Medicare will not cover you in Italy.

You do not go into details on your permissions to live in Italy next year, so I will give the answer that fits a retired American who is NOT a dual citizen of Italy or any EU country. (Or married to one)

Yes, you will need to purchase private health care. There are a variety of companies offering it. In fact there are some links right on the left side of my screen right now.

When you have your Residency Permits, you will be eligible to buy into the Italian healthcare system. The amount is based on your income and is paid for a full year regardless of when you begin coverage.

If you quit Medicare, but go back to the US some time in the future and want to get back in, You will have to pay a penalty, which, coincidentally, just happens to be equal to the amount you did not have deducted from your Social Security while you were off the program.

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If I understand this correctly, it is actually a 10% increase in the standard monthly premium for every 12 months that you were *not* covered by Medicare.

https://www.medicareinteractive.org/get-answers/how-original-medicare-works/enrolling-in-original-medicare/medicare-part-b-late-enrollment-penalty

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Dear Ray...What we did (just before leaving for our retirement in Italy) was buy a 6 month policy for International health insurance that could be renewed. That way we only had to pay for 6 months which was time enough to establish our residency and apply/pay for Italian Health ins. The Italian plan is based on your yearly income...but is only a fraction of the cost of US/Boston insurance. We were able to continue getting all our Rx here and again: a fraction of the price. We did keep our medicare for about a year until we were sure we would stay. Important Fact: Are you selling a business when you retire? Your medicare payment can skyrocket! It takes almost 3 months to drop medicare and we had to pay the new triple premium until it ended. We should have dropped it as soon as we received our Italian Health card. Good Luck....we love it here!

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Codybrandy,

Could you tell me the name of the international health insurance you initially used and if you were happy with it? Do you purchase insurance for when you are back visiting in the States?

We are dual US/Italian citizens who will be retiring and moving over next September. We will initially be renting while we continue our house search.

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Dear Lisa, This will be an exciting year for you and (we did not) I think renting for a time is a great idea...that way you get to know the different areas and service people (plumber/electricians/etc) to help in any renovations your new place might need. After a 2 yrs here we have learned so much that we wish we knew beforehand. As for the international ins...I, of course called our US Blue Cross, but it was terribly expensive and we were certain we would only need it until we got settled (6 months or so)...I then just went on line and found a cheap policy for 6 months that could be renewed if necessary. The Italian Permesso needed proof of paid ins. and they accepted this. I had the policy run for the day we left the US onward. Then we had a final checkup with our doctor and asked him to give us 6 months of Rx which he kindly did. From reading Ex-pats I see the different consulates and even questuras here act so differently, but this worked for us. One caveat: we are very healthy thank heavens and do not need much. The health ins here in Italy is adequate for our needs and the Rx is remarkably cheap...what we paid $100/month with BCBS costs c.E10 here. When we go home? Good question and something I should look into before our next trip. We live in Liguria which is wonderful...close to mountains and sea, in a hill village but near bigger cities and Pisa or Genova airports are equidistant at 1 1/2hr....Good luck with your search. You will find so much info on moving here but you will also just have to make decisions that are best for you. Our biggest challenges: driving license and staying calm while learning the bureaucratic hurdles.

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Choosing an expat health insurance provider is an important decision. Get a quote from our trusted expat health insurance partner, CIGNA. With Cigna Global Health Options, you can create an international health insurance plan that's perfectly tailored for the needs of you and your family.

Hi CodyBrandy,

Thanks so much for all of the helpful information. I have a few more things I would like to ask you and will send you a pm.

We used to live outside of Pisa and left once my husband graduated in 1983. Can't wait to move back!

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Since you are already Italian you do not need supplemental insurance. You are already covered for emergency services, everybody is in Italy, and you will have Italian health coverage once you establish residency. In the interim, Doctor services are not terribly expensive (less than buying insurance) should you need to see a doctor in the short period before your residency is completed.

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Thanks very much Sergios! Now I just need to sort out buying a car. I need to figure out how to do this without hopefully being subject to income tax for 2017.

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Another interesting post.

I turn 64 next year, which is when l plan to move to Italy. From what I have read, it sounds like l will have to pay some sort of penalty if l don't enroll and later move back to the US ?

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Yes, there can be up to a 10% penalty in increased premiums for each year that you did not sign up. I am currently thinking about how we should handle this. My husband will be eligible in 2018.

https://www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html

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I am more than a bit curious about this; I really need to investigate further.

If you are in the US, still employed, and have health coverage through your employer, there is no need to sign up for/pay for Medicare Part B, regardless of your age, until such time as your other coverage ends. Under these conditions, there is no premium penalty.

So, should it be any different if you were not employed but covered by another healthcare plan? Specifically Italian national healthcare?

I need to make it a point to check on this...

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Doppio,

I would love to know what you find out. I was going to try and contact the office in Vermont but will wait to see what you discover. Unfortunately, I have a feeling that it is not the case that we would not be subjected to a penalty in the US, even though we will have Italian insurance.

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Doppio,

I just found this:

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/special-conditions/special-conditions.html#collapse-3225

I live outside the U.S.

Collapse I live outside the United States and I don't have Part B. If I get Part B, will I pay more?

In some cases, you may have to pay a higher premium. It will depend on your situation. Listed below are 3 possible situations:

Example

You're over 65, currently getting Social Security retirement benefits and Part A, and you didn't take Part B when you were first eligible. You may only apply for Part B from January 1–March 31 each year, and you may have to pay a late enrollment penalty for as long as you have Part B.

Example

If you're over 65, and are eligible for Social Security benefits, you may file an application for monthly benefits and Part A. You'll have to file for Part B from January 1–March 31, and you may have to pay a late enrollment penalty.

Example

If you're a U.S. citizen, over 65, not eligible for Social Security benefits, and you lived in a foreign country when you turned 65, you must live in the U.S. to file for Part B. You're first eligible to enroll in Part B the month you return to the U.S. to establish your new residence. You won't have to pay a late enrollment penalty if you enroll in Part B within 3 months of when you first return to the U.S.

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More still on Medicare:

http://www.aarp.org/health/medicare-insurance/info-04-2011/medicare-enrollment.html
?If you are living outside the United States when you turn 65 and not working, you're in a Catch-22 situation. You can either:

?Enroll in Part B during your initial enrollment period (IEP) and pay monthly premiums — even though Medicare does not cover medical services overseas; or


?Delay Part B until your return to this country — but then you risk a permanent late penalty and may have to wait for coverage. Except in very limited situations, medical coverage abroad does not entitle you to a special enrollment period when you return.

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this site has been very helpful!! thanks!! From AARP "Except in very limited situations, medical coverage abroad does not entitle you to a SEP when you return" What exactly are those "limited situations"?? Could be very important....thanks for your time....

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Medicare is discusses the issue here: https://www.medicare.gov/coverage/travel-need-health-care-outside-us.html

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Richardcomerchero,

I just had a conversation with the social security office. In my husband's case, his birthday is in May. He has a 3 month window to enroll in social security, thus if he does not enroll by the end of August he must wait until the next enrollment period period. I was told that would be January, February or March, in order to have coverage for July. Thus, it is definitely best to sign up promptly, or risk being uncovered for a period of time, if you happen to be in the States.

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