All your years of hard work have paid off, you’re retired, and you are now ready to move on to your global retirement destination. You no longer need the big house, the multiple cars, or the stress that comes with them. You’ve done your homework – studied tax rates in Central America, read about low-cost living in Southeast Asia, perhaps you have even started to learn Italian so that you can converse with your new neighbors in Rome, but what about your health? Have you considered your healthcare needs in your new home? Can you be sure that a medical emergency can be treated appropriately or will you need to be transferred somewhere else for care? While you may have spent months, or even years planning your international retirement, health considerations are often overlooked.
In many places around the world, primary health care is readily available at a very low cost. Some international locations are creating communities around medical tourism, offering high-quality health care for specific procedures at costs significantly lower than they are in the US. But it is important to think about these issues before you make the move so that you do not find yourself without choices for your care.
Here are some important things to consider before you make that move.
It is important to know that Medicare pays nothing (except in rare circumstances) for health care outside the US. That means that if you need a prescription filled while you are touring the Vatican, you are responsible for the cost of medication. If you fall and turn your ankle while touring the Parthenon, you are responsible for paying the doctor’s bill out of your pocket. And if you get appendicitis while in Buenos Aires, you will be responsible for paying all the expenses related to the surgery including surgeon’s charges, hospital bills, lab work, and even ambulance charges. Those costs can add up in a hurry, so you may want to consider buying an international medical insurance policy to complement the local health care system.
There are many US-based and international insurance companies that offer a variety of policies designed for retirees living abroad. And unlike traditional US health care plans, you can tailor your coverage based on your individual needs and your willingness to absorb your own healthcare expenses. Ask yourself whether you need:
- Coverage for inpatient hospitalizations?
- Coverage for prescription drugs or high-cost medications?
- Coverage for medical evacuation to the nearest appropriate place of care?
- Coverage for temporary return visits to the United States? Some exclude all coverage in the US or Canada.
- Coverage for travel away from your new home country? Some policies have regional coverage only and exclude higher cost locations, such as Europe.
- What are the age limits on the policy?
- Are there any pre-existing conditions limitations on the policy that will affect you?
Remember, health insurance must be purchased before you need it!
It is important to realize that even if you don’t think you need Medicare now because you are not living in the US, there are penalties that come into play if you do not choose to take Medicare Part B or Medicare Part D (prescription drug coverage) at time when you are initially eligible to enroll in these plans.
Medicare Part B Late Enrollment Penalty
You may enroll in Medicare Part B at your original Medicare enrollment date or during General Open Enrollment (January 1st through March 31st, with coverage beginning July 1st). If you do not enroll when you are initially eligible, you will usually pay a penalty of 10% for each 12 month period in which you could have enrolled in Part B but did not. This penalty is charged for as long as you have Medicare Part B.
Medicare Part D Late Enrollment Penalty
You may enroll in a Medicare Part D plan at you original Medicare enrollment date or during Annual Open Enrollment. If you are without Part D coverage for 63 days or more and choose to enroll in a Medicare Part D plan, you may be required to pay a penalty of 1% of the “national base beneficiary premium” ($34.10 for 2016) multiplied by the total number of months in which you were eligible to enroll but did not have Part D. This penalty will be charged for as long as you have Medicare Part D.
There is a general perception that prescription medications are readily available and inexpensive everywhere except for in the US. In some destinations, that perception is accurate. But you may find that your brand of medication or your particular dosage is not available in your new home country. It is important that you research all of your medications, both prescription and over the counter, before you relocate. You do not want to find that you cannot get your particular blood thinner or heartburn tablets once you have already arrived in your new home!
As you travel, you should create a medication list to carry with you that includes:
- Manufacturer and full name (the brand and generic names) of each medication you are carrying. The generic information is important because not all brands of medication are available around the world.
- Dosage information for each medication – how much of each medication do you take and how often do you take this medication?
- Relevant information regarding the conditions for taking the medication – Should it be taken with food? Should it be taken on an empty stomach? Can it be taken with milk?
- Keep a copy of this document with you and give a copy to someone back home. In case of an emergency, you’ll want to make sure that all of this information is readily available.
- Never pack your prescriptions in your checked baggage. In case your baggage is lost, you want to make sure that you have your medications with you.
- Some countries (e.g., Japan) require you to carry a copy of your actual prescription with you. Make sure you check the US State Department web site before your travel to learn if there are any restrictions on carrying prescriptions or over the counter medications.
Create a list of your doctors and their telephone numbers to take with you to your new country. Leave a copy of this list with someone in the US, as well. If you have an emergency, anyone who is trying to assist you will not have to seek out this information.
While you may have used the Internet to help you plan your relocation, you’ll be best prepared for your new home by working with those who have already made the leap. The same holds true for researching your medical needs. You will certainly benefit by working with a professional (particularly one who is experienced with international medical policies) to help you determine your particular needs and budget, and can then provide you with a variety of options to consider.
Being able to live wherever in the world you desire is one of the joys of retirement. And though you may not need this medical guidance, being prepared will allow you to relax and focus on the exciting journey ahead of you.