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US health insurance for senior citizens?



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amother
Khaki


 

Post Sun, Jul 26 2015, 7:24 am
Hi, DH's parents who are US citizens but made Aliya looong time ago are now considering moving back for various reasons. First they want to keep their apartment in EY but move back with us for 6months see how it goes from there.

They have combination of savings (in Israel) and tiny pension from both countries. They're hoping to rent their apartment which we all think should be more than enough to cover costs. The only thing my inlaws are very much concerned is the healthcare cost. Looks like kuppat cholim won't cover overseas treatments and since they're old it is important they have good insurance.

Does anyone have recommendation? What is the standard for someone in mid-70s, non smokers, in decent health (though FIL had back problem and they have minor things like high cholesterol and blood pressure)? I ask DH to ask his company's HR but he was told no one covers once you're above 65. Is it true? This is for NY.
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pesek zman




 
 
    
 

Post Sun, Jul 26 2015, 7:28 am
Did the live and work in the US long enough to qualify for Medicare?
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amother
Khaki


 

Post Sun, Jul 26 2015, 8:18 am
I don't think so, FIL worked for less than 10years in the US even though he was working for the same US company from Israel for several more years (so he's getting a pension from them).
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Amarante




 
 
    
 

Post Sun, Jul 26 2015, 8:36 am
It's complicated since Medicare consists of Part A and Part B as well as what are known as Medigap policies most people purchase to cover the portion of medical expenses which are not covered by Medicare itself. And there is also Part D which covers drug costs.

Also, there is a penalty for each year of eligibility in which one doesn't sign up and pay for Medicare - I.e. you must start paying the Medicare premiums at the age of 65 or you will pay a higher premium when you do want to get into the system.

You should probably get exact figures by contacting SS but it seems to me that it would be unaffordable for in-laws - even if they could actually quality for it since premiums for Part A for a person without the minimum 10 years of working credits are $426 per month - Part B premiums are additional $120 per month or so and then there is the cost of Medigap which varies depending on what kind of plan you want. And don't forget that the actual monthly cost would be higher since they didn't enter the system at 65 so they would pay the penalty.

They could be eligible for Medicaid which is need based depending on their assets and income since they are citizens but you would need to verify that and eligibility depends on residence requirements in an individual state since it has state based requirements unlike Medicare which is administered by the Federal government. ETA - And again, not 100% sure, but I believe that they would be excluded from Medicaid eligibility based on ownership of their apartment since Medicaid for seniors is both income and asset based.
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ROFL




 
 
    
 

Post Sun, Jul 26 2015, 9:19 am
If they were not living here in the US I think that the penalty for not signing up is waived. Call SS. That will be best
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nylon




 
 
    
 

Post Sun, Jul 26 2015, 2:20 pm
They really need to contact SS. I don't think there is a bilateral agreement that counts their Bituach Leumi payments towards Medicare, but check.

The assumption here is that you have worked (or your spouse has worked) and have paid to qualify for Part A, or you are lifelong disabled and receiving SSI/Medicaid. There isn't much set up for international retirees. Is there no chance he has paid his 40 quarters? Even teen jobs count if you made more than a certain low amount. The whole reason Medicare came into being is that no one would insure the elderly.

You will also need to ask about the penalty, they advise US citizens living abroad to sign up to avoid that.

They could check on the exchange, but again, most of those plans will be assuming they have Medicare.
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amother
Khaki


 

Post Sun, Jul 26 2015, 2:42 pm
OK so if they can't qualify for medicare, should they consider getting a travel insurance in Israel before they move?
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Amarante




 
 
    
 

Post Sun, Jul 26 2015, 3:46 pm
amother wrote:
OK so if they can't qualify for medicare, should they consider getting a travel insurance in Israel before they move?


Most definitely your in-laws should have some kind of travel insurance to cover them while they are in the US. I think most people who travel from the US abroad purchase insurance and I think there have been threads on purchasing Israeli insurance for use in the US.

Even if they are eligible for Medicare as a long term solution, you certainly would not want to chance not having insurance for an emergency as even in the best circumstances, there might be a gap while the paperwork and eligibility is determined.

As others have posted, you really should contact SS to find out what the cost for Medicare would be. There are also issues regarding how soon a person needs to "elect" Medicare if they decide to move back permanently to minimize any penalty payments. Also, your FIL should determine exactly how many work credits he accumulated, if any, in the US because even though you need 40 quarters (10 years) for full coverage, there is a pro rata deduction if he worked for a lesser time.

But before doing anything, I would find out exactly what the rights and options are - and what kind of coverage "travel insurance" would provide.
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nylon




 
 
    
 

Post Sun, Jul 26 2015, 4:43 pm
It's quite likely an Israeli travel insurance plan would not cover routine care in the USA. It's expensive. Travel insurance is meant to cover short term needs; Israeli travel insurance would be priced assuming that you would return to Israel for ongoing treatment. People don't often come to the US from abroad to retire because they have no health coverage here.
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Amarante




 
 
    
 

Post Sun, Jul 26 2015, 4:52 pm
nylon wrote:
It's quite likely an Israeli travel insurance plan would not cover routine care in the USA. It's expensive. Travel insurance is meant to cover short term needs; Israeli travel insurance would be priced assuming that you would return to Israel for ongoing treatment. People don't often come to the US from abroad to retire because they have no health coverage here.


Agreed that travel insurance is a short term solution for emergencies but I wouldn't think of traveling outside of one's country for anyone without it.

Basic care for an infection isn't the issue because that would be affordable even without insurance but it protects for accidents or real emergencies like stroke or heart attack.
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grace413




 
 
    
 

Post Sun, Jul 26 2015, 5:18 pm
amother wrote:
OK so if they can't qualify for medicare, should they consider getting a travel insurance in Israel before they move?


They should get travel insurance in order to have some kind of coverage, but they will probably only be able to get it for a maximum of 90 days - and they will need to give a return date.
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rh1211




 
 
    
 

Post Mon, Aug 17 2015, 8:52 pm
I know this is a few weeks old, but since they are US citizens, they should be able to buy an "exchange"/"obamacare"/Marketplace plan, though they may not get any subsidies, which would make the premiums quite pricey. It may be cheaper to pay the Medicare Part A premiums, etc, as others mentioned above, but it's a second option to look into.
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