Locked out of going home because of health insurance???

Here is the health forum on that US retirement site I mentioned.

https://www.early-retirement.org/forums/f38/

You can browse and/or search for threads on Medicare.  You don't have to sign up but as a guest you'll have to put up with a lot of ads and can't ask any questions. An anonymous account would make the experience easier for sure, even if you never post.

 

👍😁

Am I right in thinking prescription drugs aren’t just the antibiotics you get at the drug store with a script, but also major things like chemo, or drugs used in surgery if needed?

Part D drugs are those you take yourself, that are prescribed by a medical professional.

This might be more useful than my memory - from  https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/11315-P.pdf

Drug coverage under different parts of Medicare

Which drugs does Part A cover?
■ Hospital: Generally, drugs are covered as part of inpatient treatment during a covered stay.
■ Skilled Nursing Facility (SNF): Generally, drugs are covered as part of inpatient treatment during a covered stay.
■ Hospice care: Covers drugs for symptom control or pain relief.

Which drugs does Part B cover?
Usually, Part B covers drugs that typically aren’t self-administered. These drugs can be given in a doctor’s office as part of their service. In a hospital outpatient department, coverage generally is limited to drugs that are given by infusion or injection. If the injection usually is self-administered or isn’t given as part of a doctor’s service, Part B generally won’t cover it. A person’s Medicare drug coverage (Part D) may cover these drugs under certain circumstances.

In most cases, the yearly Part B deductible applies to these drugs. This means that a person with Medicare may have to pay the Part B deductible amount before Medicare pays its share. Beginning April 2023, the coinsurance amount may be less if a prescription drug’s price has grown faster than the rate of inflation. In most cases, after the person meets the Part B deductible, they’ll pay 0% to 20% of the Medicare-approved amount
for covered prescription drugs they get in a doctor’s office, hospital outpatient department, ambulatory surgical center, or pharmacy.

Thank you Nan. I’ll look around to see what there is going. Maybe I can patch together something.

I admit it all seems VERY complicated. When I lived in the States it was before Obamacare, and we had great insurance through my husband’s work. I never had to call and plead for coverage,  or fight to have a procedure. I had two C-sections that included three days in the hospital and it cost us $50.00 each time.
My husband and I are heathy, and always have been, (no previous or ongoing conditions)but in “the zone” age wise where things can start to go wrong.

The NHS is so poor, and taxes here so high, that if I can find the right plan it might balance out. We would like to go to NM. We almost bought a house there a few years ago but the healthcare business stopped us. I wish I had never mentioned it as potential difficulty. We would have just had to live with the situation and paid up. In the end we went to Canada, which I hated every minute I was in the Vancouver area. My husband wouldn’t entertain anywhere else. (And he said I was picky!).

Anyway, we wound up back here in the  UK and I have to say the last couple of year’s weather has left me longing for America. We aren’t getting any younger and it’s difficult with all the mud, constant wind and cold . I don’t think I had even one day last year where I didn’t wear a sweater even in the house. All the mud makes me feel like I’m living in the Neolithic!
I love my house, but haven’t any  close friends, and I spend my days watching my husband cut branches in the garden. My son still lives in the Vancouver area and I miss him terribly. I don’t get to see him very often. I miss the optimism and cheerfulness of Americans. Although I think maybe that has changed somewhat. Needless to say I’m dying on the vine.

So, on the sly, I’m sorta looking at the possibilities in America. I might get one more move out of the husband if it’s NM or similar.
I thought maybe being older might for once be a good thing. I didn’t work very much whilst living in America, and much of the time I was raising my kids. So most of my work history is in the UK.
Cheers

I hear ya.  I was wanting to write that given the length of time people seem to have to wait for treatment over there even for serious issues, and the restrictions on what care the NHS would provide to you if you needed something really pricey that they haven't already approved.... You'd (I assume) possibly end up paying to go "private". Which could really add up.

It is complicated, I'm sorry to say.  In a nutshell,  generally there's three kinds of medical cover here (not counting if you're fabulously wealthy and can just pay for it):

1) Government - medicare (for "elderly" persons) or medicaid (for very low income or special disabled populations)

2) Private - you can purchase commercial plans on the marketplace. Here's the link for the healthcare marketplace in New Mexico - https://getcovered.bewellnm.com/individual/

3) Employer sponsored (which I lump the military "Tri-care" into).

Looking at employer-sponsored, it can be really really good cover (as you have experienced) or the bare minimum. It just depends on what plan the employer negotiates with an insurer for the employees. How much you pay of that premium can also vary wildly from the employer paying for everything to you paying for most of the cost. Obamacare made some issues mandatory for all plans regardless of who is providing them. Thank God.

2) Marketplace plans. Also have to meet the minimum Obamacare standards. After that, it's how much you want to pay (or can afford to pay). Deductibles can be minimal or huge. Add-on coverages (not required by Obamacare) can vary.  On the good side, there are subsidies from the Federal Government to help with costs, depending on your income.  Marketplaces are state-specific, and so what is on their approved plans in one state may not be on another. Ah, states' rights.....

3) I have heard people complaining for years about Medicare, but so far it's been some of the best care I've ever had. If something is deemed "medically necessary" by a provider (a procedure, a test, a medication) it's covered. But, again, I'm on traditional Medicare. The cheaper Medicare Advantage plans are HMOs and you may have to get prior authorizations or see only doctors affiliated with that plan.  Medicaid is bare-bones - it actually, from my experience, is very much like the NHS, but with more pro-active "keep you healthy, not just react when you get sick" programs. You do have to have very low income and almost no resources to qualify for Medicaid, and the programs are administered independently by each state. (When I was in grad school I did a research project on medicaid in Texas, and at that time there were over three dozen different medicaid programs in Texas, each with different rules. Made a good grade, but was so thankful I never had to deal with Texas medicaid as a client!)

I can certainly understand your wanting to be near your son. If he's smart, your husband will be aware of that.

Good luck!

I. 64 now, so if we moved and I worked enough to get the 30 credits before taking Medicare, would that then be cost free?
Sorry, but I’m not really up on how the whole thing works.

That's my understanding. And you do NOT have to retire at age 65. That is just the age you have to sign up for Medicare in UNLESS you have health insurance provided by your employer. Once you drop that private coverage, you then have to sign up for Medicare (if you're eligible).

No, not free. See Nans post above, she pays about $400/month but you could pay a lot more depending on the coverages you choose and the co-pays when you use the doctors and hospitals

We were in Durham Castle and the Cathedral this week. Rain of course

If you had enough credits, part A would be free. Part B is $165 for everyone unless you are a high-earner, when you would pay more. (Or if you signed up later then you should, it would then be more.)  If you wanted to go with a Medicare Advantage plan, you'd pay their premium and the Part B costs. Some plans do a "give back" where you pay "Part B" as required, but then the plan would reimburse you for some or all of that Part B expense). Some Advantage plans have no premium at all, but the caveat "you get what you pay for" applies here.  If you go with Medicare Advantage, they typically (I believe) roll drug cover under that umbrella.  They tend to work as "managed care" or HMO/PPO.

If you go with traditional Part A and Part B, you might want to get a medigap plan to cover any costs (the 20% of medicare costs you are responsible for - medicare only pays 80%, plus extended hospital stays - medicare only covers a certain number of days) that part A or part B would leave to you. You do have to have "creditable drug coverage", and the Part D (drug) plans vary from state to state. Mine this year was $44 for the entire year, but doesn't have a huge formulary. By regs, they have to offer (I believe) a couple of drugs for each class of illnesses, but they may not be the ones your medical team prefers for you. A more expensive Part D plan would have a better selection, but cost more (possibly much more).

My additional costs (to bring up to the $400 I pay) is for my $210 medigap and my Part D plan.  Maybe take a look through this -

https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics 

Thanks Nan,
my husband does not work anymore and draws on a nice pension which I’m pretty sure wouldn’t allow any subsidies.
I’m working part time. I’m American, he’s British.
His mom is 99 and can’t do anything for herself. We had to sell her little house and the NHS is refusing to fund her care. I hope I’m not looking at my son’s future. Sending his inheritance off every month,
Husbands daughter live in the UK, so missing my son will not move hi. Too much. Money will.
*sigh.
Thanks for listening.

Any time!

Oh,  here's something that might help?  Seriously, best of luck. You're in a tough place.

https://health.usnews.com/medicare/new-mexico-medicare-plans