What Do Expats Do About Medicare

August 28, 2013

What do expats do about Medicare?
By Lake Chapala wannabe, Barry Cheshier
Okay, my wife and I are thinking about moving to Lake Chapala, Mexico.
This question has come across our radar: If we move, what should we do about our Medicare coverage?
As a rule, Medicare does not provide coverage outside the United States, meaning outside the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands or American Samoa.
Since we’re not moving to any of those places, do we keep paying for Medicare or drop it?
While we’re not experts on Medicare, a quick search of the Internet turns up some answers.
If you’re moving to Mexico and haven’t yet signed up for Medicare’s medical insurance program, it may not be to your advantage to enroll and have the premiums deducted from your Social Security check, because you would have to travel to one of the above locations to use the insurance. But you should be aware that, if and when you do eventually enroll in Medicare, your premiums will be 10 percent higher for each 12-month period you could have been enrolled but were not.
For others—like us—who are already enrolled with Medicare and wish to move outside the United States and the other locations above, you can cancel your enrollment.
Who wants to pay premiums on insurance you can’t use? Just know that your premiums and coverage will continue for one more month after the month you notify Social Security you want to cancel. And, should you ever wish to rejoin the program, your premiums will be higher by 10 percent for each 12-month period you could have been enrolled but were not.
It all seems a little scary until you look at the details specific to your situation—which everyone should do. In our case, my wife and I each pay $104.90 per month (deducted from our Social Security checks) for medical insurance through Medicare, $336 each per year for supplemental coverage (for some things Medicare doesn’t cover), and $222 each per year for drug coverage (which we have never used).
We would probably drop all of those and immediately increase our annual spendable income by $3,633.60. And, after we investigate some of the Mexican insurance programs (which sound good), the savings could really provide a lot of trips home to see the grandkids!
Again, we are just regular folks and not insurance professionals. Examine your own situation and make decisions based on what you think is best for you.
Go to this web site for Social Security Publication #05-10137: http://www.socialsecurity.gov/multilanguage/10143-FR.pdf . It also lists other contact information for Social Security.
And remember, an unknown wit got it right: The world belongs to those who don’t let anxiety about screwing up keep them from moving forward!
  • MedEvac Guy

    The problem with giving up Medicare is that every government subsidized plan in Mexico is financially unsustainable. Every other viable private insurance has huge premiums or huge deductibles and long term pre-existing exclusions. The premiums take a big jump at various ages (like 75) and the plans end at 85. Then what? Medicare is for life. Smart choice is to self insure for day to day in Mexico and use Medicare for major problems. That can be facilitated by a MedEvac Expat membership like SkyMed that will take you to a specific location in an emergency. Very cost effective and available for life. BTW I am the SkyMed rep here in Lakeside but that doesn’t mean my comments are without validity. Check it out.

  • John Rutledge

    We both joined the IMSS becuase it is so very reasonable, and pay for private insurance for potential big ticket items. Dropping all US insurances and not paying for Medicare saves a lot of money. I question the ‘financially unsustainable’ opinion. Many on the right say the same about social security and Medicare in the US. We find the medical care here in Mexico to be as good or better than any care in the US and it is so much more affordable that most care can even be paid out of pocket. It is unthinkable to us to pay for a service to take us back to the US for care. In fact, if we were visiting the US it would be cheaper to pay for an emergency flight back to our home in Mexico for care here than submit to who knows what costs in the US. The care here is far more compassionate and not profit-driven. It is a major reason to live here. The savings in medical care and insurance alone more than pays for our home and living expenses. The choice was to live very frugally as we age in the US, worried about a medical event ruining us, or live with a much higher quality of life, and healthier, in Mexico.

  • Sid Grosvenor

    Some go back to the USA or Canada fro care. Hope I never need to go anywhere. I’ve got a great doctor in Chapala and I’ve been in IMSS for

    over 15 years, but thankfully have never had to use it. Good comments,

    Thanks to both of you for taking time to share, Tu amigo, Sid

  • Sid Grosvenor

    Hi MedEvac Guy, Thanks for your thoughts. The medical care options is one that deserves research by each of us to do our best to determine just what’s best for each of us. Hopefully this forum will be of some help as each of us

    shares our thoughts and research. Tu amigo, Sid

  • MaryAnn

    I live in Mexico and I’ve continued my Medicare coverage. I visit my family in the US twice a year and each time I see my wonderful doctor, have blood work and other tests done, prescriptions renewed and this month I’m getting my annual flu shot. In addition to Medicare I have Tricare for Life so I have no co-payments for doctor’s visits or routine blood work and the co-pay on prescriptions is much less than paying full price in Mexico.

  • Sid Grosvenor

    Hi MaryAnn, Thanks for sharing . I hope it helps others. Tu amigo, Sid

  • KeysParkPro

    Join a PPO in USA Pay 0 or $5 a month for Medicare. Go back every 6 months for check up. With Freedom in FL you $50 in over the counter drugs free each month.

  • Sid Grosvenor

    Hi Keys, Good advice for some folks. My blood pressure is over the counter
    in Mexico (prescription in the USA) and this is all I need. Vitamins are the same or a bit more in Mexico so I stock up on vitamins when visiting the USA.

    Been in IMSS for 15 years. My wife had 4 eye surgeries (1 in each eye) and my out of pocket was just $60 for the out patient laser surgeries. Each person needs to evaluate all the options or combinations of options for themselves. Your plan sounds good for some folks. Tu amigo, Sid

  • Barry

    Sid, do you count so pretty good? Four eye surgeries (one in each eye)? Just wondering what I missed here.

  • Sid Grosvenor

    Hi Barry, Thanks for keeping me honest. Actually I count better than I type. Yes, it was really two in each eye. Thanks again. Tu amigo, Sid

  • Pat Wilson

    That is what I plan to do – join a PPO, then go back to the U.S. for visits to my doctor. I do love my dentist in Ajijic though, but I see dentists on both sides of the border. Be careful about having too much faith in doctors though. My husband was very fatigued while we were in Ajijic . He was told by a much admired local doctor that he was anemic & to just take iron pills and he would be OK. When we returned to FL it was found he had lymphoma, and was hospitalized within a day. Quite a different diagnosis from anemia. He is now undergoing treatment and we do plan to return to our house in Ajijic in the future on a part-time basis.

  • Chris

    This is a very interesting and important discussion. I’m 65 with no pre-existing conditions; I pay for Medicare but get my supplementals for free. My SO is 76, has some serious health problems, and pays for all insurance. We would love to move to MX but this one issue has us stymied! Even simple traveling is a problem for him. Is there a solution for us??

  • Sid Grosvenor

    Hi Chris, This is a complex issue and involves a number of variables. Perhaps other will have some ideas for you. If you’d like to discuss your
    situation in more depth I suggest that you send me an e mail with your telephone number, time zone, and a good time to call you in your time zone
    and I’ll give you a call and perhaps we can find a solution that will work
    for you.

    Tu amigo, Sid (Sid @ChapalaClub.com)

  • gerona48

    Everyone seems to be quoting relatively low monthly Medicare costs; however, I recently had a quote of well over $300 a month for Medicare and drug coverage. Where is everyone getting these lower amounts?

  • John in Colorado

    What is IMSS?? Sorry I live in Colorado. And Sid –where do you pay $333/yr for supplemental?? That is a great deal-Thanks-John

  • http://www.chapalaclub.com Sid Grosvenor

    Hi John, Thanks for your questions. There are several insurance firms here. Best to check each other when you visit. Everyone’s situation is different. IMSS is the Mexican government health care system and is slowly going broke and extremely difficult to qualify for now if you’re a senior.

    There’s a new government clinic in the area and you qualify to use it if you’re here on other than a tourist visa. Some small charges for tests etc. Need to speak Spanish or take a bi lingual friend. It likely will improve over the years.

    Most gringos have private doctors at very affordable rates and pay out of their pocket.

    Blue Cross works well here in Mexico if you already have this coverage. Can’t sign up for it here.
    The local Red Cross is also available and is very good and low cost. Highly supported by the retirement community.

    Hope this helps. Tu amigo, Sid

  • http://www.chapalaclub.com Sid Grosvenor

    Hi Kathy, Medicare from the USA doesn’t work in Mexico in general.

    We do have low cost excellent health care here however. Tu amigo, Sid

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