Ex-Pat Retirees, Medicare, and Health Insurance

Category: International Retirement

June 11, 2014 — Our friend Rick recently wrote us with a great question on how ex-pat retirees deal with healthcare and healthcare insurance when living in another country. We thought we had addressed this question in the Blog before, but after careful searching it doesn’t look like we did that in any great depth.

Here is the question:
Recently one of our Bayview Park tennis players was traveling to Mexico, where he fell gravely ill and needed an emergency operation… Now it seems, since he first got sick on the plane flying there, Medicare will reimburse him for medical costs in Mexico… I will be traveling to Mexico soon myself, where I used to live, and may be spending more time there again. My question is about medical care and coverage abroad. I understand there are Medigap policies that may cover this, but I was wondering if you have any info as to how retired Americans living abroad deal with Medicare, health insurance and health issues. Thanks.

And this is how we responded:
Our friend from KW was lucky about getting Medicare coverage for his illness, because otherwise Medicare doesn’t provides coverage outside of U.S. You always have the option to go back across the border and be covered. Lots of people do that for everything but emergency needs.

The gist of the answer is:
– No Medicare coverage outside of U.S. 1800Medicare
– Some ex-pats plan to return to the U.S. (and Medicare) if they major health issues. Some people buy Medivac insurance to cover emergencies.
– Health care is generally pretty good in most countries popular with American ex-pats, such as Mexico, which has many English speaking providers. In most 2nd and 3rd world countries the health care will be best in the larger cities and popular expat destinations.
– Some people from the U.S. actually go abroad specifically for Medical Tourism – to get procedures not covered by insurance in the U.S., or because of the low cost of the operations.
– Prices are quite reasonable compared to US
– In some cases your U.S. health insurance (non-Medicare) might reimburse you for medical expenses incurred outside of the U.S.
– Health care insurance is available, and usually much more affordable than in U.S. If you search on Google you will find some sources.
– Sometimes foreigners are eligible to participate in foreign government programs akin to Mexico. For example, American retirees can become eligible to join Mexico’s popular and inexpensive IMSS healthcare program, provided they pay the annual fee.
– You might consider dropping Part B of your Medicare insurance if you are going to be living permanently abroad

Here are some links to articles we have published that touch somewhat on this subject.
Medical Tourism in Guatemala – Report on a Recent Emergency
Taking Baby Steps to Retire in Mexico
Mexican Retirement Gone Bad – Why This Gringo Can’t Wait to Get Back to the USA (the comments are at least as interesting as the article)

More about health insurance abroad
As one of our friends in the insurance business once told us, you can buy insurance for anything. It’s all about the price. This is true for health insurance abroad too, where many recognizable companies sell policies, generally for far less than they cost in the U.S.

Useful Links
This site, Health Care in Mexico, has a great deal of useful information about the types of health care available there as well as links to companies that sell healthcare insurance, including Medivac insurance.
Insurance, Health Care, and Medical Tourism in Mexico. This site describes what Mexican health care is like and has a description of the IMSS program.

Comments? How are you planning to get medical coverage if you are going to retire abroad.

Posted by Admin on June 10th, 2014

5 Comments »

  1. Are you sure about no Medicare / Medigap insurance outside the U.S.?
    Here what I found today on the Medicare.gov website at http://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html:

    Medigap & travel

    Your Medigap policy may offer additional coverage for health care services or supplies that you get outside the U.S.

    Standard Medigap Plans C, D, F, G, M, and N provide foreign travel emergency health care coverage when you travel outside the U.S.

    Plans E, H, I, and J are no longer for sale, but if you bought one before June 1, 2010 you may keep it. All of these plans also provide foreign travel emergency health care coverage when you travel outside the U.S.

    Medigap coverage outside the U.S.

    Medigap Plans C, D, E, F, G, H, I, J, M, and N pay 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year. These Medigap policies cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care.

    Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000.

    Seems like Medigap covers travel, but not living out of the U.S.

    by Thomas — June 11, 2014

  2. This comment came in from Fred:

    I am going against the flow and retiring from Australia to the US – to St Pete FL. I loose my generous Australian free health care, when can I avail myself of the services under the Affordable Care Act? I am 56 and have just been granted US Residency. My wife is a US citizen.

    by Admin — June 12, 2014

  3. Florida is not an Affordable care Act participant. You would have to qualify for Medicaid to get those services which is tough as your resources are limited to something like #4,000 in savings, 1 car, and a house. And income below the poverty level of about $11,000 per year. I don’t know if you can buy into Medicare, if so Medicare HMO’s & PPO’s are prevalent in most FL counties. I am wanting to know how good the HMO & PPO docs are? And generally how well specialists accept HMO or PPO insurance? Anyone know?

    by D. Allen — June 25, 2014

  4. Thank you very much for your updates. My wife and I have only $1800 SS benefits per month, and we are thinking about to relocate in a different country with lower living costs. I hope we will not have big problem with housing because we already have a decent town hose in NC. However, I heard that we will not be able to use our SS benefits (“pension” and Medicare) in any different country than US. Could you please advise me where I could find the list of countries where we could use US Social Security benefits?

    Editor’s Response: Your Social Security benefits are good anywhere in the world – doesn’t matter where you live you will get that benefit once you qualify and apply. However your Medicare benefit does not apply anywhere outside the U.S. You can always come back to the U.S. and get benefits as long as you are paying the premiums.

    by Igor — June 25, 2014

  5. For D. Allen: We are on a Medicare Regional PPO with Blue Cross/BlueShield in Lee County, FL (Fort Myers area) and could not be more pleased with the choice of doctors/hospitals and various other medical providers (lab, etc.). You do have to do your homework as there are other HMO’s and PPO’s in this area that are lousy and have very few doctors on their plans. BC/BS is prevalent in Florida and we have other retiree friends in other counties who all use BC/BS and are very satisfied.

    by Toni — June 26, 2014

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