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1 hour ago, Floradude said:

Just remember if you sign up for Medicare Part B that you cannot use it (Medicare)  outside of the USA.  

You would need to return to the US for treatment.

Yes that is what I read too. Thanks

I would rather not return to the US if I can help it except for a family or friends visit.

I am hoping they would come here though.

We haven't decided for sure where we will settle but will finish our residency here with Spencer's help.

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12 hours ago, SunFan said:

You're upper middle income and you're surprised? This was a tax cut for the "middle class"  was it not?

From an uninformed Canadian

SunFan

Since I know that Canadians are often  known for their humor, I’m going to assume that your comment was meant for just that. I’m nowhere near ‘upper enough’ for that tax cut to have given me anything! Orange giveth and Orange taketh away. 

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All of this makes me glad I am old & never had to buy health insurance. It was included with all of my military and civilian employments, and we never gave it any though when sailing about the oceans, etc.  In retirement, before age 65, BC/BS was part of the retirement package, until Medicare kicked in. There were uninsured periods, but we were younger and healthier....and lucky.  Now, we are really happy to have Medicare and the VA health system to look after us.  Even with that, our co-pay and the monthly SS deductions, do add up to quite a bit of our meager income; but, we manage. Without it, we could not.

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On 4/3/2019 at 1:36 PM, sm1mex said:

 I had a neighbor that had IMSS and he broke his shoulder badly which needed surgery and pinning and they let him lay In IMSS for nine days before he went to surgery because they said he was not an emergency. 

Yes That's standard procedure, to wait at IMSS to the next doctor has his rounds usually a week.

Had a friend  who broken his ankle very bad he had imss, from motorcycle injury, DR said yes i scheduled you for surgery 8 days from now or I can fix right now in a private hospital.

It was a bad injury, my friend took out his credit card and said lets go, ankle was fixed  10 hours later  he was able to walk on it in 8 weeks.

cost was about $10,000 with physical therapy, MY friend said best decision i ever made. 

 

 

 

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On 4/4/2019 at 9:36 AM, Floradude said:

Just remember if you sign up for Medicare Part B that you cannot use it (Medicare)  outside of the USA.  

You would need to return to the US for treatment.

Very true.  But if you ever decide to return to the US (just read this forum for all the good reasons this happens)  you will have to wait to get into Part B and pay a penalty plus all monthly fees you didn't pay.  Choose wisely for your individual situation...and remember life is what happens after we make all of our plans.

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It worked for you..... it did NOT work for me!  Everyone’s taxable income is so different it is virtually impossible to say carte blanc that the ‘cut’ actually worked.... or not. 

Let me refine that comment.... I am pretty sure it worked for those with wealth. For the other 99% it is probably a crap shoot. 

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Rick S: I have to disagree with you as I am not wealthy... Those still in the workforce also saw larger paychecks since the rates were cut... Less withholding means less back in returns...

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17 hours ago, pappysmarket said:

Very true.  But if you ever decide to return to the US (just read this forum for all the good reasons this happens)  you will have to wait to get into Part B and pay a penalty plus all monthly fees you didn't pay.  Choose wisely for your individual situation...and remember life is what happens after we make all of our plans.

What is your source for saying that you would have to "pay a penalty plus all monthly fees you didn't pay?

I understand that your rate would go up, based on the length of time you were not on Part B.  But that's it, according to my information.

 

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7 minutes ago, gringal said:

What is your source for saying that you would have to "pay a penalty plus all monthly fees you didn't pay?

I understand that your rate would go up, based on the length of time you were not on Part B.  But that's it, according to my information.

 

"You'll have to pay this penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it. " -Medicare.gov

The penalty is as long as someone wants to continue with Part B. Ouch!

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This is the calculator at Medicare site. https://www.medicare.gov/eligibilitypremiumcalc/

I entered this scenario:  Birthdate: 1/1/1954. Did not take Part B when eligible in 2019.  Wanted to start Part B 10 years later in 2029. 

If person did this and lived to age 85, in those 10 years, they would have repaid what  would have been paid had they joined in 2019. 

Beyond the 10th year, they would still be paying double what their rate would have been in 2019.  

 

Quote

 

This calculator provides an estimate of your Part B premium based on the information that you provide. Social Security (or the Railroad Retirement Board (RRB) if you get benefits from RRB) will notify you of your official premium amount each year

2019 Part B premium (most people pay this amount)
$135.50
Late enrollment penalty
$135.50
Total estimated premium Total estimated premium contextual help
$271.00

 

 

 

 

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.Considering that I cancelled Part B in 2004, I think I'll stay in Mexico till the "end".😂

But, while we're on the subject, I would like to know what the government's rationale is for selling an insurance product which can only be used in the U.S. but must be paid for monthly, and if not continued, will result if a outrageous penalty for re-upping it.  I can't think of anything else that works like that, can you?🙄

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Insurance is by its very nature a pooling arrangement and relies on a bunch of people paying in and relatively few taking out. It also relies on lots of people paying in for years before or if they ever use it. It is really most effective as a "hedge" against really catastrophic events that could wipe you out and is not very efficient for "financing" simple day to day medical expenses.

One analogy that is used in the insurance business is that you can't by home insurance once your house is on fire. So you can't wait until you get sick to buy health insurance. The "outrageous penalty" is just making up for the time that you weren't paying into the system but others were. You want to go back in so you have to make up some or all of what you would have paid if you had staid in.

The government rationale for selling an insurance product to U.S. citizens/residents, in the U.S., for use in the U.S. seems pretty logical to me but I guess I am missing something.

I guess I agree that insurance is different from lots of other things. We may not like it but it works exactly the way it is designed to.

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Sorry, but that explanation doesn't work for me.  The problem is that a person is paying for something THEY CAN'T USE.   If Part B could be used in Mexico, I would have no problem with it.  The government rationale "for U.S. citizens/RESIDENTS, in the U.S......etc."  We aren't residents if we are living outside the country. 

I calculated the amount the cancellation saved me and my husband so far and the number is approaching $40,000 U.S.  That takes care of a substantial number of out-of-pocket medical expenses.  If I had retained Part B, I would have had to pay for it, plus the out of pocket expense here.  A fair system, IMHO, would be to reimburse those carrying Part B for their Mexican medical bills.  For one thing, it would cost the govt. less than if the person returned to the U.S. with their far higher costs.

However, who ever said the U.S. Govt. was concerned with fairness?🙃

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Good savings for you when you're certain you'll stay in Mexico 😀.

However, some people may maintain a house NOB and they travel back and forth, some are not sure how long they've staying in Mexico because of aging parents, grandchildren or their own deteriorating health, and some with pre-existing conditions, etc. 

Those might be the reasons that they have to enroll in Part B.

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34 minutes ago, Lily H said:

Good savings for you when you're certain you'll stay in Mexico 😀.

However, some people may maintain a house NOB and they travel back and forth, some are not sure how long they've staying in Mexico because of aging parents, grandchildren or their own deteriorating health, and some with pre-existing conditions, etc. 

Those might be the reasons that they have to enroll in Part B.

Those are good reasons, and they are wise to maintain coverage.

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1 hour ago, gringal said:

Sorry, but that explanation doesn't work for me.  The problem is that a person is paying for something THEY CAN'T USE.   If Part B could be used in Mexico, I would have no problem with it.  The government rationale "for U.S. citizens/RESIDENTS, in the U.S......etc."  We aren't residents if we are living outside the country. 

I calculated the amount the cancellation saved me and my husband so far and the number is approaching $40,000 U.S.  That takes care of a substantial number of out-of-pocket medical expenses.  If I had retained Part B, I would have had to pay for it, plus the out of pocket expense here.  A fair system, IMHO, would be to reimburse those carrying Part B for their Mexican medical bills.  For one thing, it would cost the govt. less than if the person returned to the U.S. with their far higher costs.

However, who ever said the U.S. Govt. was concerned with fairness?🙃

If there weren't so many dishonest people in the world that would be the truly fair way to do it.  One of my jobs many moons ago was to question the validity of health insurance charges while working for a major insurance company.  Simple sleuthing usually like when we got a bill from a surgeon for say an appendectomy that was twice or three times as much as everyone else in the area.  Surgical complications are supposed to be coded differently in order to account for that but many times the billing party didn't code correctly.  That was usually easy to clarify by getting and reading of the op report itself.  They had sent me to school to be able to do that. But more and more often the answer became "that's what I charge".  No problem for me as our policies covered "reasonable and customary charges" so we covered the usual cost and told the policyholder they owed the balance to the doctor.  How to win friends and influence people!  My office was in San Diego so they frequently had me going down to TJ and thereabouts to sniff out more sinister claims which was sometimes a bit scary and sometimes resulted in discovering groups of doctors charging for entirely fictitious procedures.  Fast forward to last June.  Our health coverage was through my wife's company for retirees, a major oil company.  Excellent coverage with a max out of pocket $2000/ yr. per person with a $200 deductible.  Gold plan that had a $324/ month premium for both of us.  We suddenly got a notice that the premium would increase to $1183/ month in January with a further rise this April of an undetermined amount, but again expected to be substantial. I was finally able to talk with someone who knew the scoop and, off the record, she told me the number of fraudulent claims being received from retirees living overseas had mushroomed in the last couple of years and was going to result in everyone paying a lot more so they decided to hit the ones who were the biggest cause with the raise.  She explained, which I totally understood, that investigating suspicious claims that come from the US are easier and much cheaper to do.  I had to agree, been there done that.Once the bad guys figure out who has the money they figure out how to get it.  Remember they asked Eddie Sutton why he robbed banks and he replied because that's where the money is.  So we did what we had to do and are now relearning what it's like to deal with American doctors who want to run every test known to man, not for us but to cover their a** for their malpractice insurance.  Too bad there aren't more doctors here like mine in San Diego, Dr. Don Wilson.  He had a sign in his office, framed in the waiting room that read "I do not have malpractice insurance and everything I own is in my wife's name."  Great doc and very reasonable fees.

 

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Can someone use IMSS in the United States? Or Seguro Popular? Is Mexico unfair for not allowing that?

You don't have to pay for Medicare Part B. If you do pay for it you can use it - in the U.S. 

It would be essentially impossible for Medicare to audit medical bills from Mexico, manage fraud, errors, duplicate billing, do investigations, etc. All those things are very important and very difficult even in the U.S. And then Mexican medical providers would have to adhere to Medicare coding and other billing requirements. And Medicare fee schedules wouldn't be likely to make sense in Mexico - even if bills were lower.

With any insurance plan when you are "out of network" things change a lot. If you have Medicare and you are in Mexico you are definitely out of network.

I understand why people want this to work differently but there are practical reasons why it is impractical for Medicare to work "out of network" - like way out of network in another country. I agree with pappysmarket and I have direct hands on experience in this area too.

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NOTE:  cross-posted with REC

gringal said, " what's the government's rationale for selling an insurance product which can only be used in the U.S. but must be paid for monthly, and if not continued, will result if a outrageous penalty for re-upping it.  I can't think of anything else that works like that, can you? "

The biggest rational... and it is a very good one.... is what pappy touched on. Payments made by Medicare are based on "reasonable and customary charges" and I would add 'based on charges in the US.  Two things come to mind. If Medicare was opened up to cover one anywhere on the globe how on earth would one 'control' that. They can't even control graft and corruption within the borders much less have any chance of regulating it throughout the world. Think of the workforce that would be required.... and for only 0.0025% of the population that is expats. Not good economics.
The other 99.0075% would scream bloody murder and rightfully so. The second is how to integrate fees and capabilities from differing countries and cultures. What a nightmare.

Now I agree that a 10% annual, accumulating penalty might be a bit rich and have no idea how they came up with that figure but I suspect that it keeps some folks from considering dropping coverage.... and saves others who 'come back but thought they never would'.

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I do realize that there is no practical way to make Medicare work in Mexico.  My major problem with the way it works is the size of the penalty for dropping it, for people who have been out the country and couldn't use it, and then want to re-up.  Seems way out of proportion.  However, I also realize that scaring the spit out of people who aren't certain they will stay in Mexico for the rest of their lives is a very effective way to keep them paying.  Unfair, but effective.

 

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The only reason anyone would want to reup is so they can use it, no?  They have reason to believe they need a procedure or two done and so they want the folks who have been paying every month to subsidize them.  If it was truly insurance, the only way they could get back in would be to pass a physical, like you have to do for life insurance.  But it's not really insurance, it's a welfare entitlement that has been partially paid for by workers and employers with the effect of going broke while also pi**ing off many of the recipients. As long as the rules are clear not much to complain about.  Most of us are used to not being the rule makers.

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6 minutes ago, Kyle said:

The new hospital being built has a sign out front that says they take most US insurance .  Anyone know if that encludes Medicare or supplement insurance?

You're kidding, right?

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If pappy’s remark was not clear enough.... Medicare does NOT pay for any services rendered out of the US. ANY. And if Medicare is not going to pay, your ‘supplement’, that is tied to Medicare at the hip head and ankle, isn’t going to either. 

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