won't cover expats. I paid into it all my working life, and they ding retired me for $109 a month (in case I get something really nasty & go to states for treatment). How do they get away with that? Simple. Expats have zero political clout.

If you are not coming here to live, I wonder why you made this post on TV. Seems there would be more appropriate sites in the USA to raise your issues.

How they get away with that is it's something the Republicans put in. I have to pay it, too, and have to pay cash up front. I get what's called Tricare Overseas, which reimburses me ¾ of what I paid, after the first $150 for outpatient treatment. Currently the claim processing is taking more than two months. Luckily the hospital I use is able to print invoices that are partly in English, so I've got the translation down pretty pat, but it's still a pain. It's unfortunate that the Thai government coverage only covers Thai citizens. I'm hoping for a nice massive heart attack or aneurysm instead of a lingering thing like cancer or something.

curtklay · January 12, 2017

"I'm hoping for a nice massive heart attack or aneurysm instead of a lingering thing like cancer or something."

Aren't we all?

Jingthing · January 12, 2017

One thing I learned recently is that long term expats even if eligible for old age social security from work credits may become ineligible for social security disability benefits by being out of the system too long. In other words, if you're too young to claim old age social security, and you become disabled and need the income, lack of more RECENT work credits will eventually cut out that option. Not a theory ... it's real.

Pib · January 12, 2017

1 hour ago, Acharn said:

How they get away with that is it's something the Republicans put in. I have to pay it, too, and have to pay cash up front. I get what's called Tricare Overseas, which reimburses me ¾ of what I paid, after the first $150 for outpatient treatment. Currently the claim processing is taking more than two months. Luckily the hospital I use is able to print invoices that are partly in English, so I've got the translation down pretty pat, but it's still a pain. It's unfortunate that the Thai government coverage only covers Thai citizens. I'm hoping for a nice massive heart attack or aneurysm instead of a lingering thing like cancer or something.

You must be mailing in your Tricare claim. I to use Tricare Overseas...submit the claim online and usually get reimbursed via Direct Deposit in 3 to 4 weeks...use to be around 2 weeks.

DogNo1 · January 12, 2017

To qualify for Medicare Part A, you must have worked for 40 quarters. You don't have to make much, so a part-time job would probably do. If your friend has some working years left, maybe she can accumulate enough quarters to be at least partly covered. She could ask for a statement from SSA to see how many quarters she presently has. Medicare has no earnings test, so if you have 40 quarters of employment during which you pay SSA tax, you can draw at least the minimum benefit no matter where you live. You must also purchase Part B (if you want it) when you start drawing Part A. Part B cannot be used outside of the USA but Guam is in the USA.

If you live in Little Saigon, you can probably get some Vietnamese doctors and dentists to give you lower prices for treatment. You can stop by the Lien Hoa Temple on Bixby Ave and ask the abbot, Rev. Chon Thanh, to introduce you to some medical people. Here's a link to where it is.

https://www.mapquest.com/us/california/business-garden-grove/chua-lien-hoa-temple-303618742

ericthai · January 12, 2017

6 hours ago, thailand49 said:

He isn't wrong. Everyone gets Part A/ if they have the credits. Then you buy B or you can defer but if you do it is basically around $109.00 per month. Part A/B covers 80% of Doctor and Hospital. What you refer to as Medicare Advantage is purchased by you to cover Part C/D. Depending what company/package determines the Deductible. Part A/B is not covered outside of the United States but you can get partial coverage for your Medicare Advantage but you got to go to a Certified/Accredited Hospital to make the claim to get your money back.

The 109.00 is for part B coverage and anyone new to Medicare now pays $134.00 Anyone already on Medicare will pay the 109.00 since you have not received a Cola adjustment. (increase in SS for inflation) You need to work for about 10 years paying into medicare to get part A. Part B as stated you pay for. Medicare you pay into when working so this is an entitlement not a benefit. No such thing that rich people can only have one house as Medicare only reviews your income not your assets and it only affects your part B premium. If you make over $85,000 USD as an individual or $170,000 or more as a couple per year your part B will increased depending on your income. When you turn 65 and eligible to for Medicare and dont enroll then there is a penalty of 12% per year for each year you do not enroll, unless you have creditable coverage. Creditable coverage for Medicare benefits is any coverage that offers coverage equal to or better than what original medicare offers. Same for Part D if you are eligible and dont enroll then you will receive a 1% penalty for each month you did not enroll, unless again you have creditable coverage.

Medicare Advantage programs are not Medicare. They are plans that offered by private companies which are contracted with Medicare to provide plans. These plans cover more than what medicare provides. These plans are regulated by medicare. They must submit their plan benefits to Medicare each year for approval. Their are allot of advantages to the Medicare Advantage plans and Medicare Supplement plans. They provide protection that original Medicare does not. With original medicare there is no out of pocket limit for a patient. So if some drastic happens they could spend Thousands of dollars out of pocket. With a medicare advantage plan you have max out of pocket so no matter what happens you dont pay more than the out of pocket max. That can be anywhere from $5000 USD up to $10,000 USD depending on the plan and location.

The affordable Care Act or Obamacare is not he same as Medicare. Medicare is a government organizations that you paid into all your working years. ACA is private insurance offered through the government where the government is paying for part of the premium. Companies that offer ACA need to follow the government guidelines on the plans.

Medicaid is for low income. You can have people that are on Medicare and Medicaid at the same time. Medicaid will pick up the 20% that Medicare does not cover and depending on the level of coverage of Medicaid it can also pick up the part B premium for Medicare and provide coverage for drugs.

Medicare / ACA / Medicaid can be very difficult to understand.

ericthai · January 12, 2017

6 hours ago, thailand49 said:

He isn't wrong. Everyone gets Part A/ if they have the credits. Then you buy B or you can defer but if you do it is basically around $109.00 per month. Part A/B covers 80% of Doctor and Hospital. What you refer to as Medicare Advantage is purchased by you to cover Part C/D. Depending what company/package determines the Deductible. Part A/B is not covered outside of the United States but you can get partial coverage for your Medicare Advantage but you got to go to a Certified/Accredited Hospital to make the claim to get your money back.

Part A is Hospital, which covers Hospital, Skilled Nursing, Hospices, Labs etc. Part B covers Doctors, Specialists, Medical Equipment, etc. Part D is drug coverage. There is no real part C, however Medicare advantage plans are often referenced as Part C, some plans cover Part A,B and D and some plans only cover Parts A&B. Not all medicare advantage plans cover outside the USA and most have limits or $25,000 or $50,000. However Medicare advantage plans only cover you overseas for travel not living so you need to make sure they dont know you are living outside the USA.

akentryan · January 13, 2017

Have Medicare A and B (which costs $110 a month in 2017) and supplemental insurance which covers about 80% of medical and medicine here in Thailand. Pay up front and get reimbursed by supplemental in a couple of months. It is vital that you retain the option of returning to the USA for treatment. Recently had my Pacemaker reading tell me the battery life is down to 3 months. Cardio doctor at Bangkok Hospital Pattaya gave me an estimate of 400,000 baht to replace it and I am inclined to believe he was referring to just replacing the battery. My supplemental would have covered whatever the cost was after I pay my annual deductible of $5,500. I opted to go to the USA because I know the quality of care there is superior to care in Thailand. The cost of the new Pacemaker with new leads was $62,000 of which Medicare paid about $60,000 and my supplemental paid about $2,000. Cost to me was zero other than RT airfare. Just had a Pacemaker reading at BHP and the technician said I have the latest model which is not yet available in Thailand. Additionally Medicare will not pay for replacement until the battery reaches a critical point and sends a "urgent replacement needed" signal which is at one month approximately. I sent out e-mail queries to hospitals in Guam and American Samoa - one never responded and the other responded 3 months later. Keep your options open if you are an American.

thailand49 · January 13, 2017

6 hours ago, ericthai said:

The 109.00 is for part B coverage and anyone new to Medicare now pays $134.00 Anyone already on Medicare will pay the 109.00 since you have not received a Cola adjustment. (increase in SS for inflation) You need to work for about 10 years paying into medicare to get part A. Part B as stated you pay for. Medicare you pay into when working so this is an entitlement not a benefit. No such thing that rich people can only have one house as Medicare only reviews your income not your assets and it only affects your part B premium. If you make over $85,000 USD as an individual or $170,000 or more as a couple per year your part B will increased depending on your income. When you turn 65 and eligible to for Medicare and dont enroll then there is a penalty of 12% per year for each year you do not enroll, unless you have creditable coverage. Creditable coverage for Medicare benefits is any coverage that offers coverage equal to or better than what original medicare offers. Same for Part D if you are eligible and dont enroll then you will receive a 1% penalty for each month you did not enroll, unless again you have creditable coverage.

Medicare Advantage programs are not Medicare. They are plans that offered by private companies which are contracted with Medicare to provide plans. These plans cover more than what medicare provides. These plans are regulated by medicare. They must submit their plan benefits to Medicare each year for approval. Their are allot of advantages to the Medicare Advantage plans and Medicare Supplement plans. They provide protection that original Medicare does not. With original medicare there is no out of pocket limit for a patient. So if some drastic happens they could spend Thousands of dollars out of pocket. With a medicare advantage plan you have max out of pocket so no matter what happens you dont pay more than the out of pocket max. That can be anywhere from $5000 USD up to $10,000 USD depending on the plan and location.

The affordable Care Act or Obamacare is not he same as Medicare. Medicare is a government organizations that you paid into all your working years. ACA is private insurance offered through the government where the government is paying for part of the premium. Companies that offer ACA need to follow the government guidelines on the plans.

Medicaid is for low income. You can have people that are on Medicare and Medicaid at the same time. Medicaid will pick up the 20% that Medicare does not cover and depending on the level of coverage of Medicaid it can also pick up the part B premium for Medicare and provide coverage for drugs.

Medicare / ACA / Medicaid can be very difficult to understand.

Thanks for providing the information. But I wasn't the one to ask the question.

But I will confirm extremely hard to understand. In regards to your last statement and this is from first hand experience dealing currently with my mother situation. Yes, there is a provision depending on one's income and age can and will pick up the part B. Premium, but creates a catch 22. In my mother situation Medi-Cal pick up part B, giving her a extra 109, per month then on her annual review sent us a letter this year that she was now over $22.00 ( as noted they have some type of equation ) therefore she had to pay each month a additional $650.00 for the service she is getting now. I had to spend a lot of time to obtain a hearing from Medi-Cal but in the end I was able to point out the catch 22, and the decision was reversed.

In regards to this year Cola, my mother did get a increase, which was $5.00, I cross my fingers hoping this doesn't her to be review again for her benefits.

Langsuan Man · January 13, 2017

19 hours ago, smo said:

Today I went to my CVS pharmacy to drop off my prescription erythromycin 500mg,anti-biotic given by my dentist to keep infection/inflammation at bay after she made 3 fillings on my front teeth.

Dental visits are not covered by any Medical Insurance program, only by Dental Medical Insurance plans. The only time a dental visit could be covered would be in the case of an accident, then it is considered a Medical (reimbursable) necessity

This is one of the failings of the US medical system, despite the fact that dental health is critical in overall health, the dental community is treated as second class citizens in the US

Even Blue Cross, a cadillac insurance plan will not cover anything to do with my teeth

Pib · January 13, 2017

Let's see, with Medicare Part B now at $134/mo for new entries since 1 Jan 17 (folks who entered earlier are covered under the "hold harmless rule an may pay as low as $109), a Bt400K hospital bill basically repaid you for 7 years of Medicare Part B premiums. And expect that Bt400K bill would have actually been significantly higher....probably at least double that so maybe 14 years of premiums would be a better guesstimate. And if using the $60K figure that comes to 37 years of current Medicare premiums. And I expect your additional medical bills to be reimbursed over your remaining lifetime will rack up more years of recovered premiums.

Now days with the way medical costs are (HIGH!!! & still climbing fast) a low cost medical plan such has Medicare is indeed a lifesaver (both medical and financial). It only take one major medical event (bill) in a person's life to make medical coverage a must. Or you can just self-insure because everyone has plenty of money to save for a big medical bill (an unknown size big medical bill).

thailand49 · January 13, 2017

31 minutes ago, akentryan said:

Have Medicare A and B (which costs $110 a month in 2017) and supplemental insurance which covers about 80% of medical and medicine here in Thailand. Pay up front and get reimbursed by supplemental in a couple of months. It is vital that you retain the option of returning to the USA for treatment. Recently had my Pacemaker reading tell me the battery life is down to 3 months. Cardio doctor at Bangkok Hospital Pattaya gave me an estimate of 400,000 baht to replace it and I am inclined to believe he was referring to just replacing the battery. My supplemental would have covered whatever the cost was after I pay my annual deductible of $5,500. I opted to go to the USA because I know the quality of care there is superior to care in Thailand. The cost of the new Pacemaker with new leads was $62,000 of which Medicare paid about $60,000 and my supplemental paid about $2,000. Cost to me was zero other than RT airfare. Just had a Pacemaker reading at BHP and the technician said I have the latest model which is not yet available in Thailand. Additionally Medicare will not pay for replacement until the battery reaches a critical point and sends a "urgent replacement needed" signal which is at one month approximately. I sent out e-mail queries to hospitals in Guam and American Samoa - one never responded and the other responded 3 months later. Keep your options open if you are an American.

This is so true! Many of us expats rack our brains each day over coffee trying to figure out what to do in being covered in Thailand, at least I do in the case of not having insurance from my former employer. All these years I have purchase insurance here and end of last year l sign up for Medicare, I reduce the coverage in Thailand and hope it something happens here the coverage would fix me so I can hop on a airplane home.

When I first came here and use their hospital I was amazed and happy but through the years from experience aside from how great these private hospital look really how bad they can be. I wrote a number of months ago from my last experience with particularly BPH, with a good friend. Te Doctor at BPH, said he needed a pacemaker, but cost was going to be 2 million baht. While he was waiting for his insurance clearance in U.S. he was too weak to travel? paying over 15,000 baht a day to hospital while waiting. During the waiting we had a discussion with the adminitration regarding the fee, and they drop the amount to 800,000 baht, if insurance wouldn't cover the procedure.

Once the insurance said they wouldn't going to cover the procedure at BHP, and my friend decided even at 800,000 wasn't going to go home to get a second opinion. Now he was strong enough to leave.

When he got home the last thing he needed was a pacemaker, it was his kidney failing. BPH, does a lot great thing for simple things but it is all about money and if one does further research their Dr. aren't as train as they make them out to be?

As noted, keep your options open, don't burn your bridges. I feel more comfortable in a County emergency hospital than at BPH.

Edited January 13, 2017 by thailand49

mikiea · January 13, 2017

17 hours ago, muffy said:

In the USA you pay more for drugs so the rest of the world can get them cheaper .Thanks

true words

JLCrab · January 13, 2017

Regarding Part B enriollment penalties:

If you plan to move back to the United States one day or will travel back frequently, you should only consider delaying or dropping Part B if:

You (or your spouse) currently work outside the United States for a foreign or American company that provides you health insurance, or you (or your spouse) work in a country with a national health system. You qualify for a Special Enrollment Period to enroll in Part B without penalty, and at anytime while you or your spouse are still working and for up to eight months after you lose your health coverage or stop working.

You volunteer internationally for at least 12 months for a tax-exempt non-profit organization and have health insurance during that time. You have a six month Special Enrollment Period to enroll into Medicare without gaps or penalties that starts once your volunteer work stops, or your health insurance outside of the United States ends, whichever is earlier.

https://www.medicareinteractive.org/get-answers/medicare-and-other-types-of-insurance/medicare-and-living-abroad/medicare-coverage-if-you-live-abroad-but-plan-to-move-back-to-the-united-states-or-travel-back-frequently

smo · January 13, 2017

It's OP here. Sorry for misconstruing the circumstance when I said "been living in Little Saigon". I should have said "been staying in Little Saigon during my home visit" which lasted all 4 months of turbulent world events: King's death, Trump's win, deadly winter weather blanketing/flooding Europe and US SouthEast, etc. So glad to be coming home to tropical BKK the day after tomorrow. And yes, I'm a Yank (and a confirmed bachelor to boot .)

Thank you all for your inputs and it's a lot to digest. If nothing else, Diane's being both right and wrong by inference means that I'm both wrong and right. There, girl! (she insisted on having my defense argument "in writing"). However I'm still baffled by the fact that the VNmese seniors here get (free) Medicare even though they have no work history whatsoever (haven't been on US soil that long, most being brought over here - quite often against their will- by their offsprings who have long resettled in the States.)

Tomorrow I'm going to visit a couple of VNmese grandpa and grandma (I'm godfather to their grandchildren) to say goodbye. This old couple have the best medical care from Medicare, it seems their main daily activities are going to doctor appointments! They both have surgeries one time or another (grandma had brain surgery, grandpa colon) all done by top-drawer UCI (University of California of Irvine).

In the past I've heard them discussing Medicare part A/B but I never paid attention to it. I"m going to drill them tomorrow and will get back here and enlighten you all (no I dare not!)

"

[My next "broadcast" will be from my comfortable studio in Ramkhamhaeng (yeehaw!)]

ps - Also I wonder what I'll need to do in order "not to burn any bridges? I forgot to add that no, I have never entertained the idea that somehow Medicare would cover me when living overseas. In fact, I am going to sign up Cigna Global upon my return....

Edited January 13, 2017 by smo

smo · January 13, 2017

7 hours ago, Langsuan Man said:

Dental visits are not covered by any Medical Insurance program, only by Dental Medical Insurance plans. The only time a dental visit could be covered would be in the case of an accident, then it is considered a Medical (reimbursable) necessity

This is one of the failings of the US medical system, despite the fact that dental health is critical in overall health, the dental community is treated as second class citizens in the US

Even Blue Cross, a cadillac insurance plan will not cover anything to do with my teeth

But it does, (it in this case is Obamacare/Medical): so far I have had one check up (with xray), one cleaning and 3 fillings and haven't paid one penny. The one thing (maybe there are others) that is not covered is root canal when done on front teeth (according to my dentist who was quick to point out I'm going to need one - maybe two. Ouch)

Edited January 13, 2017 by smo

Jingthing · January 13, 2017

Are you saying you are on A.C.A. EXPANDED Medicaid which is part of Obamacare or rather traditional standard Medicaid? I assume it's EXPANDED Medicaid as you almost need to be homeless or a single impoverished mother to get on standard Medicaid.

EXPANDED Medicaid, already not available in so many states, is likely to be killed very soon in the "repeal" part of what's happening with the new political regime.

Mr0Yallow · January 13, 2017

23 hours ago, elgenon said:

You are kind of wrong. Depends on the Medicare you chose. I have Medicare Advantage and it covers hospital visits including the drugs prescribed. As an outpatient there is a $75 deductible as an inpatient no deductible.

As I understand it Medicare is Medicare period, I understand Medicare advantage is a Medicare supplemental plan, in other words you pay an additional premium, just like Kaiser or any other HMO, As I have been told, Medicare will not cover medical treatment outside the USA, I believe that includes their portion of any supplemental plans.

DogNo1 · January 13, 2017

I have Medicare Parts A & B. I bought Part B because, although I am a permanent resident of Japan, my Japanese National Health Insurance would lapse if I need to return to the USA for assisted care or 24-hour care. I inquired about buying a Medicare Advantage plan in the US but was told that I can't do it unless I transfer my residence to the USA. I would need to be living there physically. In the meantime, my Japanese Health Insurance pays for everything including dental care although it won't pay for implants or premium bridges. It pays for root canal procedures and porcelain crowns though. My Japanese health insurance also pays for my care while I'm here in Bangkok but I must present the proper receipts translated into Japanese. Also, it won't pay the actual cost of medical care here, only what the procedure would have cost in Japan. It's a good deal for old people like me because the co-payment is quite low.

I will be curious to hear how the elderly Vietnamese people that the OP knows are able to have Medicare. My hunch is that they are low-income individuals and actually have Medi-Cal. OP, please let us know what you find out.

ericthai · January 13, 2017

16 hours ago, thailand49 said:

Thanks for providing the information. But I wasn't the one to ask the question.

But I will confirm extremely hard to understand. In regards to your last statement and this is from first hand experience dealing currently with my mother situation. Yes, there is a provision depending on one's income and age can and will pick up the part B. Premium, but creates a catch 22. In my mother situation Medi-Cal pick up part B, giving her a extra 109, per month then on her annual review sent us a letter this year that she was now over $22.00 ( as noted they have some type of equation ) therefore she had to pay each month a additional $650.00 for the service she is getting now. I had to spend a lot of time to obtain a hearing from Medi-Cal but in the end I was able to point out the catch 22, and the decision was reversed.

In regards to this year Cola, my mother did get a increase, which was $5.00, I cross my fingers hoping this doesn't her to be review again for her benefits.

Sorry about that. Each state is different on their programs. In California if she is living along she needs to make under $1366 per month. I have had clients that are just over by $10-15 a month and the state cant do anything. At that time I typically start reaching out to drug manufactures for help in costs, grants etc. Yes, cola was given this year but not last few years, therefore anyone previously on Medicare is still at $109.40 and anyone new is $134.00 but again depends on earnings. I dont understand that she had to start paying $650 per month. Glad you helped her to work things out.

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