If you are thinking about, or have decided to retire outside the U.S., one of your concerns may be health care coverage. Medicaregenerally does not cover health care you receive outside the United States, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
There are only three exceptions for Medicare-covered services you receive in a foreign hospital. One exception is when you are in the U.S. and have a medical emergency and the foreign hospital is closer than the nearest U.S. hospital that can treat your injury or illness. Another is when you are traveling through Canada without delay between Alaska and the continental U.S., you have a medical emergency, and a Canadian hospital is closer than a U.S. hospital. And the third exception is when you live in the U.S. and a foreign hospital is closer than a U.S. hospital that can treat your condition, even if it is not an emergency.
As indicated by Laura Cohn in an article for Kiplinger, you should sign up for Medicare Part A when you turn 65 so you will be covered if you come back to the U.S. If you plan to retire outside the country you may not need Medicare Part B. You have to pay for Medicare Part B and it covers outpatient services and doctor visits only in the U.S. You may want Part B if you plan to spend part of your time in the U.S. and part outside the country. If you delay enrolling in Part B there is a 10% penalty in the premium for each year after you reach age 65.
A Medigap supplemental health insurance policy available through private insurance companies may provide coverage outside the U.S. in certain cases. According to Medicare, Medigap Plans C, D, F, G, M and N provide emergency health care coverage when you travel outside the U.S. And Medigap plans C through N pay 80% of billed charges for care necessary due to a medical emergency outside the U.S. after you meet a $250 deductible. But foreign travel emergency coverage under Medigap policies has a $50,000 lifetime limit.
Suzan Haskins points out in International Living that many countries offer their residents a government-sponsored health plan. And you may be able to contract a private health insurance policy in another country that costs much less than in the United States.
If you want to get quotes from private insurance companies for health coverage outside the U.S., Laura Cohn mentions Bupa International, which provides coverage for travelers and full-time expatriates, Nationwide for foreign travel health coverage, and the Abrams Insurance Agency, a broker that collaborates with American Citizens Abroad. The U.S. Department of State Bureau of Consular Affairs also provides a list of health insurance companies for informational purposes.
Health insurance, American Citizens Abroad
Health insurance for you, Bupa International
Laura Cohn, What You Need to Know About Health Care Outside the U.S., Kiplinger
Medical Insurance, Bureau of Consular Affairs, U.S. Department of State
Medicare Coverage Outside the United States, Medicare
Specialty Health, Liability and Travel Insurance, Nationwide
Suzan Haskins, Medicare Benefits for U.S. Citizens Living Abroad, International Living