US Medicare payments while living in Mexico

You have to have a place in the US to be able to access Medicare to begin with.
That said, I suppose if you are in the states anywhere, you can get treated in a hospital under Part A.  What if you give a Mexico address?  Will Medicare honor the claim?  See the first sentence again.

Part B., you have deducted from your Social Security check which is deposited in your US bank account, Same for Part D, and any MAP or Medigap policy.  Mail order your prescriptions to your US home, three months worth at a time.  Splitting time between home in the US and a place you rent or buy in Mexico entails extra expenses, no getting around that.

I see, I think. Bear with me because I have not yet reached medicare age and so all i know is what I hear from my workplace HR. From that, it seems that Part A is automatically deducted from your SS whether you like it or not (is that wrong?).  Part B, in my case, is paid for by the state in perpetuity (at least for now) as I will have been a state employee here in NC hired before they stopped doing such things.

Once I move, I will NOT have a place in the States, so what does that mean for me vis a vis Medicare? And what about the Mexican equivalent? I will be eligible for that if I get temprary residency, right?

I,too, am interested in this topic.  Please keep explaining it to us......

nikolas4squid wrote:

I see, I think. Bear with me because I have not yet reached medicare age and so all i know is what I hear from my workplace HR. From that, it seems that Part A is automatically deducted from your SS whether you like it or not (is that wrong?).  Part B, in my case, is paid for by the state in perpetuity (at least for now) as I will have been a state employee here in NC hired before they stopped doing such things.

Once I move, I will NOT have a place in the States, so what does that mean for me vis a vis Medicare? And what about the Mexican equivalent? I will be eligible for that if I get temprary residency, right?

Part A is being deducted from your paycheck while you are working.
Once you retire, there's a yearly deductible and copay if you use it.
It's great that the state pays the Part B premium.  Do I understand that they don't deduct it from your pension check?

Even if you did nothing now, if you ever moved back to the states, you wouldn't have a penalty for not paying continuously.

Just thinking out loud.  Suppose you had a relative or close friend who would receive mail for you.  You'd use that address as your address for all business in the US.  That might work.

If you are healthy, private insurance might be within your reach.

There are two government programs.
1) IMSS - you pay about $300/yr and have access to IMSS doctors and hospitals anywhere in Mexico.
2) Seguro Popular - free unless you are quite well off.  There is a list of procedures and treatments they cover but just about everything that's life threatening or uncomfortable to affect quality of life is covered,

Both programs mean red tape, long waits and other bureaucratic rigamarole..

That's a rundown of the options.

Thank you, Gudgrief. OK. Got it on the Part A now - that is the current monthly deduction and is the hospitalization portion. As for Part B, I misspoke as to what the state gives me as I don't understand clearly. I will have to go back in and ask them again, but here is what I wrote a friend the day I spoke to the HR retirement person at work:

"If I retire before 65, I can keep my same health insurance coverage as now for the current rate of $34 a month or switch to the free 70/30 plan (both Blue Cross). After 65, I will then switch to Medicare, and must pay the federal government's monthly fee for Part B (currently $104), and the state will then pay for my supplemental B with Parts C and D included, thus providing me with, they said, full coverage. There are four options to choose from, two of which are free and two of which cost $33 per month. I can also continue the supplemental benefits (vision, dental, etc) at the same rate I pay now, which is not much. "

When you said there is no penalty for not having paid continuously if I go back to the US, are you referring to that $104 part B amount?

As for the in-Mexico options, what is the difference between IMSS and Seguro Popular?

I was hired just before they cut out the benefits for new hires in terms of insurance, and they all make it sound a great thing. One thing I can understand is the continuation of my current insurance at the same cost as now (or less) if I retire before 65. (Early retirement in NC's state pension system is 60. 

When you say private insurance, do you mean Mexican private insurance?

Private insurance can be either Mexican ir from an International company.  Try Googling "expat health insurance" for links to international companies and "Mexico private health insurance"

IMSS costs about $300USD a year.  Seguro Popular costs nothing for almost everyone.  Beyond that I don't have the info to talk about difference.

Yes, definitely talk to personnel and get specific answers.  Pretty sure dental, vision and any Medicare add on or supplement is only good in US.

There are a few places in Mexico that accept Medicare, or there was a few months ago. It was in the Ajijic area. Aside from that, Medicare isn't accepted in Mexico. At 65, if you don't accept part B and decide at a later date to enroll, it will be more expensive. Not a lot, but some. https://www.socialsecurity.gov/foreign/

It might be wise to read this to find out just what Medicare covers outside the US.
https://www.medicare.gov/Pubs/pdf/11037.pdf

Thanks for the link, Gudgrief.  That is handy. I didn't really expect that I could use the Medicare in Mexico, but I figured that it is nice to know you've got it as an emergency backup when you're in a country not too far away. I am wondering about the Part B payment. The HR folks made it sound as if it was automatically deducted from my SS as soon as I hit 65. If so, then seems the medicare is up and there regardless of what I do. lol. Bear with me, it confuses me greatly.

I was thinking that I'd try to get into one or the other ofthe Mexican systems and have my Medicare there as a backup if need be if I ever go or have to go to the US. Can I keep Part B and pay for it as backup even if I stay out of the country and do not maintain a US address (other than a P.O box)?

When you turn 65, you will get a Medicare Enrollment letter. Part A is automatic and free, C (outside care) and D (Prescription drugs) are up to you. Part B is doctors, tests, etc. If you don't wish Part B, you must check the box on the form contained in the letter stating that you DO NOT want Part B, sign and return it.  If you want it, the cost will be deducted from your monthly SS check.

Best ask your HR department about how they do Part B for you.  I quit work before I signed up for Medicare so I applied for it myself.  Most people have it deducted from their SS checks, same with Part D. prescription coverage.  If you don't sign up when first eligible, you pay a penalty when you sign up later depending on the number of years you didn't pay.  The penalties aren't that high in my experience.  If you have a private mail service, your address won't have a P.O. box number in it.  So, that's really not a problem.  You'd be able to access Part B immediately if you returned to the states as a resident.

I go back to the USA for eye procedures and use the dentists in Mexico to clean my teeth, filling, I have scratches on both corneas because of sand in my face. So I am going to a USA eye surgeon for this so it depends on the problem.

Ah, thank you all for that information. So now I know how the B works. I am going to talk to HR this week to clarify the letters of these parts with what they told me. Then I'll have a better idea of what I have. From what they said, and per the descriptions you all gave, then all I have to pay for is that monthly for B that is directly deducted from SS. They said my medicine coverage is covered by my retirement package, so I assume they mean part D.  I will ask them about C.   

At any rate then it seems the only cost to keep medicare A,B & D would be that monthly direct deduction from SS, currently said to be $103. Seems worth doing, at least as figure things out.

I wouldn't call any part of Medicare part of your retirement package.  Some companies provide prescription coverage through a private company. You'll want to clear that up too.

Ah, ok. Thanks for pointing that out. I will also check that when I talk to them.

OK, just got back from HR,  and it seems I got my alphabet soup mixed up. What they said is that for employees who have been in the system for 20 years or those hired before Oct 2006 (my case), the retirement benefits package includes part C & D coverage from age 65. That is either free or $33 a month for an enhanced plan (have not looked into the specs of the "enhanced" plan). If I retire between now and 65, then my current 80/20 Blue Cross plan continues at the current $21 a month or, if I opt for the 70/30 plan, for free.

In regard to Gudgrief's point about needing to be in the US to apply for Part B. . . I will have to figure that one out. The private mail service might be the best route. Of course, then I wonder if having an address in a state would then make me liable for state taxes. Here in NC, they don't tax Social Security, but they do tax the state pensions, so. . .  just wondering.

No taxes in Texas, but then you would be a Texan.

joaquinx wrote:

No taxes in Texas, but then you would be a Texan.

LOL. The double edged sword. Hmm.

nikolas4squid wrote:

OK,
In regard to Gudgrief's point about needing to be in the US to apply for Part B. . . I will have to figure that one out. .

I got Medicare some months ago and they take Part B out of your SSI direct deposit to your bank automatically or really adjust your total to include the minus $105 per month.. I didn´t need to apply or be there or phone them. If you do not want Part B they sent a form with the Medicare card and booklet and you have to fill it out and mail it in to cancel getting it automatically. If you don´t get SSI at 65 then I presume you would have to phone them to arrange a monthly payment to have Part B.

It's now 8 years since I started Part B.
Here's a link to the Medicare website for the application to sign up for Part B.
Did I imply you had to be in the US to apply?  Not so.
Wherever you are, you may want to sign up as soon as eligible.  If you don't and need to sign up later, you'll pay a slightly higher premium.  The difference may not be enough to worry about, but is something to consider.  Living outside the US doesn't stop that clock from running for most people.

https://www.cms.gov/Medicare/CMS-Forms/ … S40B-E.pdf


It appears you do have to apply for Part A.
https://www.ssa.gov/medicare/apply.html

gudgrief wrote:

Did I imply you had to be in the US to apply?  Not so.
Wherever you are, you may want to sign up as soon as eligible.

Ah, I see, I misinterpreted that. What you had said was:

gudgrief wrote:

You have to have a place in the US to be able to access Medicare to begin with.
That said, I suppose if you are in the states anywhere, you can get treated in a hospital under Part A.  What if you give a Mexico address?  Will Medicare honor the claim?  See the first sentence again

Does that mean that if I were to go for treatment in the US for something there is the chance that they might not honor the claim if I have only a Mexican address? Or how about a mail service address? I will have to check these points out.

nikolas4squid wrote:

gudgrief wrote:

Did I imply you had to be in the US to apply?  Not so.
Wherever you are, you may want to sign up as soon as eligible.

Ah, I see, I misinterpreted that. What you had said was:

gudgrief wrote:

You have to have a place in the US to be able to access Medicare to begin with.
That said, I suppose if you are in the states anywhere, you can get treated in a hospital under Part A.  What if you give a Mexico address?  Will Medicare honor the claim?  See the first sentence again

Does that mean that if I were to go for treatment in the US for something there is the chance that they might not honor the claim if I have only a Mexican address? Or how about a mail service address? I will have to check these points out.

Here's what I believe applies;
http://www.elderlawanswers.com/getting- … rseas-8229

"Retirees who are moving to a foreign country cannot use Medicare to pay for health care while they are living overseas. The options for retirees are to buy private coverage, to pay into a government-sponsored system in their new country of residence, or to go without coverage. If the retiree is moving to a country with a strong national plan, he or she may be able to pay into the plan and receive coverage similar to that accorded residents of the country. If national insurance isn't an option, many companies offer "expatriate" health insurance plans. Choosing the right plan depends on where the retiree is moving. For example, if a retiree is traveling somewhere remote or with poor local health care, evacuation coverage may be important. Another country may offer excellent health care, but each doctor visit may cost a lot of money, so a plan that covers outpatient doctor visits may be necessary there. No matter where the retiree is moving, another consideration is whether the plan covers pre-existing conditions.

Whatever option retirees choose while abroad, if they return to the United States they will still be covered by Medicare Part A. Medicare Part A covers institutional care in hospitals and skilled nursing facilities, as well as certain care given by home health agencies and care provided in hospices. There are no premiums for this part of the Medicare program and anyone who is 65 or older and is eligible for Social Security automatically qualifies.

Medicare Part B, which covers outpatient services, charges a monthly premium. Unless retirees continue to pay the premiums while they are overseas, they will not automatically be covered by Medicare Part B when they return to the United States. Retirees who drop Part B and then move back to the United States will have to pay an enrollment penalty. Premiums increase by 10 percent for each year that an individual is not enrolled in Part B. Therefore, retirees who think they may return to the United States may find it worthwhile to continue paying Part B premiums while they live abroad. "

A US mailing address may not be required but it is likely to avoid questions or delays when you see a doctor or go to an emergency room or hospital when you're in the US.

That was great, Gudgrief. Thanks for that.

I'm not, but many are. If you plan to get all your health care in Mexico, you'll want to stop (or not start) paying into Part B, C, etc. Why pay for something you'll never use? But if there's a fair chance you'll move back to the US, or return there for medical care other than hospitalization covered by Part A, then go for it. This is a very personal decision.

fdinolfo wrote:

I'm not, but many are. If you plan to get all your health care in Mexico, you'll want to stop (or not start) paying into Part B, C, etc. Why pay for something you'll never use? But if there's a fair chance you'll move back to the US, or return there for medical care other than hospitalization covered by Part A, then go for it. This is a very personal decision.

There's no decision to make about Part A other than to apply when you turn 65.  It doesn't even matter what address you use.  You can't access it till you move back to the US.  The question would be, would you have to notify Medicare of your change well before trying to access Part A?

All I can say in regards to this is that an MRI here in Cancun costed $350.00 USD. One dental implant or crown is about $200.00 USD. We are just about ready to cancel our US plan and get an EXPAT plan that will save us $1000.00 USD every month in premiums and the quality of care that we have received has far exceeded anything we have received in the US. I have recurrant cancer and the options for treatment are far more numerous and less expensive than in the states. I'm not medicare eligable yet, but seriously doubt that it would be better than what we can do down here... And we are meeting more and more Americans who have traveled to Cancun to have dental work done, or surgeries (one for a hernia repair, another for knee surgery, another for some plastic surgery) as they are so much less expensive here.

I have canceled part B........I can use the $100.00 plus here for other things.......If you go back to the USA to live you can have it reinstated.

I only have US Medicare part A  and I live in Ensenada. Part B will cost me $125 monthly if I choose to reignite it. I am 52 yrs old and am concerned about preventative medical services that are covered by Part B. I am looking for options and would prefer to pay Ensenada doctors cash for procedures. True, the doctors I have encountered here are superb and cost 1/4 of US doctors, but it is still pricey on my fixed budget.

I chose to not pay for part B....I can use the over $100.00 a month^to pay for any medical care here.  If and when I should ever go back to the USA to live I can reinstate Bart B....It ust be done abtween Jan and Mar and can not use it until July.....That was my information.

We are over 70.  Same as you we pay.  Remember that in Mexico some pharmacies have doctors on the side. It is cheaper and some are free. I use them but the situation becomes harder when we get really sick with cancer.  Now I have a lot of regrets to have left the US.  Cancer treatments and radiation and etc, is expensive, may be not as much as in the US, but without insurance, hard to find 30,000 US for radiation beside the other treatments.  May be better to stay in the States and pay for the extra insurance. I feel it is sager. But I feel Imhave no more choice now.

Have you looked into Seguro Popular or IMSS.  Pre-existing conditions are covered.
Is there a relative in the US you can stay with?
If you make that your residence, you are covered by Part A automatically.
Part B will be more expensive  than if you had it from the start but nowhere near what it would be for private insurance if you could get it.

I'm in my 70's too and I have a fair number of complaints.  I have Seguro Popular and it does my blood tests and supplies almost all my meds.  I did have a 2 night stay in a good hospital in Mexico for a strange condition where I was shaking, had low blood sugar and low electrolytes.  I didn't want to wait at the IMSS or Seguro Popular emergency room.  They ran a whole slew of tests, recommended meds including electrolytes and I had a suite for an extra $10US a day.  The bill for everything came to less than $1000 US.

I hope things work out for you.

I'm so sorry to hear about your cancer.  I just wrote you about living in Chetumal.

I lost my husband to lung cancer, so I've made a long long study of how to stay away from doctors and cancer the last few years.  The one thing to DO KNOW is that FOOD is the best healer.  IF you can drink a lot of fresh clean water and eat all the vegetables that you can, and cut out most meat, AND get your colon cleared....all very doable,......then you have a good chance to enhance your body.  I'm sure about this.  Cancer is poor nutrition gone crazy.  But eating mostly vege's and less less meat is not easy.  Cleaning your body is a necessity.  Have you had chemo and radiation?  They are the killers.  IF you have not then this routine will help you tremendously.  It will save your life.  My husband did nothing, had Stage IV and chemo and radiation and died in 5 months.  He smoked, only drank coffee and ate a lot of junk food.  That all adds up to cancer.  I'm 66 now and don't take anything, am perfectly healthy except I don't exercise enough.  Climbing all those pyramids is going to be a chore.

I hope you are not offended....I felt compelled to give you some hope with food as your prescription.

So sincerely,
Ally

sorry, this post I cant delete and is intended to become trash..

You can apply or cancel your Part B over the phone from Mexico. I just did. Be aware of the enrollment deadline period for this year that begins soon, I think it applies here. To give you an idea of cost, Part B for me is $121 per month, if I were to re-enroll today.

A month ago, I spoke with HR at SS and learned that there is a distinction between "SSA and SSI" benefits concerning living abroad. "SSA" folks can live outside the US legitimately and don't have to provide SS with any residential address to maintain their benefits (email address or other alternative mode of contact recommended). But if on SSI you are required to maintain a US residence.  I say this because it seems that many of us seem to feel a need to be sly or sneaky about where we reside abroad when speaking with HR at SS, unecessarily. Keeping US citizenship is the fundamental criteria to continue receiving SSA benefits. I quote directly from the SS representatives lips, " you can live anywhere you want, just dont lose your US citizenship." Bottom line seems: once retired, free to roam. Please correct me if I have somehow misinterpreted what the SS rep told me.

Personally, I Intend to find a better insurance  alternative for preventative medicine here in Ensenada. No way I am  paying $121US monthly to part B anymore. Rather than a trek to California to see a doctor, I have been opting to pay cash to Ensenada doctors for my medical and pharmaceutical needs.   

Thank you for the IMSS insurance tip. I will start here.

alleycat1 wrote:

nikolas4squid wrote:

OK,
In regard to Gudgrief's point about needing to be in the US to apply for Part B. . . I will have to figure that one out. .

I got Medicare some months ago and they take Part B out of your SSI direct deposit to your bank automatically or really adjust your total to include the minus $105 per month.. I didn´t need to apply or be there or phone them. If you do not want Part B they sent a form with the Medicare card and booklet and you have to fill it out and mail it in to cancel getting it automatically. If you don´t get SSI at 65 then I presume you would have to phone them to arrange a monthly payment to have Part B.

I should have said SSA not SSI - sorry

HI Gudgrief:
When you say that splitting your time between the US and Mexico "entails extra expenses" what do you mean?
I plan to have both Parts A and B.   But I expect I will need traveler's insurance if I spend 5-6 mos/yr. in Mexico, yes?  Is this what you mean?    And I'm not really sure what to do about C  (prescriptions).   Any advice there?   Thanks.

Suppose I have a health incident here in Mexico and don't want to subject myself to hours long wait in an IMSS or Seguro Popular emergency room.  Does it make sense to pay for insurance here that was quoted to me at $300/mo.  A couple of nights in a private hospital while they do tests would only be around $1,000 to 2,000.  Then, If it were something serious, I could either go to an IMSS hospital or Seguro Popular hospital with a confirmed diagnosis and maybe not have to wait so long.  Or, I could call my US doctor and find out if it was serious enough that I'd feel more comfortable to return to the states for treatment.  So, there is potentially extra insurance and extra transportation cost living in two countries at the same time.

I decided to have a hernia operation in the US.  I spent a whole month at home in real pain, that was managed very nicely with /!\ I AM A STUPID SPAMMER /!\ and I was more comfortable with A/C in TX rather than none in Mexico and US food rather than Mexican.  The thing that confirmed my correct decision is that Mexican doctors cannot use opiates or other narcotic pain killers outside the hospital.  The stuff they are allowed to use is fine for tooth extractions or a few stitches from a cut, but abdominal surgery, not for me!

Okay, so if I have time to decide, it is probably just best to go back to the U.S.    But if I have something that needs immediate attention, will my traveler's insurance cover it??  I expect there are different levels to choose from.    So private insurance in Mexico is $300/mo??

mmacdonald1026 wrote:

You can apply or cancel your Part B over the phone from Mexico. I just did. Be aware of the enrollment deadline period for this year that begins soon, I think it applies here. To give you an idea of cost, Part B for me is $121 per month, if I were to re-enroll today.

A month ago, I spoke with HR at SS and learned that there is a distinction between "SSA and SSI" benefits concerning living abroad. "SSA" folks can live outside the US legitimately and don't have to provide SS with any residential address to maintain their benefits (email address or other alternative mode of contact recommended). But if on SSI you are required to maintain a US residence.  I say this because it seems that many of us seem to feel a need to be sly or sneaky about where we reside abroad when speaking with HR at SS, unecessarily. Keeping US citizenship is the fundamental criteria to continue receiving SSA benefits. I quote directly from the SS representatives lips, " you can live anywhere you want, just dont lose your US citizenship."

I got a bit confused here because something seems off. SSA is the Social Security Administration, and from it we get Social Security. SSI is Supplemental Security Income, which is for "which is needs-based, for the aged, blind, or disabled" who have no income, no savings, etc. It is administered by the SSA, but it is not the same thing as the Social Security retirement system we pay into while working and prepping for our future retirement. See more here:  http://www.differencebetween.net/busine … i-and-ssa/

What your HR folks said makes sense - you can get Social Security payments while abroad but not Supplemental Security Income (which is not what we are paying into when we pay our monthly percentage into Social Security while working), so good info.

One thing that does not make sense, however, is why your citizenship would have any bearing on your ability to collect Social Security. Social Security is not a right of citizenship but a right stemming from participation. You get Social Security because you paid into the system. Many people who are not citizens but who worked legally in the US and paid into the system, collect payments when they retire, whether in the US or abroad. They paid into it, and played by the rules, and the rules let them collect. Natural enough. But it is not dependent on citizenship. My great uncle was a green card worker, never a citizen, and retired to his birthplace, the former Yugoslavia, where he could live like a kind on his Social Security income.  My former co-work in Portand, OR, a citizen of South Africa (and Hungary), has retired to the Republic of Georgia (for now) after a few years in Chile, and receives his Social Security payments.

I believe somewhere in this chain (or maybe another) was the question as to whether or not we needed a US address to use Medicare Part B when in the States. So maybe that got mixed into things.