Medical Insurance

[chrissyG]

Originally Posted by Bevdeforges

Here's a money-saving hint: rather than an accountant, try and find an "enrolled agent." EAs are specialists in taxation, tested and certified by the IRS. They normally are considerably less expensive to consult than accountants (CPAs), and very often are more oriented toward personal taxes and small businesses.

There are also tons and tons of books on the market about US taxes. One of the best starting points is Publication 17 from the IRS - which is basically "Everything you Ever Wanted to Know About Federal Income Taxes" and is available for free on the IRS website or from a local IRS office.

State taxes very often start from your completed Federal income tax form.
Cheers,
Bev

I did think about getting a book on US taxation when I got there, but felt it might be too complex for me, although years ago I did my own book-keeping to trial balance so maybe I should have more confidence. It's generally better to do stuff yourself anyway & you obviously learn more that way & become self-reliant - cheaper too. I have made a note of the publication & it'll be a good starting point & will also look for an EA for when I feel I need some extra advice.

Thank you so much for taking the trouble to reply to me I felt I was going into an adventure on my own and although eager, was also considering that I'd have quite a bit of research & adjusting to do, but I can see I've hit gold with this website.

[JohnSoCal]

Originally Posted by chrissyG

(Silly of me but I only just saw this post.)

I find this info amazing am I right in thinking you are saying that effectively the government does cover medical costs for everyone over 65, if they can't themselves, so that there is a state medical system of sorts. Also seems like you're saying the premiums are subsidized so aren't as high as I'd assumed since I was extrapolating & thinking as I got older they would rocket up. I was assuming a starting premium of about $3/4000 a year with a deductible of about $3/4000 which might go up to about $10000 a year & I'll be very happy if this isn't the case since I'm certainly not rich.
Thanks

No, the premiums are not subsidized. No, not everyone over 65 is covered. Every US citizen and legal resident is covered if they met the requirements. Rather than reiterate everything, I am giving you the link to the official Medicare web site for the qualifications. It is interactive.

Medicare.gov - Medicare Eligibility Tool (Eligibility Questions)

By the way, it is not automatic. You do have to apply for it.

The Medicare Advantage plans are offered by private insurance companies and must be approved by Medicare and follow their rules. They are not offered in all localities. Basically the government pays them $1000+ /month for each subscriber that qualifies for free Part A Medicare and is enrolled in part B. Medicare part B is optional and costs $96 /mo for everybody. The premium is higher for high income people ( $170,000 /yr for a couple ). The insurance company can offer whatever additions they want and can add additional premiums if they want. You can also check them out on the official Medicare web site. Many do not charge any premium. Whether they charge a premium or not is not an indicator of the quality. Most of the highest rated ones do not charge any premium.

Personally, I have had one of Health Net's Medicare advantage plans for 4 years. I pay no premiums, zero co-pays for any doctor ( general or specialist ), zero for labs or diagnostics etc. I do not pay any premium for prescription drug coverage. It even includes free gym membership. Each plan has a network of doctors, hospitals, etc. that you go to within your locality. The size of their network is an important factor to consider. My plan has 5000 doctors in its network. Other plans may only have 500. You do have coverage worldwide for any illness or injury requiring treatment.

Doctors, labs, etc. have a free choice whether they wish to belong to an insurance plan's network or Medicare. Most of them do.

If you don't meet qualifications for free Medicare part A then you can still enroll in it or a Medicare Advantage plan by paying a premium for it. This premium is not subsidized and won't be cheap. Most people that have regular Medicare and not an Advantage plan also buy a Medi-gap policy from an insurance company. It basically fills in the gaps not covered by regular Medicare and has a low premium.

Some of the medical insurance offered is from non-profit organizations. Also some states have their own health insurance.

I have only given you the basics. It by no means is a complete explanation. You can do your own research on the Internet by searching for "Medicare", "Health Insurance", or some other related term.

[chrissyG]

Originally Posted by JohnSoCal

No, the premiums are not subsidized. No, not everyone over 65 is covered. Every US citizen and legal resident is covered if they met the requirements. Rather than reiterate everything, I am giving you the link to the official Medicare web site for the qualifications. It is interactive.

Medicare.gov - Medicare Eligibility Tool (Eligibility Questions)

By the way, it is not automatic. You do have to apply for it.

The Medicare Advantage plans are offered by private insurance companies and must be approved by Medicare and follow their rules. They are not offered in all localities. Basically the government pays them $1000+ /month for each subscriber that qualifies for free Part A Medicare and is enrolled in part B. Medicare part B is optional and costs $96 /mo for everybody. The premium is higher for high income people ( $170,000 /yr for a couple ). The insurance company can offer whatever additions they want and can add additional premiums if they want. You can also check them out on the official Medicare web site. Many do not charge any premium. Whether they charge a premium or not is not an indicator of the quality. Most of the highest rated ones do not charge any premium.

Personally, I have had one of Health Net's Medicare advantage plans for 4 years. I pay no premiums, zero co-pays for any doctor ( general or specialist ), zero for labs or diagnostics etc. I do not pay any premium for prescription drug coverage. It even includes free gym membership. Each plan has a network of doctors, hospitals, etc. that you go to within your locality. The size of their network is an important factor to consider. My plan has 5000 doctors in its network. Other plans may only have 500. You do have coverage worldwide for any illness or injury requiring treatment.

Doctors, labs, etc. have a free choice whether they wish to belong to an insurance plan's network or Medicare. Most of them do.

If you don't meet qualifications for free Medicare part A then you can still enroll in it or a Medicare Advantage plan by paying a premium for it. This premium is not subsidized and won't be cheap. Most people that have regular Medicare and not an Advantage plan also buy a Medi-gap policy from an insurance company. It basically fills in the gaps not covered by regular Medicare and has a low premium.

Some of the medical insurance offered is from non-profit organizations. Also some states have their own health insurance.

I have only given you the basics. It by no means is a complete explanation. You can do your own research on the Internet by searching for "Medicare", "Health Insurance", or some other related term.

I only meant subsidised in the sense that the health scheme is, because the government pays them $1000 for each subscriber. Thank you so much, I understand the system now & have just checked out the site, I've made notes & a reminder for me to apply when I'm 65, I'll have been in US the 5 year qualifying period by then.

Thanks again

[chrissyG]

Originally Posted by A8NNC

Hi
No this is for a year, it is like a travel insurance policy but you can return back to the UK (not sure how many times) they have quite a few different policies, but it is mainly emergency cover - but with an excess on it. For the first year until you decide what to do it seems ok. As i said my brother and his family have it and have used it for dental emergency and calling out doctors and they paid up ok. Ring American Express and explain and they will tell you the best policy for a year. Bupa are thousands per year even if you are a member here, at least by taking this policy you are covered until you decide what to do. They will email you the quote and you can see exactly what it covers.

Thanks again for suggesting this, it would have been a brilliant idea, unfortunately there is an age cut-off of 49 & I am 56, so they wouldn't let me do this. I may get this for my children though. Am still looking at policies.....

[Elphaba]

I have an unrelated question regarding US medical insurance and would appreciate some information.

I have an American client, currently resident in the UAE, for whom I am arranging medical insurance. The plans we arrange here are not suitable for US citizens living in the US, so when he eventually returns he will have to replace the plan.

My question therefore, is would he be likely able to obtain some sort of continuous cover upon his return? Full claims history would be available for medical underwiting, but he would want a plan where any existing conditions would be covered on what is called 'no worse terms'. I simply require an 'in principle' answer, not recommendations.

Many thanks for your assistance.

-

[Bevdeforges]

Originally Posted by Elphaba

The plans we arrange here are not suitable for US citizens living in the US, so when he eventually returns he will have to replace the plan.

My question therefore, is would he be likely able to obtain some sort of continuous cover upon his return? Full claims history would be available for medical underwiting, but he would want a plan where any existing conditions would be covered on what is called 'no worse terms'.
-

Medical insurance in the US is a highly charged (at this moment) and very complicated matter. Basically, nothing regarding his prior claims history is going to help him on his return to the US.

Under normal circumstances, medical insurance is a benefit offered by your employer - with the premiums either covered or split between employer and employee. You do everything in your power to avoid having to buy medical insurance on your own because it's just too darned expensive that way, even if you're perfectly healthy and have no bad habits (i.e. smoking, sky diving or other "dangerous pursuits").

Short of having an employer who offers insurance, some people are able to insure through a club, church or professional association. But single policies are to be avoided like the plague unless you have lots of money to throw around.
Cheers,
Bev

[Fatbrit]

Originally Posted by Elphaba

I have an unrelated question regarding US medical insurance and would appreciate some information.

I have an American client, currently resident in the UAE, for whom I am arranging medical insurance. The plans we arrange here are not suitable for US citizens living in the US, so when he eventually returns he will have to replace the plan.

My question therefore, is would he be likely able to obtain some sort of continuous cover upon his return? Full claims history would be available for medical underwiting, but he would want a plan where any existing conditions would be covered on what is called 'no worse terms'. I simply require an 'in principle' answer, not recommendations.

Many thanks for your assistance.

-

The first thing to note is that there is a major health care bill in the air at the moment that could change everything or nothing. So future planning is generally difficult at the present time.

There are two sorts of healthcare insurance: group and individual plans. Group plans are commonly offered by employers or associations.

For the group, conditions are either covered for everyone or excluded for everyone, whereas for individual plans the insurer can exclude conditions for individuals. The continuous coverage comes in with both of these in the period where there is a delay before coverage starts. A foreign policy should be good, and I can, for example, tell you that the UK's NHS coverage usually counts.

Health insurance in the US is currently tails you lose and heads they win. And given my fellow Americans susceptibility to the insidious lobbying by the insurance companies, I really can't see it changing this time around.