MidAtlantic

Part B covers doctor services and the basic cost is $134 per month (higher for higher incomes).

https://www.medicare.gov/your-medica...t-b-costs.html

morpeth

Lets see if I understand- Medicare Part A is free if I worked enough years in USA, and covers hospital services , and I assume if for an operation Doctor at the hospital, if I don't at part B any doctor visit I would have to pay for -but for an operation I would have to make sure surgeon worked fro the hospital ? And if I didn't pay part D I would have to pay for prescriptions ( though I get free in UK anyway).

Trying to figure out if I wanted when the time comes to spend part of year in USA, how I would handle medical OR if I am in UK and have a seriously delay getting a serious operation could I just go to states and get done ( not that I have had even the slightest issue with NHS so far).

durham_lad

There are also deductibles and coinsurance payments to pay when you have treatment under Medicare Part A. Add on the cost of flights and accommodation and it becomes fairly expensive. If you are really concerned then you could always take out private health insurance in the UK which is pretty inexpensive if you opt for only getting private treatment if the NHS waiting period is over 4 weeks. You could also simply pay for private treatment when you need it. In London for example hernia surgeries seem to cost well under £3k depending on the type of hernia.

https://www.medicare.gov/your-medica...at-glance.html

Hernia Operation Cost - Package Prices - London Hernia

robin1234

Because the Advantage plan has an annual out-of-pocket max (albeit high.) Traditional Medicare (if no supplement plan is taken) has a risk of limitless copayments under certain circumstances. See the link in durham_lad's post, just above this post.

morpeth

Wow I had no idea under Medicare there was a deductible or copays like that. What is the benefit period, by quarter or year ?

I did look at private insurance in UK, it wasn't too expensive it seemed.

I am to "young" for Medicare just trying to look ahead a few years. One just reads about the stories of delays for NHS operations, but my own experience is that the NHS has been superb and efficient, and the one minor operation I had in USA in 2016 took three weeks to schedule, with NHS this year, four weeks, so not much difference- quality of doctor similar except in UK specialist took a lot more time discussing matter, and of course less time with annoying paperwork that one finds in USA. In fact when I saw specialist there was no paperwork that I can recall, except at the counter they asked for my name and address. Just anecdotal experience, but I think NHS great.

Nutmegger

Why don't you go to the government Medicare site and read all about it? They have a comparison tool you can use -- the permutations are endless and far too complicated for the folks here to describe. I'm sure that every one of us who has responded to your queries in this thread has a different type of coverage, which we have decided works for our personal situations. For instance, unlike robin1234, I have the government Medicare Part B (it's $402 per quarter on my last bill), an Anthem high-deductible "medigap" policy that runs $158 per quarter (no longer available, I'm grandfathered in), and a drug policy for about $14 per month.

robin1234

(Well, I do have Part B.)

The Medicare site is a good start. I feel the ultimate reference source is Medicare For Dummies. A new edition came out just a month ago. It's 432 pages long! Yes, Medicare and its endless permutations and choices really is that complicated. I read the book through twice at the time I became eligible for Medicare, although if I was living in the US full time I would have made a series of choices somewhat similar to Nutmegger's rather than the cheap and high deductible choice I currently have.

lansbury

Here is another permutation to the puzzle. My primary care doctor does not accept patients with basic Medicare only. It must be an Advantage plan and then from one of four companies.

Nutmegger

Sorting it out is a full time job -- the health insurance specialist with whom I've worked for decades said that I should stay away from Advantage plans because they are too limiting, giving one a much smaller network to deal with! But all this stuff is also state specific.

morpeth

I should, though I find the answers given have been very helpful at introducing me to the subject, and I thank everyone. Since many on this thread know both the UK and American system, it gives me I think a better perspective on key points.

robin1234

I'd seriously advise the book I mentioned a couple of posts back. It's available from Amazon in either UK or US. I think about £18. It really goes into all the options and explains the history of all the little quirks. It's published under the auspices of AARP.

theOAP

I apologise for bringing up this massive, old thread again. The subject is our old favourite, WEP.

I'm sure there are some bright sparks out there who are going to say "Yes, of course I knew that. Nothing new", but a thread has come up on another site which has aspects I don't think we've adequately discussed here, if at all.

It's often been said here that once one has 30 years of substantial contributions, WEP will not apply to a US Social Security pension. That may be true in many cases, but it seems it is not true for all cases.

The example we're working with:
Jane is 62 and lives and works in the US. Jane qualifies for a UK State pension through past work in the UK (11 years of Class1 NICs - and no additional voluntary contributions) which she intends to start taking once she gives up her US work. She has 26 years of substantial earnings to date under US SS. Jane intends to work until she is 68. The extra years past her full retirement date (age 66 years and 4 months) will increase her final US SS benefit, plus, Jane will have 32 years of substantial earnings at the time she first claims her US SS benefit.

Jane will still be WEPed. In fact, her WEP reduction amount will increase due to the extra years she has worked (and contributed to FICA). I thought, with 30+ years of substantial earnings, Jane would avoid WEP. I was wrong. I suspect I may not be alone. For example, here:
"Yes, the WEP exemption that applies for people with at least 30 years of substantial covered earnings can be reached at any age." https://maximizemysocialsecurity.com...ng-past-age-70 and here in the SSA WEP info: "The Windfall Elimination Provision doesn’t apply if: You have 30 or more years of substantial earnings under Social Security." https://www.ssa.gov/pubs/EN-05-10045.pdf

Here's the culprit:
https://www.ssa.gov/planners/retire/wep.html

Any comments aside from "I told you so".

Giantaxe

Not sure what aspect of the link you post is the "culprit". Is it that Jane didn't have 30 years of contributions by her full retirement age?

theOAP

No, it's because Jane didn't have 30 years of contributions at her ELY (age 62).

I've been searching this evening for confirmation. I found this post from 2013: "As I understand it, the WEP is based on the number of years of Social Security-covered service you have at age 62, whether or not you apply for a Social Security benefit." http://retirement.federaltimes.com/2...-provision-30/

On the SSA site for the past many years, there has been a PDF on WEP which went to great lengths to extoll the "Guarantee" (never more than 50% of your foreign pensions or 50% of the Max WEP income limit). I can no longer find that reference, other than the "The law protects you if you get a low pension. We won’t reduce your Social Security benefit by more than half of your pension for earnings after 1956 on which you didn’t pay Social Security taxes" on the latest WEP page.

https://www.ssa.gov/pubs/EN-05-10045.pdf

I don't remember seeing this page before ("the culprit page") and wonder if SSA have decided to re-interpret when WEP applies.

Giantaxe

Ouch. If true, that's going to trip a lot of people up and drag them into the WEP net. Fortunately I am past 30 years before that age.