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Medicare for expats?

Medicare for expats?

Old Nov 30th 2006, 2:37 am
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Default Medicare for expats?

My wife and I have been living in the US for two years and are pretty much retired. We were told that if we became citizens we would be covered by Medicare on reaching 65. I have been wading through material on the complexities of US health insurance to discover that one of us would have to have worked for ten years to qualify. Even if the younger of us started working now, there is no way we would qualify before the eldest reaches 65. I can only imagine continuing with private health care after 65 is going to be very expensive. Can anyone confirm this, and does anyone know if there is an alternative, apart from returning to live in Europe?
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Old Nov 30th 2006, 3:03 am
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Default Re: Medicare for expats?

Originally Posted by qwerty007
My wife and I have been living in the US for two years and are pretty much retired. We were told that if we became citizens we would be covered by Medicare on reaching 65. I have been wading through material on the complexities of US health insurance to discover that one of us would have to have worked for ten years to qualify. Even if the younger of us started working now, there is no way we would qualify before the eldest reaches 65. I can only imagine continuing with private health care after 65 is going to be very expensive. Can anyone confirm this, and does anyone know if there is an alternative, apart from returning to live in Europe?
You're discovering why there isn't a visa for retirees to the US.

Health insurance is expensive for many, even those in employment and even when the employer is subsidizing the premiums.

Perhaps if one or both of you can work (even part-time), it will help ease the burden of health insurance. If you're really fortunate, one or both jobs may offer some kind of health insurance.

I would check carefully about your eligibility for Medicare. It may not be as straightforward as you were lead to believe.


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Old Nov 30th 2006, 10:36 am
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Default Re: Medicare for expats?

My husband migrated at age 57 and started working in the US 8 months later. At age 65 he went on my advice to Social Security to ask about medicare and retirement. He is now a USC and has been since 2003. He is NOT eligible for social security retirement benefits or medicare as he has not worked 40 quarters. If he does retire now, he can draw against mine but still not be eligible for medicare. Was told to apply for a state healthcare program.

So yes, retirement in the US without having worked 40 quarters is a bitch and will kill you if you can't afford private medical insurance. At least with Jim, he can still get coverage under my healthcare until I retire. Still have 9 years left for that to occur. Plus he is going to continue working until he is 68-1/2 so he qualifies, god willing he stays healthy and remains employed/employable.


Originally Posted by qwerty007
My wife and I have been living in the US for two years and are pretty much retired. We were told that if we became citizens we would be covered by Medicare on reaching 65. I have been wading through material on the complexities of US health insurance to discover that one of us would have to have worked for ten years to qualify. Even if the younger of us started working now, there is no way we would qualify before the eldest reaches 65. I can only imagine continuing with private health care after 65 is going to be very expensive. Can anyone confirm this, and does anyone know if there is an alternative, apart from returning to live in Europe?

Last edited by Rete; Nov 30th 2006 at 10:54 am.
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Old Nov 30th 2006, 12:21 pm
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Default Re: Medicare for expats?

Originally Posted by Rete
My husband migrated at age 57 and started working in the US 8 months later. At age 65 he went on my advice to Social Security to ask about medicare and retirement. He is now a USC and has been since 2003. He is NOT eligible for social security retirement benefits or medicare as he has not worked 40 quarters. If he does retire now, he can draw against mine but still not be eligible for medicare. Was told to apply for a state healthcare program.

So yes, retirement in the US without having worked 40 quarters is a bitch and will kill you if you can't afford private medical insurance. At least with Jim, he can still get coverage under my healthcare until I retire. Still have 9 years left for that to occur. Plus he is going to continue working until he is 68-1/2 so he qualifies, god willing he stays healthy and remains employed/employable.

I am from England. I worked in England and Germany for 6 years, before coming to the US. I am not qualified to receive any state pension, because I did not have 11 years of employment in. So those years are wasted.

If your husband can draw half the amount of your Social Security, in all likelihood that will amount to about the same as the UK full state pension.

Why wouldn't he be drawing the UK state pension?

As an aside, re healthcare. I know someone that works part-time at Sears, apx 20 to 28 hours a week. After 1 year part-time she was offered full health insurance coverage, at a very very reasonable price. Just thought he might be interested in that.

Last edited by Mallory; Nov 30th 2006 at 12:30 pm. Reason: change
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Old Nov 30th 2006, 2:24 pm
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Exclamation Re: Medicare for expats?

Originally Posted by Mallory
I am from England. I worked in England and Germany for 6 years, before coming to the US. I am not qualified to receive any state pension, because I did not have 11 years of employment in. So those years are wasted.

If your husband can draw half the amount of your Social Security, in all likelihood that will amount to about the same as the UK full state pension.

Why wouldn't he be drawing the UK state pension?

As an aside, re healthcare. I know someone that works part-time at Sears, apx 20 to 28 hours a week. After 1 year part-time she was offered full health insurance coverage, at a very very reasonable price. Just thought he might be interested in that.
Er.... Rete is American and her husband is originally from Canada. Neither is British.

Don't assume that all BE members are British because this is not true.
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Old Nov 30th 2006, 3:17 pm
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Default Re: Medicare for expats?

Thanks for all those useful comments. I am going to my local social security office to see if there is a way round this dilemma. We can afford the health insurance now, and won't need a pension, but without Medicare, health insurance could get nasty (unless there are any major reforms around the corner). I understand that places like Vermont and New York have a state enforced flat rate, albeit higher than average rate. I wonder if that extends to over 65s?

On the face of it, it looks like the only way round it is for one of us to work part time, but my wife still won't qualify when she is 65. Also, I understand Medigap goes up 30% each year unless you register within three months before reaching 65, and my guess is you can't do that until you qualify for Medicare. It's a pity immigration doesn't warn new immigrants over 55 that health care is going to be a major issue. I suppose it's such a political hot potato, everyone's in denial.

For everyone's info I discovered this issue in Paul Pilzer's "The New Health Insurance Solution" in which he tries to offer cheap solutions for health cover. The thrust of the book is HSA's, and giving up employer schemes to buy your own plans, which he claims will be cheaper for you. There are some useful tips, such as never to use an HSA for health costs, until you retire, due to tax benefits you gain, and what to do if you or a family member are uninsurable. However, the book has it's critics, and some of the savings figures assume everything is equal.
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Old Nov 30th 2006, 5:24 pm
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Default Re: Medicare for expats?

So your not even allowed to pay for medicare ?
In Missouri, if you dont have 40 quarters its about $398 for part A and $98 for Part B,then it goes up again in January .

Maybe each state has different rules.
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Old Nov 30th 2006, 5:28 pm
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Default Re: Medicare for expats?

Also really hard to find any private health care after 65 as most people then get Medicare.
I asked my blue cross guy and he hadnt a clue as they only insure up to 65.
So its a big pain.
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Old Nov 30th 2006, 5:47 pm
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Default Re: Medicare for expats?

Originally Posted by unicorndreams
So your not even allowed to pay for medicare ?
In Missouri, if you dont have 40 quarters its about $398 for part A and $98 for Part B,then it goes up again in January .

Maybe each state has different rules.
You need to differentiate between Federal and State benefits.

A no goer for Federal benefits, but you may be lucky on State.

Or you just make sure when you go for emergency treatment you have no Credit Cards and no ID with you.
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Old Nov 30th 2006, 8:21 pm
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Default Re: Medicare for expats?

Beginning to panic now.
Someone told me that if you became a citizen all the years you worked in the US before taking citizenship would count towards medicare etc. Is that right?
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Old Nov 30th 2006, 8:51 pm
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Default Re: Medicare for expats?

Originally Posted by unicorndreams
So your not even allowed to pay for medicare ?
In Missouri, if you dont have 40 quarters its about $398 for part A and $98 for Part B,then it goes up again in January .

Maybe each state has different rules.
Yes you can pay, and I think the figures you quote are across states. However, the Medicare website is woefully inadequate in answering minutiae. It's probably safe to assume that this rate is for an individual, so do couples get discounted rates? Can you use funds from an HSA to pay premiums without losing the tax break. Does paying the Medicare premium affect the Medigap premium? Are there any circumstances were Medicare may refuse cover, or increase the rate etc etc. My estimates are that a couple aged 65 at today's rates, unless they are discounted could end up paying over $1100 a month, when you factor in Medigap, which I believe covers deductibles, co-pays etc. Of course then there is long term care

Last edited by qwerty007; Nov 30th 2006 at 9:05 pm.
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Old Nov 30th 2006, 8:52 pm
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Default Re: Medicare for expats?

Originally Posted by jumping doris
Beginning to panic now.
Someone told me that if you became a citizen all the years you worked in the US before taking citizenship would count towards medicare etc. Is that right?
depends....it doesn't matter when you become a citizen, it's the time worked.

there is a reciprocal agreement with the UK that NIC credit could be used to supplement SS contributions, or the other way round, but that would be for pension, not medicare.
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Old Dec 1st 2006, 12:54 am
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Default Re: Medicare for expats?

Because he is not from the UK? He draws a Canadian pension. The pension is not the issue, the medical care is. And as a spouse he does not draw 1/2 of my social security benefit but more like 1/4. Also if he starts to withdraw before I retire it reduces our amount from what it would have been if we had waited for me to retire.


Originally Posted by Mallory
I am from England. I worked in England and Germany for 6 years, before coming to the US. I am not qualified to receive any state pension, because I did not have 11 years of employment in. So those years are wasted.

If your husband can draw half the amount of your Social Security, in all likelihood that will amount to about the same as the UK full state pension.

Why wouldn't he be drawing the UK state pension?

As an aside, re healthcare. I know someone that works part-time at Sears, apx 20 to 28 hours a week. After 1 year part-time she was offered full health insurance coverage, at a very very reasonable price. Just thought he might be interested in that.
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Old Dec 1st 2006, 12:56 am
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Default Re: Medicare for expats?

Originally Posted by jumping doris
Beginning to panic now.
Someone told me that if you became a citizen all the years you worked in the US before taking citizenship would count towards medicare etc. Is that right?
Yes, that is correct.

Just as my hubby's 4 years of working before becoming a citizen counts.
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Old Dec 1st 2006, 5:55 pm
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Default Re: Medicare for expats?

Originally Posted by qwerty007
My wife and I have been living in the US for two years and are pretty much retired. We were told that if we became citizens we would be covered by Medicare on reaching 65. I have been wading through material on the complexities of US health insurance to discover that one of us would have to have worked for ten years to qualify. Even if the younger of us started working now, there is no way we would qualify before the eldest reaches 65. I can only imagine continuing with private health care after 65 is going to be very expensive. Can anyone confirm this, and does anyone know if there is an alternative, apart from returning to live in Europe?
This is my understanding as I have been recently researching this issue for my 65+ parents I am petitioning for I-130.
If you do not not have 40 quarters of work(for free Part A Medicare), it may be purchased by US citizens and by LPR (green card holders) with 5 Years residence. This is the "5 year bar".
Unfortunately even the Medicare 1-800 phone line line employee may not be correct, nor the employees at the local Social Security office, as they all "incorrectly" said LPRs may purchase Part A immediately (pay their own premiums). Write to Medicare and ask "When are LPR s allowed to purchase Part A Medicare?"
The 2006 cost of Part A is nearly $400 per person per month.
Part B, Part D, and Medigap supplements - if you choose them -everyone pays those premiums, if eligible (USC and LPR with 5 years residence), regardless of work quarters.
I am not sure why Medicare became included in the 1996 5 year bar signed by President Clinton, as it is not in the "means tested Federal Benefits" list.
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