Everyone has their own healthcare strategy, particularly when they become an expat. As a seasoned Medicare agent and consultant, Ron Elledge recommends that Medicare be a part of that strategy.
Ron shares some reasons why, below…
By Ron Elledge
I believe everyone, including full-time expats, should enroll in Part A and Part B of Medicare as soon as they become eligible.
Medicare is an endless maze of rules and regulations, but at its core, it is designed to cover as many people over 65 as possible.
In order to qualify for Medicare, you must be 65 or older and a U.S. citizen or permanent legal resident for at least five consecutive years. There is no residence requirement for Part A or Part B for citizens. It is also available to those who are disabled and receiving Social Security Disability for 24 months, or who have end-stage renal disease (ESRD) or Lou Gehrig's disease (ALS).
You may also enroll if you have been married to a qualified beneficiary for at least one year before applying. You may also be eligible if you are divorced from a qualified beneficiary to whom you were married for a minimum of 10 years and you are single at the time of application.
Reason #1: You worked hard for it; you should use it.
If you are one of the above individuals, and you or a spouse have worked and paid Medicare taxes for 40+ quarters during your lifetime, you have become eligible for premium-free Part A of Medicare. As for Part B, you're also eligible to enroll in that for the same reason.
Part B is the portion of Medicare that provides financial help for visits to the doctor, outpatient services, and medically necessary treatments. Preventative care is often included, too. It's not free, though. The standard Part B premium for 2021 is $148.50 a month.
Reason #2: Medicare Parts A and B become your advocate.
When you are enrolled, Medicare negotiates with hospitals, clinics, doctors, and other service providers for all qualified medical expenses. When a bill is submitted to Medicare, they determine if it is a Medicare-approved service.
If it is deemed to be an approved service, Medicare will then determine the approved amount, which is seldom over 60% of the billed service and is often much lower.
Medicare then pays its 80% share of the approved, and the remainder is the responsibility of the beneficiary.
This negotiation power is far greater than an individual can achieve on their own. Those expats living outside the U.S. who are taking part in their in-country health coverage, and have not enrolled in Part B, will seldom have coverage when visiting the U.S. They should obtain travel insurance for their U.S. visits or they place themselves in danger of financial disaster.
Reason #3: You will avoid future penalties.
If you do not enroll in Medicare Part B during your Initial Enrollment Period, and you do not qualify for one of the Part B Special Election Periods, you will incur Part B Late Enrollment Penalties if you choose to enroll at a future time. The Part B Late Enrollment Penalty accumulates by 10% for every full 12-month period in which you have not had Part B coverage after your Initial Enrollment Period passes.
Reason #4: You will avoid delayed coverage.
If you miss your Initial Enrollment Period, you will be required to enroll during the General Enrollment Period, which runs from Jan. 1 through March 31, with coverage beginning July 1. The ramifications of this can be catastrophic for those returning to the U.S. from living overseas.
Reason #5: Medicare Advantage and Medicare Supplement Plans.
Medicare Supplement Plans offer a large range of benefits and services, but you'll need to be enrolled in Medicare Parts A and B to be eligible for them. For Medicare Supplement and Medicare Advantage Plans, the applicant must be enrolled in both Parts A and B at the time of application.
Because our futures are ever-changing, based upon fluctuating circumstances in life, I recommend to every individual who will not qualify for a Part B Special Election Period in the future to enroll in Parts A and B of Medicare. Do it when you first have the opportunity during your Initial Enrollment Period.
Medicare, Parts A and B: don't leave home without them.
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