Should You Carry Medicare Part B In Panama?

I just received a letter from SSA to apply for Medicare. I decided I would post the above question and get some feedback before I sent my form in.

First let me say that I understand that Medicare is worthless in Panama. This is one of the downsides of moving to Panama. While you may have worked your entire life in the US and religiously paid all of your taxes, you will not be able to collect a penny from Medicare unless you are in the US.

That being said the US puts the squeeze on you by telling you that your premium for Part B will go up each year at a rate of 10% a month for each year you postpone taking it. The current premium which went into effect January 2007 is $93.50 if your annual was $80,000 or less. In 2005 the cost was $78.20. The current rate of $93.50 will translate to $112.20 with a two year delay.

Example: You delayed enrolling in Medicare Part B for 24 months

$93.50 base premium in 2007

+ $9.35 (10% of $93.50) for the first 12 month delay

+ $9.35 (10% of $93.50) for the second 12 month delay

= $112.20 will be your Medicare Part B premium for 2007

So the gamble you have to weigh, if you live outside the US, is based on whether you think you will ever return there to to the US to live or return there for medical treatment for some extreme condition. Also there is the cost of Medi-gap insurance since Medicare doesn’t cover everything.

I realize this is a personal thing, but I would like a little outside input before I make my decision. At the present, I can’t imagine my wanting or being able to return to the US to live in a retirement situation as good as I have here, but when you have lived this long you learn that the word “Never” should never be used.

I really feel that this is one item where the US is really cheating or steeling (you pick the word) from the people that have paid into the system for so many years. I think a person should be able to use Medicare benefits no matter where he or she lives.

Well, that is my poser for the day. Should a person subscribe for Medicare even if he isn’t living in the US. What are your thoughts? Like I said in the past, there is no care in Medicare is you are not in the US.

31 thoughts on “Should You Carry Medicare Part B In Panama?

  1. A further poser is that some private or corporate retiree health care plans *REQUIRE* that you join medicare once eligible and that all payments after that point will be based on using medicare as the Primary Provider. Ours is like that.

    So based on your example we’d have to pay a couple hundred a year for a useless system to deny our claims and delay our ability to receive payment from our *REAL* insurer for perhaps an additional six months..

    Oh wunnerfull…………

  2. Don Ray:

    You are about to turn 65? But, I thought that at one point you said you were old.

    Your question may come down to your personal finances. Are you willing to pay that extra $1,100 a year for piece of mind?

    And, hey, what about Plan D? That might be the most valuable one of all for you since it provides for pharma products, and nowadays that is all they are treating people with anyway. I suspect that you could make Plan D work even if you are not living in the United States. You might have to travel to the USA, and get the doctor to give you a lot of refills on the prescription. A trick to Plan D is the find the least expensive one for now; that way there is no penalty even if you later switch to a more extensive one. I am not, by the way, 65, but I’m thinking about it. :)

  3. For military retirees, Plan B is not an option. You lose Tricare benefits if you don’t have Plan B after 65. I see it as just another tax which has to be paid.

  4. dear don ray,

    so glad you are back. although i am not a techie i live with one.

    now onto your question as a nurse i say see “SICKO” first.

    it is frighteningly close to the usa truth! also plan D is a very

    good idea. ellen

  5. Hi Ellen. I have to watch “SICKO” to be able to make a decision. Why don’t you just give me your best judgment or should I interpret that you are saying to sign up and take Part D too?

  6. Don Ray, Don Ray, Don Ray. I say that as if what I’m about to impart to you is some great wisdom, but it’s really not.

    As for Plan B, if giving up the $93 or so a month now isn’t going to put you in a bind, then do it and never think about the money again. Also, like someone else said, go ahead and get the absolute cheapest Plan D you can find just to get in the system.

    Like you say, never say never. You’re in great shape now. But no one knows what the future brings. And, so (trying not to be too indelicate), should something happen and your kids need to bring you home for medical care, you’ll all be glad you took these steps. I hope this makes sense.

  7. Don,
    What socialism does not work? Damned FDR! Damned LBJ’s Great Society! Trillions of dollars of fiat currency (if it ain’t gold or silver it ain’t money) down the rat hole of government programs that don’t work or just plain wasteful (or unconstitutional). I’ll throw the military industrial complex in for good measure. If I may quote Major General Smedely Butler – “War is a racket”.

    This rant is guaranteed Microsoft tax free, and brought to by Ubuntu Linux and Open Office.

    Whoa,
    Kevin

  8. dear don ray,

    when all the “baby boomers” come on board madicare will be

    broken not broke but broken!

    my opinion is to not take the medicare part d or b, for me not you!

    collin had it right God bless his soul.

    canada and england do have “it right” i am not speaking scandinavian

    countries.

    that is why i said see “sicko” the stats in the movie are correct,

    i have quoted them many times. ellen

  9. Gold bugs always use the term fiat currency. Terribly redundant; currency is fiat by definition.

    However, it might surpise people to realize that even money backed by gold is fiat. You are only receiving the promise of payment in gold.

    Quite obviously, the world economy could not run on just gold. Remember back in the 30s, there wasn’t any money around? That’s because there simply wasn’t any money. Today money is backed up by industrial and agricultural production, not by a glittering mineral dug out of a hole, then put back in a hole with high paid guards. (Stole that one from Warren Buffet).

  10. Don,

    Just wondering if you have decided what to do. Facing the same dilemma and I’m having a real issue with paying more into a system I cannot use. Unfortunately it’s not a dollar issue (for me) but a “it’s just not right” thing – which has gotten me into trouble in the past.

    take care

  11. Hi Steve. I understand your feeling. I haven’t completely made my decision. I guess I am leaning toward paying for it and just considering it insurance. I don’t expect to use it, but I have learned to never say “never”. I still have a little time to make the decision.

  12. Hi Don. I elected to Not sign up for Plan B. I’d rather put my $93 aside and use it here for Med Service at Hospital Chiriqui, which, by the way, is a pretty good deal. You can write me privately for my experiences there. If I have something bad enough that the docs and hospitals in Panama can’t handle, I doubt I’d want to travel back to the US for what is not the best healthcare in the world. In any case, Part A, would handle my hospital stuff (the hospitals here can arrange admission there) and I’d end up back here for the incidentals covered by Plan B (if I lived that long).

  13. Hi Wendy. Thanks for taking the time to write. It is a puzzler. I have mixed emotions about either route. Another thing I have thought about is that the US may wise up one day and make Medicare available no matter where you live. If that ever happened then you would have to pay the rates based on when you started in the program.

    I still have not made my decision.

  14. Hello, Don Ray & Company – I might have a solution to your Part B of Medicare. The Nacional Hospital in Panama City has taken care of the Veterans with disabilities, treating them, billing the VA in Texas for treatment and medicines. Also the wives of the soldiers/airmen
    at Fort Clayton had Medicare as the first payer, then Tricare as a secondary, both together is known as “Tricare for Life” My wife has
    Tricare for Life, and was treated in 2006 at Nacional Hospital, they
    billed Medicare in Maryland, and handed the balance off to Tricare to
    finish the payment. The way I understand it, Medicare likes these folks there at Nacional, because they are cheaper than in the States
    and will bill ion english, with drug codes (To Tricare) and they get paid pretty fast. Some people that might can shed some light on this is “International Living”, they have an office in casco Viejo. But
    also you should “Google” Va Clinic in Panama and it will refer to all I
    said.

  15. Hi Randall, I think this will take care of all vets, however, I don’t think it will work for those that didn’t serve in the military. Thanks for taking the time to comment.

  16. Hey, Don Ray, Read my post again – my wife didn’t spend a day in the service either. She has Medicare, Part A & B, using Tricare as
    a supplement. This is called Tricare for Life. Nacional Hospital in Panama City honors it, does all billing and waits for their payment.

  17. Hi Randall, As I read the Tricare requirement, it is for people that have been in the military. I haven’t and don’t believe I qualify.

  18. Don Ray – If you wanna know for sure – Call the Billing Dept at the
    Nacional Hospital in Panama City, Panama. I KNOW that they treat
    retired folks with Medicare Part A & B. I never met anyone there that didn’t speak english and they are real familiar with Medicare.

  19. Don Ray and Company – If you wanna know about Medicare, Blue Cross & Blue Shield, Tricare or VA Care, Call of email these folks below:

    Elsa R. de Bermudez
    (507) 207-8344
    Massiel Campbell
    (507) 207-8345
    or email:
    ebermudez@hospitalnacional.com

  20. We are thinking about moving to Panama and I’m trying to find out what options my grandmother and grandfather has
    She gets diability ($ and meds)
    grandfather retired (not military) and medicare

    It seems like they would have to pay for some med insurance. I saw on another web site in order to get residency you need to have $40,000 to invest over there? Is this accurate and how do they do that for grandparents and such are we concidered one family

    I need to find an area to live that offers a private school for my daughter she is in 4th grade. I’m having a hard time finding schools online

  21. Go into the link area and look under “Panama Pensionado/Retiree Benefits and Requirements”. You will find a Panama Government site that specifies the different ways to obtain a pensionado visa.

    Medicare will not cover anything in Panama. You will be able to find some bilingual schools, but I can’t speak to their quality. I doubt if you will find them online. There are several in David.

  22. I came across this old post and wanted to give you my 2 cents update. It maybe a good option for some expats to look into getting a Medicare Saving Account (MSA). This is newish Medicare option where you sign up for Part B, pay your $96 a month, in return the government deposits around $1500 per year in a bank account for you which you are free to use (tax free) for any medical expenses. You can also use this money taxable for anything else other than medical benefits (it also goes into your estate when you die). The only catch in MSA is that while you now have Medicare A & B, you are not entitled to submit any bills to Medicare until you spend $4000 on your own first. In other words, you enroll and pay for Part B, you get that amount of money back in the form of cash into a saving account + an extra bonus of coverage with a deductible of $4000 (which maybe very handy if you get very sick and return to the US). I read somewhere that you must be living in the US for at least 6 months of the year to be eligible for an MSA. I am sure how that would work if you go back and forth. I suppose if you file residence state tax, then you can make a case for being qualified(?) (pretty sure it would be a problem if you sign up for MSA and then do not file residence state tax).

    As far as I know with Part D, you do not pay the late enrollment penalty if your current plan offers “creditable coverage”. Your current insurance must give you a letter once per year saying that what they offer is as good or better than Part D.

  23. Nov 11 2009 – I am trying to figure out what to do . I understand completely about never saying never . Don what did you finally decide? I am staying awake wrestling with this. I do not understand why no exception for expats – we are not using the system as long as we live elsewhere.

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