Health Care by Glynna Prentice, reprinted from International Living
What do you do for health insurance if you retire abroad at age 65 or older? Some U.S. expats are relying on their Medicare coverage. But this only pays for medical care performed in the U.S. Why not use your Medicare as part of a three-pronged health-insurance strategy that also includes local health care and a medical evacuation policy for emergencies?
Let’s assume you’ve moved to a country where health care is excellent and relatively inexpensive. Costa Rica, Ecuador, Mexico and Panama, for instance, all fit this description. As a 70-year-old, you’re too old to
qualify for most private health-insurance plans. But—thanks to the low health care costs in your new country—you can afford to pay out-of-pocket for your basic health maintenance. That can include check-up visits to your local internist; lab tests to check your cholesterol and high blood pressure; your medications; and perhaps even things like your eyeglasses, hearing aid or other devices you need. In addition, in some countries you may be able to sign up for their low-cost nationalized health care plan, despite your age. Mexico, for instance, allows expats with residence visas to sign up for its nationalized plan, and there is no age limit—though the plan won’t cover most pre-existing conditions. Still, a nationalized plan can be a very low-cost way to cover basic health maintenance. Either regionally based—for instance, covering just Latin America
and the Caribbean—or worldwide. Mexico is one of many low-cost destinations where you can get health care.
Medevac insurance, as it’s commonly called, generally runs about $250 a year for an individual and about $350 a year for a couple or family, though it can cost even less. Medevac insurance won’t work in all cases, however. Review medevac companies’ guidelines carefully before buying a policy to make sure it will meet your needs. And look closely at your own situation.
Here are some things to look for:
Remember that medevac insurance is designed to get you to adequate care you can’t get locally. If you live within shouting distance of a first-class hospital in your new country, this may be a hard argument to make. Make sure the plan will evacuate you to the U.S. if you become seriously ill, so that you can use Medicare. Some policies specify that you’ll be taken to the nearest appropriate hospital—which may well not be in the U.S. Again, remember that medevac insurance’s primary purpose is to get you to proper care—not to ferry
you to the States so you can tap your Medicare coverage. Finally, make sure you understand just who decides that an illness warrants your being evacuated, and what those criteria are. This information can help you decide whether a medevac policy will work for you, and how best to use one as part of your healthcare strategy
Will Medevac Insurance Work for You?
Those who may most easily and successfully use Medicare together with a medevac policy include the following:
Snowbirds or others who live abroad only part-time. Maintaining a U.S. address and medical records help make the argument for evacuating you back to the U.S.
Those living abroad in an area that has no first-rate hospital nearby.
Those with a known health condition that can require specialized care.
Medevac Insurance Companies
Here are a few companies that offer medical evacuation insurance.
MASA Assist (see: Masaassist.com). Texas-based MASA Assist has been offering medevac insurance for more than 30 years. Annual “memberships” are $240 for individuals and $360 for families, plus a one-time $60 sign-up fee. MASA also has branch offices throughout the Caribbean.
Emergency Assistance Plus (see: EmergencyAssistancePlus.com). This company states upfront that it only authorizes medical evacuation if your current hospital does not have adequate equipment for treating you. However, if you have only a small hospital near you, this plan could work—and the price is right: $129 a year for one person, and $149 a year for you and your family.
USI Affinity Travel Insurance Services (see:Travelinsure.com) offers at least two medical insurance
options that include emergency medical evacuation. Though designed more for overseas travel than for residence, one plan is valid for travel of up to one year.
MEDEX (see:Medexassist.com) offers two medical-insurance plans for travelers that include emergency evacuation. One policy allows overseas stays of up to 365 days.
In addition, in some countries you may be able to sign up for their low-cost nationalized health care plan, despite your age. Mexico, for instance, allows expats with residence visas to sign up for its nationalized plan, and there is no age limit—though the plan won’t cover most pre-existing conditions. Still, a nationalized plan can be a very low-cost way to cover basic health maintenance.
For major medical surgeries or serious illnesses you have Medicare, which you’ve already been paying into during your working years in the U.S. But you must return to the U.S. to use it. That’s not a problem for non-urgent procedures like knee surgery. You can just arrange to have the surgery during a regular trip home to the States.
But heart surgeries, serious accidents and illnesses aren’t planned. That’s where medical-evacuation insurance can be handy. It allows you to be evacuated back to your home country (usually by airplane or helicopter) if you have a medical emergency.