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Question about declining Part B Medicare

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Well I guess my VA medical card has some value.

 

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In recent years more and more surgeries are performed as outpatients and hospitals are building more and more separate outpatient surgical facilities.  Also fewer ER visits result in official hospital admissions (even if they keep you overnight in the ER).  Both these situations require Part B for payment (not covered by Part A).  

Right now some knee replacements and even hip (!) replacements are being done as outpatients.  This is the future and it could impact what you pay if you do not have Part B.  

https://www.peerwell.co/blog/2017/12/11/outpatient-hip-replacement-surgery-day/

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Outpatient hip replacement surgery is on the rise across the country. But what exactly does outpatient hip replacement surgery entail? What's the difference between same-day hip replacement surgery versus a traditional, hospital replacement? Read on as we answer these questions (and more) so that you can determine if an outpatient hip replacement is right for you.

An outpatient hip replacement is also called a "same-day hip replacement". During a same-day hip replacement, the whole procedure (admittance, surgery, discharge) happens in less than 24 hours. An outpatient replacement usually takes place in a local surgery center (also called an ambulatory surgery center) or in a special hospital wing. Outpatient hip replacement surgery is not recommended for every patient, but is increasingly becoming the preference of more surgeons and patients.

 

 

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Yes, that VA Card does hav e value, and I sure do appreciate it.  I am reminded of it every time I have my eyes checked, or have another skin cancer removed, and even when half a dozen medicines arrive at my mail box.  I do have co-pay charges for the medicines, but nothing for the treatments.  Without this coverage, we would now be bankrupt.  Medicare covers my wife, and is an alternative that I have, but have seldom used.  We are both happy that we are covered by these socialized programs in the USA.

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21 hours ago, RickS said:

Part B is such a personal decision and there's no right or wrong. If it were me, and I had not already 'lived' in Mexico for a while so knew the ropes and more importantly had more than a guess as to whether I'd surely be living in Mexico 'forever', I'd pay Part B for at least a year then make the decision. I have at least 4 sets of couple who said they would have to take them out of Mexico in a box, but all moved back after a number of years here for either medical or family reason.

If our own Gringal was able to post at this moment she would tell us again that she and hubby opted out of Plan B years ago when they came and used that money as a 'pay out of pocket fund'. Seems to have work so far for them, but again one should make this decision after long deliberation IMO. 

Still true, and I just had more surgery recently.

I can't imagine the mentality of people who would use "Go Fund Me" to pay for their medical expenses, but that's just me, perhaps.

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22 hours ago, Mrs. Rupert said:

We opted out of Part B.  A mistake for my husband, and I have private insurance which costs much more than Part B, so a mistake for myself, as well............    I am currently in a conversation with a Senator from my state in the US about the penalties being charged to expats who want to start up their Part B again.  Why are we charged a penalty?  Is it because they have to re-enter our name onto the computer which will validate our membership in the Medicare program?  It is a mystery to me, so I am going to try to get an answer.

That's an easy question to answer... if one could just cancel Part B payments and wait a few years or a decade, then have a BIG medical problem and want to rejoin and run up big bills would bankrupt the Fund. EVERYONE would just wait until really sick to join.  Similarly one could just opt out of car insurance until one had a wreck and then call them and want to enroll. Why pay all those years? Just wait for the wreck. Unfortunately that's a business model that would be doomed before it got started. 

 

 

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56 minutes ago, Mrs. Rupert said:

Rick-there is no crystal ball.

My point exactly. That's why one pays into the system, buys insurance etc. 

Good luck with your talk to the Senator but that conversation is not going to go anywhere.

 

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Smart move if you are never going back to USA to Live and getting health insurance locally

use the 1200 plus dollar you save every year to buy local health insurance lake side

any future raises you get  from social security if you stay in is going to pay for your  medicare insurance increases.

last year the SS raise went to pay increased cost of medicare insurance,

so if you opt out you that increase in your social security in your pocket to help pay for local health insurance.

when look at the cost of going back to the US for health care, the travel time, if you healthy enough to travel, you may need to get stabilized first.

had a friend cost $40,000 Us dollars to get stabilized form heart attack locally, then transported to USA. medicare did not pay  for that.

it's an individual decision, i find the medical here, much better than USA, yes i have large deductible policy lakeside.

 Just had a yearly blood work up, urine and stool good basic tests .

plus doctor physical exam and consultation cost less than 100 dollars, no airfare, no travel,  results in 24 hours.

the doctor even cared about me and spent over a hour with me.

that never happened in USA

 

 

 

 

 

 

 

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5 hours ago, traderspoc said:

 

...................had a friend cost $40,000 Us dollars to get stabilized form heart attack locally, then transported to USA. medicare did not pay  for that................

 

Wow, that's more than three quarters of a million pesos!  He must have been mightily unstable or the hospital/docs saw a gringo coming.

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If they want to help shore up Medicare I suggest that anyone who declines Part B should never be allowed to get it later. $100/Mo. for the coverage it provides is dirt cheap, no private company could ever afford to offer it for that. The only people who would ever buy back in are certain even with the penalty they will get more than they pay, which just defeats the whole concept of "insurance". At a minimum they should pay the penalty and then have a 2 year waiting period before any benefits are payable.  traderspock was correct when he said "Smart move if you are never going back to USA to Live and getting health insurance locally" but with the "no second chances" added in.

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20 hours ago, RickS said:

That's an easy question to answer... if one could just cancel Part B payments and wait a few years or a decade, then have a BIG medical problem and want to rejoin and run up big bills would bankrupt the Fund. EVERYONE would just wait until really sick to join.  Similarly one could just opt out of car insurance until one had a wreck and then call them and want to enroll. Why pay all those years? Just wait for the wreck. Unfortunately that's a business model that would be doomed before it got started. 

 

 

On the other hand, consider the fact that not all people who move to Mexico ever return to the States for any reason, but save Medicare great amounts if money from the services they didn't get. Basically, they are paying for the "possibility" of their moving back and getting no services in return.  When you consider what you would have to do in order to have to have a "wreck" taken care of in the states, I suspect most or many would stay right here and pay out of pocket at the much lower cost of having their "wreck" taken care of here...home.  ...a certain unfairness is inherent in this system.

I just had a bad fall which resulted in needing stitches this morning.  The doctor came to my home, did the stitching and gave me the name of a medication to reduce the time  of swelling.  She charged me 900 pesos. That's less than 50 bucks currently.  Can't complain.  I am receiving much better care here in Mexico than I had in the States.

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1 hour ago, gringal said:

On the other hand, consider the fact that not all people who move to Mexico ever return to the States for any reason, but save Medicare great amounts if money from the services they didn't get. Basically, they are paying for the "possibility" of their moving back and getting no services in return.  When you consider what you would have to do in order to have to have a "wreck" taken care of in the states, I suspect most or many would stay right here and pay out of pocket at the much lower cost of having their "wreck" taken care of here...home.  ...a certain unfairness is inherent in this system.

I just had a bad fall which resulted in needing stitches this morning.  The doctor came to my home, did the stitching and gave me the name of a medication to reduce the time  of swelling.  She charged me 900 pesos. That's less than 50 bucks currently.  Can't complain.  I am receiving much better care here in Mexico than I had in the States.

Respectfully I would  suggest there are a number of folks here that could not afford having a "wreck"..hence the GOFUNDME insurance policy 

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If you decline  Part B you can only sign up in Jan. to the first of March and it won't start until July 1st. with the added penalty. People going back to sign up won't have it immediately.

 

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2 hours ago, lakeside7 said:

Respectfully I would  suggest there are a number of folks here that could not afford having a "wreck"..hence the GOFUNDME insurance policy 

And they don't have IMSS or SP because...?😏

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Pre-existing conditions for one....  Is age another? A lot of us are over 75.

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8 hours ago, RickS said:

Pre-existing conditions for one....  Is age another? A lot of us are over 75.

Pre-existing conditions are a problem with IMSS.  SP takes anyone. I haven't heard of an age barrier.  I suspect that a number of people are simply in denial and using the "cross your fingers" approach to health care.  There is no reason involved there. As we age, parts wear out or become fragile. We get the karmic results of our poor health habits of a lifetime.  That's just inevitable, and health care costs skyrocket in our last years.

IMHO, comparisons of Medicare Part B to an insurance policy don't hold up on a practical level.  If you carry car insurance and have an accident, it's taken care of. If you drop the insurance, there is no penalty for signing up again.  If you continue with Part B while a permanent resident of Mexico, you pay for the "insurance" monthly, but if you have an "accident", nothing is paid unless you get yourself back to the States (after the cost of being "stabilized" in Mexico), find a doctor and hospital that will take Medicare patients (not so easy) and pay whatever costs are involved in living away from "home" for you and perhaps a family member until you have recovered sufficiently to return to your Mexican home.  Calculate this likely cost and see what you come up with before deciding to carry this "insurance" .  While you're at it, imagine what "stabilized" really means if you have a heart attack or broken hip.  Meanwhile, find out what the usual costs for likely "accidents" is in Mexico.  For elders, the most common problems are cardiac and broken bones. You may be surprised. If you happen to be eligible for commercial health insurance in Mexico (I'm not), check it out.  Friends had such a policy, and it wasn't cheap, but it really paid off when the husband got colon cancer and the next years were non-stop medical expense until his death.  In other words, learn about all the options and make an INFORMED decision. Be a responsible adult and don't expect a "go fund me" solution to your medical care. 

If you're one of those people who are afraid to trust your body to Mexican doctors and hospitals, then you should probably continue relying on getting back to the U.S. for your care.  Before making that decision, spend some time with Senor Google and learn where the U.S. stands on quality and cost of medical care.  It's number one on the latter, but nowhere near the top on the other.  Still, 
"peace of mind" is a very important factor in your happiness level. Do what works for you.

After 15 years of my "medical savings account" which resulted from dropping Part B, I have been able to pay out of pocket for all my "accidents" (quite a few now) and have half left. I carry SP as a backup but have never used it.  I have had much better care here than I had in the U.S.  I am lucky to now be older than dirt.😄

End of lecture.🙃🖖

 

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I respect everyone's decision on how they choose to receive/pay for their healthcare. I decide for me and let others make different decisions for themselves without being judgemental. Just don't look for me to show up at some "benefit" or GoFundMe web page if that is their idea of insurance. Now, if they could only afford a high deductible and even that is breaking the bank, count me in.

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Soon you can just renounce your citizenship, go back to the States as an illegal alien and your healthcare will all be free!

And you will get more in benefits than you get from Social Security as a citizen!

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6 minutes ago, Aquaponicsman said:

Soon you can just renounce your citizenship, go back to the States as an illegal alien and your healthcare will all be free!

And you will get more in benefits than you get from Social Security as a citizen!

Ya, you will be greeted by Santa Claus and he will gift you a BMW.

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The decision is a tough one, which will depend upon many health and financial factors, as well as the mindset of the individual.

I lived happily in Chapala from 2001 through 2014, but eventually had to leave. The cause was a combination of poor health, thin air and a thinning wallet.  Too many hospitalizations will do that to you, but I must say that the health care that I received was much better that what I receive in the USA; and by much more pleasant and caring providers in Mexico. In particular: Drs.Ramon Garcia Garcia, Hector Briseño, Hector Valenzuela, and DDS Eloy Barragan.  

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11 hours ago, Aquaponicsman said:

Soon you can just renounce your citizenship, go back to the States as an illegal alien and your healthcare will all be free!

And you will get more in benefits than you get from Social Security as a citizen!

And, a free bunk in a concentration camp!

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I would NEVER donate to a Gofundme for someone who was not responsible enough to provide for their OWN health costs first, by either private insurance, SP, Part B, or private savings. Retirement planners have been telling retirees for YEARS that to cover co-pays, deductibles, etc with Medicare, they need to have at least $50,000 set aside. I cannot comprehend someone that would expect other people to pay for their poor planning. Wow. How irresponsible. 

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