Ex-Pat Retirees, Medicare, and Health Insurance

June 11, 2014 — Our friend Rick recently wrote us with a great question on how ex-pat retirees deal with healthcare and healthcare insurance when living in another country. We thought we had addressed this question in the Blog before, but after careful searching it doesn’t look like we did that in any great depth.

Here is the question:
Recently one of our Bayview Park tennis players was traveling to Mexico, where he fell gravely ill and needed an emergency operation… Now it seems, since he first got sick on the plane flying there, Medicare will reimburse him for medical costs in Mexico… I will be traveling to Mexico soon myself, where I used to live, and may be spending more time there again. My question is about medical care and coverage abroad. I understand there are Medigap policies that may cover this, but I was wondering if you have any info as to how retired Americans living abroad deal with Medicare, health insurance and health issues. Thanks.

And this is how we responded:
Our friend from KW was lucky about getting Medicare coverage for his illness, because otherwise Medicare doesn’t provides coverage outside of U.S. You always have the option to go back across the border and be covered. Lots of people do that for everything but emergency needs.

The gist of the answer is:
– No Medicare coverage outside of U.S.
– Some ex-pats plan to return to the U.S. (and Medicare) if they major health issues. Some people buy Medivac insurance to cover emergencies.
– Health care is generally pretty good in most countries popular with American ex-pats, such as Mexico, which has many English speaking providers. In most 2nd and 3rd world countries the health care will be best in the larger cities and popular expat destinations.
– Some people from the U.S. actually go abroad specifically for Medical Tourism – to get procedures not covered by insurance in the U.S., or because of the low cost of the operations.
– Prices are quite reasonable compared to US
– In some cases your U.S. health insurance (non-Medicare) might reimburse you for medical expenses incurred outside of the U.S.
– Health care insurance is available, and usually much more affordable than in U.S. If you search on Google you will find some sources.
– Sometimes foreigners are eligible to participate in foreign government programs akin to Mexico. For example, American retirees can become eligible to join Mexico’s popular and inexpensive IMSS healthcare program, provided they pay the annual fee.
– You might consider dropping Part B of your Medicare insurance if you are going to be living permanently abroad

Here are some links to articles we have published that touch somewhat on this subject.
Medical Tourism in Guatemala – Report on a Recent Emergency
Taking Baby Steps to Retire in Mexico
Mexican Retirement Gone Bad – Why This Gringo Can’t Wait to Get Back to the USA (the comments are at least as interesting as the article)

More about health insurance abroad
As one of our friends in the insurance business once told us, you can buy insurance for anything. It’s all about the price. This is true for health insurance abroad too, where many recognizable companies sell policies, generally for far less than they cost in the U.S.

Useful Links
This site, Health Care in Mexico, has a great deal of useful information about the types of health care available there as well as links to companies that sell healthcare insurance, including Medivac insurance.
Insurance, Health Care, and Medical Tourism in Mexico. This site describes what Mexican health care is like and has a description of the IMSS program.

Comments? How are you planning to get medical coverage if you are going to retire abroad.