Nicholasstj

Interested to talk to someone who has moved to Washington DC from UK as my parents (aged 85 and 78) are planning to do. I am their son and a US citizen, so I can petition for them. They are a military family and used to travel/relocate so am not so concerned from that perspective. I understand the biggest initial issue is medical. Is Medicare a good system/cover; are there any issues with claiming pension? Advice from someone with similar experience would be very welcome.

nun

There are no issues with having UK state, government and private pensions paid in the US. How they are taxed needs a little thought, but in your parents' case as US residents and UK citizens the UK state and Private pensions will only be taxable in the US and any UK Government (ie military) pension will only be taxable in the UK.

Your parents won't qualify for US SS. If they are legal immigrants they can buy an ACA health plan but that will be very expensive, but they might qualify for some state medical/medicaid benefits depending on their income level. I believe that they will qualify for Medicare 5 years after becoming US residents, but they'll have to pay the full part A and B premiums which is about $500/month right now.

Nicholasstj

Thank you. I understand they dont qualify for Social Security and the Medicare parts A and B will be roughly US$500 per month. Do you know anyone in the DC area who knows and understands the medicare world: is it sufficient, does it work, what are the limitations and how to overcome them? (Someone who has come from UK and experienced this transition). I looked at the Community connection but it does not seem to allow me to specify location and find a way to meet.

civilservant

Is medicare sufficient? Well I work in healthcare billing and I can tell you that about 80% of the people on MCR have a supplemental policy to cover items not covered by Medicare - and that they run at about $200 a month. Cigna or BCBS are some of the best.

robin1234

I'm pretty sure that (as nun mentions) they will not be eligible for Medicare until they've been US residents for five years. Until then, they'll need to get a ACA health plan.

Nicholasstj

Thanks for this. I will check these out. N

SanDiegogirl

I am from the UK and use Medicare.

Please be aware that the $500 a month per person you have been given is for Part A and B Medicare at today's costs.

In addition, Medicare only pays for 80% of bills and therefore most people take out either Medicare Advantage plans or Supplementary plan. That would be approx another 100 + bucks a month. Then there is the cost of Prescription plans.

Medicare is a very good system. What Senior Citizens did before it came in I don't know. However having to pay for Part A in addition to the other charges makes it expensive.

..... and of course it does not pay for long term nursing home costs.

Your parents will not qualify for Medicare until they are 5 year residents.

scrubbedexpat099

Are they independently wealthy?

What are your long term care plans?

Bear in mind that may providers who will take Medicare will not take OCare due to lower reimbursement rates. I doubt if those who deal with OAP's are used to having OCare clients.

nun

Parts A and B do not give sufficient coverage and you should get extra insurance to pay for the things they don't cover and a drug plan. I can see the total cost being $700 a month each and you'll still have out of pocket costs. Medicare is a good system and pays for the healthcare of those over 65 in the US.

A critical thing is where your parents will live, particularly for the 5 years before they qualify for Medicare as that will govern their health insurance. So are you looking at DC proper or Virginia or Maryland?

civilservant

You are correct that MCR doesn't pay for long term care in an SNF (which incidentally is where I work in a billing office) - however subject to income they may qualify for Medicaid which will. If they will not qualify (think income over $2k a month, or $2k in assets, but different rules apply if one remains in the community) then they will be looking at private pay, which in my facility is around $6k a month.

Not sure why you mention this, or why you think it would make a difference, but billing is billing - regardless of weather it is billing an insurance company or the state. The slight difference is that insurance will mostly require pre-auth where MCR doesn't (most of the time) - in any event the person conducting the insurance intake should be aware of the differance.

robin1234

I, and several other people I know, made the choice to get a Medicare Advantage plan with a premium of $0. Essentially, the way this works is that it rearranges the way the reimbursements and deductibles work with Part A and Part B, meaning it is more like a conventional high deductible plan. My maximum out of pocket for the year is about $6,500. It (like all Medicare Advantage plans) also includes a drug plan, so no Part D is needed. So the only premium is Part A premium (if any,) plus Part B premium.

Like all Medicare Advantage plans, it's administered by one of the commercial insurance companies rather than Medicare itself. Mine is United Healthcare.

(I went this low premium, high deductible route because I plan to spend most of my time in the UK, so may not be using health care in the U.S. unless unplanned issues arise.)

BEVS

As you know I cannot help so no use to your thread and topic at all.
Just wanted to say hi and I am pleased to see you have found your way to this helpful lot.

All the best with moving your parents to the USA.

Nicholasstj

Thank you all for your great contributions. My parents are probably wealthy enough to be called independent (but only for a few weeks! - most of it will go into buying a house). We hope they will buy close to us (near the centre of DC) but will be open to MD (where we used to live) and Virginia. I am confused about the qualifications to join Medicare. The advice given by some staffer at Medicare was that they can qualify but they will have to pay. Are you saying that they cant join even if they pay? (We have a friend whose mother nominally worked at a supermarket for 5 years in order to enjoy Medicare, but that would not be practical/the right thing to do.) I will check again with Medicare who seem to employ people who have to look up the regulations....are not actually familiar with the regulations!!

robin1234

They need to pay, AND they need to have been residents for five years. Up till that point, they will need to get coverage under the Affordable Care Act (informally known as Obamacare.)

To qualify for Part A with no premium, one needs to have worked for ten years, not five..

civilservant

Just to make you aware - if one or both of them go into a nursing facility and receive Medicaid the Estate Recovery Act will come into effect and upon their passing the house will be taken and sold to repay any amount paid in Medicaid benefits.