Medicare Support Group

Basic Medicare Facts for Americans Abroad
NOTE: Information below only touches on a few points of this very complex subject. The Medicare website (www.medicare.gov) is a rich source of information and personalized advice.
If you already live abroad, you should consult with the Federal Benefits Unit of the American embassy in the country where you reside for personalized advice. They have direct access to the Social Security files, and have experience with problems specific to people residing outside the US. Website links to American embassies worldwide can be found at www.usembassy.gov.
The single most basic fact is that you are not covered by Medicare while living abroad (with very rare exceptions). That said, you may still need to consider enrolling in one or more parts of Medicare.
Basic rules on qualifying for coverage
Workers (and spouses of workers) who have contributed at least 40 quarters (10 years) to Social Security are eligible for Medicare coverage at age 65 even if Social Security "full retirement age" is more than 65 years.
Individuals who are eligible for railroad retirement benefits, or who have worked long enough in a federal, state, or local government jobs can also qualify for coverage.
Certain other categories of individuals (such as those on Social Security disability) may qualify for one or more parts of Medicare earlier than 65 or under certain conditions.
For greater detail on qualifying for Medicare, see: http://ssa-custhelp.ssa.gov/app/ans...

Basic rules on non-coverage abroad
In most cases, Medicare won't pay for health care or supplies you get outside the US.
There are a few narrow exceptions to this rule:
• When a foreign hospital is nearer than the nearest US hospital to:
o The place in the US where you have a medical emergency, or
o Your home, for treatment of your medical condition (regardless of whether it is an emergency)
• You are traveling through Canada between Alaska and another state when a medical emergency occurs, and a Canadian hospital is closer than the nearest US hospital that can treat your illness/injury.
• Medically-necessary health care services on a cruise ship which is no more than 6 hours away from a US port.
For greater detail on these exceptions, see: http://www.medicare.gov/Publication...

Parts of Medicare
Part A is Hospital Insurance
Individuals who have paid into Social Security for 40 quarters (10 years) or more are eligible to receive Medicare Part A at age 65 (or earlier, under several exeptions). There is no cost for qualified individuals for this coverage.There will be automatic enrollment if you start drawing Social Security (or railroad retirement) benefits at 65. If you start receiving Social Security payments at a later age, you should sign up at 65 for Medicare Part A.
People who do not qualify for premium-free Part A can pay up to $451 a month to buy into it (and are generally required to buy Part B as well).
If you do not sign up for Part A when first eligible, you may have to pay a penalty equal to 10% of the Part A premium for twice the number of years you could have had Part A, but didn't sign up.

Part B is Medical Insurance (doctors fees, etc.)
If you are living abroad, you will not automatically receive Part B, for which there are monthly premiums. It does not cover expenses while abroad; however American medical insurances may require that you sign up for it. TRICARE, the medical care program for military (active and retirees) and their families, which does provide coverage abroad, also requires signing up for Part B.
BEWARE: There is a penalty attached to late sign-up for Medicare Part B: for each 12-month period you are eligible for Part B but do not sign up, your premiums for life are increased by 10%. So, for instance, you sign up 5 years after becoming eligible, your premium will be 50% higher than someone who had signed up when initially qualified.
People who anticipate returning to the US in their later years – as well as those who regularly spend time in the US -- may find it financially advantageous to pay premiums for Part B while still living abroad.
Part C is called Medicare Advantage Plans (private group health care plans approved by Medicare – available only within the US).
Anyone who has both Medicare Part A and Part B is eligible. If you move back to the US after living abroad, you can join for the first 2 full months after the month you move back.
People who don't enoll in a Medicare Advantage Plan often take so-called Medicare Supplement Insurance (Medigap) policies to cover differences between actual health care costs and Medicare coverage limits.
Part D is the Medicare Prescription Drug Plan (available only within the US)
Anyone who has both Medicare Part A and Part B is eligible. If you move back to the US after living abroad, you can join for the first 2 full months after the month you move back. There is a monthly base premium, with additional cost for higher-income people. If you join later than your initial sign-up period, you may have to pay a penalty for as long as you maintain the prescription drug coverage.

I know the post was made a year ago, but just in case the issue is still open.

Please let me know if you need any additional information.

Take care,

Darryl