US Medicare and moving to UK

My wife, who is a UK citizen, and I are thinking of making the jump over to the UK but are wondering how or if this would effect our ability to receive Medicare medical benefits in the USA?

I am in my early 50's she is mid 40's so we have quite a few years before we are even eligible for Medicare. But perhaps these years away would have an effect?

I realize I am a little ahead of myself on this one but if we move to the UK for the next, say 15 years and then want to move back to the USA would this effect our Medicare benefits?

Any thoughts would be appreciated.

NWKH

I believe you would still be eligible for Medicare but note that it can be used only in the United States.  You would have to go back to receive any care under it. 

Will you have turned 65 while residing outside the US?  That has implications as to how you would sign up.  https://www.medicare.gov/people-like-me/outside-us/signing-up-for-part-b-outside-us.html

If you get Social Security the Medicare (part B) premium will be deducted from the SS payment.  Otherwise they would bill you.  I would think if you are paid up over the period you are away you would be able to use Medicare on your return.

You automatically get your Medicare A card if you meet the eligibility criteria. You have the option to sign up for Medicare B; we chose not to do that, as we were in the UK when Medicare kicked in. If by any stretch of the imagination I ever go back to the US to live, I will opt in and pay the higher rate for Part B.

Your wife will be entitled to Medicare benefits in the US if she visits and needs treatment that's covered by Medicare.

As others have stated, you are definitely entitled to Medicare at age 65, if you are qualified by years of working in the U.S. 

The real question, as Vadio mentions, is the level of Medicare coverage you choose, bearing in mind that when living abroad, you can only enjoy Medicare benefits if you make the trip back to the U.S.

First level; Part A, no further cost
Second level; Part B, significant monthly premium
Third level; various add-ons, such as Part D, Medicare Supplement policies, Medicare Advantage policies, etc., most with significant additional monthly premiums

(Important to note that you MUST pay the Part B in order to then take Part D, Medicare Advantage, or Medicare Supplement.  AND you must take Part B every year, or there's a cumulative penalty if you decide to belatedly take it in the futur, having missed years.)

Since I divide my time between the UK and the U.S., my choice was to pay Part B premiums and to take a high deductible Medicare Advantage plan ($0 premium.)  I don't really intend to use healthcare in America, but, of course, you need some sort of coverage there, in case of illness or accident while visiting...

Since I divide my time between the UK and the U.S., my choice was to pay Part B premiums and to take a high deductible Medicare Advantage plan ($0 premium.)  I don't really intend to use healthcare in America, but, of course, you need some sort of coverage there, in case of illness or accident while visiting...

I like this option, and will consider it in 3 years when we qualify for Medicare. We plan to spend significant time visiting our children in the US for the foreseeable future.  I understand that with Medicare part B you are still on the hook for 20% of the bills with no out of pocket maximum.  I guess that the high deductible Advantage Plan you mention covers most if not all of the costs after the deductible is spent, and does have an annual cap on OOP expenses.

I like this option, and will consider it in 3 years when we qualify for Medicare. We plan to spend significant time visiting our children in the US for the foreseeable future.  I understand that with Medicare part B you are still on the hook for 20% of the bills with no out of pocket maximum.  I guess that the high deductible Advantage Plan you mention covers most if not all of the costs after the deductible is spent, and does have an annual cap on OOP expenses.

Yes, the Medicare Advantage plan ($0 premium) basically takes your Part A & Part B and benefits, and reorganises them into a more conventional type high deductible model.  I think the total potential out of pocket is approx. $6,500 per annum.  Not a great model, but satisfactory & cost effective for a situation where the centre of life is in the UK, not US.

Wouldn't you just buy travel insurance for when visiting the US, or even have it on one of your credit cards? I'd rather do that (and also have medical evacuation to my country of residence where necessary) than potentially be on the hook for $6500 in the case of an accident.

Wouldn't you just buy travel insurance for when visiting the US, or even have it on one of your credit cards? I'd rather do that (and also have medical evacuation to my country of residence where necessary) than potentially be on the hook for $6500 in the case of an accident.

It's really a long term question of whether or not you want to keep up your Medicare eligibility.  To put it another way, do you know for certain that you'll never again live in the United States.  I can't say that for sure, I'm 65, I retired less than three years ago, I have one child living in America, another child may well decide to move back to the U.S., etc.

If you do not pay the monthly premium for Part B every year from age 65, there is a penalty of 10% for each year you don't pay it.  So, for instance, if you don't pay for Part B, then belatedly decide to move to the U.S. and pay for Part B at age 65, the premium would be double the standard premium - for the rest of your life.

Thanks for the explanation! At this point I'm not sure where we will retire so this info is useful. I'll file it away somewhere for when I need to do research on Medicare/Social Security etc. Thanks again 

It's really a long term question of whether or not you want to keep up your Medicare eligibility.  To put it another way, do you know for certain that you'll never again live in the United States.  I can't say that for sure, I'm 65, I retired less than three years ago, I have one child living in America, another child may well decide to move back to the U.S., etc.

If you do not pay the monthly premium for Part B every year from age 65, there is a penalty of 10% for each year you don't pay it.  So, for instance, if you don't pay for Part B, then belatedly decide to move to the U.S. and pay for Part B at age 65, the premium would be double the standard premium - for the rest of your life.

Sorry, my example makes no sense because of a typo.  It was meant to read;

So, for instance, if you don't pay for Part B, then belatedly decide to move to the U.S. and pay for Part B at age 75, the premium would be double the standard premium - for the rest of your life

(Because for each year you didn't pay Part B, the penalty increases your future annual premium by 10%)

It's really a long term question of whether or not you want to keep up your Medicare eligibility.  To put it another way, do you know for certain that you'll never again live in the United States.  I can't say that for sure, I'm 65, I retired less than three years ago, I have one child living in America, another child may well decide to move back to the U.S., etc.

If you do not pay the monthly premium for Part B every year from age 65, there is a penalty of 10% for each year you don't pay it.  So, for instance, if you don't pay for Part B, then belatedly decide to move to the U.S. and pay for Part B at age 75, the premium would be double the standard premium - for the rest of your life.

This is our situation as well.  2 children living in the USA, so ~$2,500/year to maintain our US Medicare insurance is worth it to us. We currently plan to spend about 3 months a year in the US for the foreseeable future, so not sure what travel insurance to the USA would cost for that length of time given our ages and the fact that I have a pre-existing heart condition.

This is our situation as well.  2 children living in the USA, so ~$2,500/year to maintain our US Medicare insurance is worth it to us. We currently plan to spend about 3 months a year in the US for the foreseeable future, so not sure what travel insurance to the USA would cost for that length of time given our ages and the fact that I have a pre-existing heart condition.

Exactly, and at least you know that Medicare is rock solid (despite its known limitations.)  Travel insurance, by its nature, is largely untested and is mainly for emergencies and repatriation.

Travel insurance, by its nature, is largely untested and is mainly for emergencies and repatriation.

That's right.  And you never know if one or the other of you may develop some condition that would make travel insurance prohibitively costly or even impossible to get coverage for.

I was already on Medicare Part A and when I retired 5 years ago when I opted for Part B, payment deducted from Social Security. Fortunately I had worked long enough with my employer to be eligible for one of their 3 medigap plans, premiums coming out of my (tiny) pension. I also opted for their retiree dental plan (Delta Dental)  So it does all add up.  Not to mention the fact that there are still co-payments and deductibles to be met.  It can get a bit complicated because provider has to bill Medicare first before the other plans kick in for their share and you're left with whatever isn't covered.

DH feels I should be going back to US regularly to take advantage of all this (for checkups at least) but I worry about what would happen if your US PCP prescribes something that would not be covered by NHS when you came back.  But still it's there if I need it during yearly visits or if I ever move back.

But if you're filing US income taxes, the Medicare part B qualifies for the ACA coverage.