Expat medical health insurance expert John W. McGee takes a look at how Medicare A, B & D benefits work for US citizens choosing to retire overseas to a life of freedom, wealth and privacy…

I was compelled to do the research and write this article because of the numerous amounts of e-mails I received from U.S. Expats concerned about their Medicare "A", "B" & "D" benefits and how they would apply to them once they reached age 65 and beyond while living outside the United States?

I just hung up the phone from www.hhs.gov and to my surprise they cannot even begin to direct me to any page on their website that informs U.S. expatriates of their benefits…so what does that tell you? It tells me that people pay into the system most of their adult lives and once they decide to be adventurous and relocate outside the U.S.A. they get the crap penalized out of them when it comes to medical benefits after the age of 65.

Yes, there are income tax benefits, (tax free for the 1st $ 85,700 - 2007), if you reside outside the USA for more than 330 days on any given year, unfortunately; the past U.S Government has had little interest in addressing this Medicare issue.

Medicare only authorizes payments to medical providers for U.S. citizens and resident, (green card holders with 40 quarters), inside the United States. I find it quite silly that Medicare will authorize the payment for a heart procedure at the cost of $ 40,000 USD. in Los Angeles, California, while that same surgery in Brazil, Thailand, India or Mexico would cost only $ 5,000 - $ 8,000 USD. I forgot, no one ever said the U.S. system ever made sense….maybe that's why the Social security system will be close to bankruptcy , (if formulas aren't changed),by 2042.

Since information was so hard to attain on this important topic…I came across a forum that had no name, however; this very interesting explanation for Medicare so impressed me…I didn't think I could express it any better words than this:

Contrary to political myth, Medicare does not provide health insurance to people; it provides payment insurance to the health care industry. In the post-war years, health care executives realized that the best way to protect their revenue was to identify the people who most used their services -- people over 65 -- and have the government guarantee their hospital bills. Thus was born Medicare Part A."

Viewed in that light, Medicare's rule against foreign reimbursements makes sense. The low price of high-quality, overseas health care is good for patients and good for the Treasury, but it's terrible for U.S. health care providers. They want that money! And they damn sure won't allow their pet goose to stop laying golden eggs.

So the Medicare laws contain a "Benedict Arnold" provision which prohibits otherwise eligible U.S. citizens from collecting benefits if they are treated abroad. While this theoretically affects everyone, the brunt is felt by expat retirees.

IS THERE HOPE? Tom Rose, an expert with the Association of Americans Resident Overseas, said he did not think it likely that Medicare would be extended internationally in the coming years. A great article addressing this entire issue and the possibilities of relief in the future are found on http://www.cnsnews.com/public/content/article.aspx?RsrcID=33914

If change is upon us, you couldn't ask for a better time for this issue to be presented. Personally I feel this will be put to the back burner for at least the next couple of years or so, until the economy gets back on its feet and the budget is heading south. Never say never, who would have ever thought we would have seen an African American as the United States President in our lifetime?

I have some interesting money saving strategies to share with those who are closing in on age 65 or older that want to control expenses, while protecting themselves, their assets and family members against a catastrophic illness or injury.

Further resources: Expat Global Medical represents Multi-National Underwriters, a Lloyds-of-London coverholder offering health, medical, travel and term life policies. Whether living, working or traveling internationally, they have a policy tailored to cover you. They are the only professionally-run company we know that offers true worldwide cover irrespective of residence or citizenship - very important for our many readers who are not US citizens. With these plans you have the freedom to choose your own medical provider, or select from an established global network of hospitals for expats that have direct billing agreements with the insurers.

This article is provided free by The Q Wealth Report in association with the retirement overseas and international real estate portal Offshore World as a service to American citizens considering retirement overseas and concerned about their Medicare benefits and health coverage. If you found this article useful, please note that we cover this topic in greater depth in each issue of The Q Wealth Report, the world's premier guide to international living and lifestyle with an offshore investment focus. If you would like to know more about us, our philosophy and what we do, feel free to browse this site.