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(US) Medicare Coverage

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YJM
  6/30/2022 11:10 EST

As an American, a few months away from my 65th birthday, I will be confronted with the dilemma of what to do about signing up for Medicare Parts B & D. Can any American(s) out there publically post what YOU have done and WHY? Also it would be helpful if you can also provide some context on your living status in CR ... from (a) I live here in CR full-time and I occasionally visit US, (b) I am a "snow-bird" so I live a significant part-time in the US as well as in CR. Thanks so much for sharing!

shermanwc
  6/30/2022 16:31 EST

My wife and I lived in Costa Rica 2013-2018, and since then have lived in Nicaragua (to be close to family living there). I retired at the end of 2012 at age 60.

We maintain Medicare Parts A & B coverage in the USA, but we skipped Part D coverage for prescription medications, since we purchased most of our meds in Costa Rica (or Nicaragua). I did return to the USA to have rotator cuff surgery performed. My wife and I have had some medical appointments and tests performed in the USA when there, paid under Medicare.

We obtained the required Caja insurance for coverage in Costa Rica once we became legal residents of Costa Rica. We also maintained international health insurance, as we had not heard good stories about the public hospitals in CR. I used the local "EBAIS" (Caja public health clinic) for routine health care and prescription medications, which I found suitable - but it did require some ability to communicate in Spanish. My wife generally stuck with private medical clinics in the area where English was spoken.

My wife ended up having an emergency while in Costa Rica due to atrial fibrillation - she obtained good, but very expensive, care at a private hospital in Liberia. Our international health insurance covered the costs above the deductible, although it took a while to get the bills paid to the providers, and it took a letter from my Costa Rica lawyer to get them to complete the final payments.

We dropped our international health coverage when close to age 70, as its cost had become prohibitive. We are now in Nicaragua and self-pay for our healthcare here. We could fly back to the USA for care under Medicare if needed.

We were happy with our international health insurance for several years, but we had a very bad experience in 2020. My wife had to have a heart ablation, and we traveled to Panama for treatment at a Johns Hopkins hospital, where she received very good care. (Our granddaughter living in Nicaragua also had heart surgery there.) They accepted our international health insurance - but later in 2020 the insurance company declared bankruptcy, and we got stuck with entire the bill (over $30,000!). We could have returned to the USA to have this treatment done under Medicare, but we thought we could save some money using our international insurance in Central America. Bad timing for us!

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RelocateNow Costa Rica's clients who run through the RelocateNow Program get quick results in formulating and successfully executing our laid out plan for moving to Costa Rica! Expert consulting for future expats in Costa Rica who wish to fast track the process of their move by receiving the specialized information they need, trustworthy connections within the country, and high level 1:1 support through the entire process.
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YJM
  7/2/2022 17:35 EST

Thanks shermanwc! If I summarize your experience ... you had signed up, and then always kept your US medicare A+B. You supplemented it with local insurance (Caja in CR) or internatonal insurance, until they went bankrupt. Now that you're in Nicaragua, you will probably rely on US insurance should you come across "something big".

shermanwc
  7/3/2022 11:20 EST

YJM - Good summary!

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