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Kent Payne of Gran Pacifica – Best Places In The World To Retire User Account
By USA law, Medicare is not applicable  Hospital Metropolitano Vivian Pellas in Managua Nicaragua – Best Places In The World To Retire – International Livingoutside the borders of the states.  But there are many expats who use Medicare as a secondary alternative to healthcare in Nicaragua.  Many people who live here in Nicaragua have their Medicare deducted from their Social Security, and then go back to use their personal doctor in case of dire emergency.
 
My personal insurance is covered for major medical from the Vivian Pellas Metropolitano Hospital, one of the accredited hospitals in Central America.  Most doctors are bilingual, and have been trained on the newest equipment and many in the United States. 
John Ohe of Hola Expat Tax Services – Best Places In The World To Retire User Account
medicare – Best Places In The World To Retire – International LivingFor the most part, Medicare cannot be used outside the US by permanent expats. There is some travel coverage with the Medicare policy, but it is not a significant coverage level. As far as US expats are concerned, Medicare is really designed for coverage when you go back to the US and have routine checkups or you have a condition that you want to be treated for in the US. Medicare is not designed for coverage in another country. 
 
For expats who live abroad, the basic options are:  1) pay out of pocket; 2) pick up a health insurance policy that is local in nature and get into the "nitty-gritty" of what that coverage would be locally; 3) get international health plans that are out there with a few vendors like Cigna, Bupa, and a couple other smaller companies, but these policies tend to be very expensive; or, 4) evacuation insurance, which will only cover a US expat to get back to the US. 
 
I have clients who rarely go back to the US. They have cancelled their Medicare coverage. However, Medicare is not that expensive. If you can afford the physician coverage, I would recommend keeping it. Part A is the hospital coverage. Part B is the physician coverage. Now there's also Part D, which is the pharmacy coverage. Drug costs are much lower outside the US. The fourth part of Medicare is the Medicare Supplemental, which fills in the gaps that Medicare has and that you buy from a private medical insurance company.
 
I would maintain the hospital and basic physician coverage on Medicare even if you live outside of the United States. Let's say you are a young retiree living abroad for a decade.  Anything could happen. You might need to go back to the US. Healthcare costs are so expensive in the US. If you think about what you pay in premium for Medicare versus the benefits, it is a highly-subsidized insurance coverage provided by the US government, so why not take advantage of it?
By Edgington – Best Places In The World To Retire User Account
Medellin River, Christmas 2004 – Best Places In The World To Retire – International LivingThe short answer is no, you cannot use Medicare here in Colombia. The long answer is beyond the scope of a response. International health care policies are a good option, but, as always, the fine print is your friend. For instance, many international policies will not insure you within a certain number of miles of your 'home address,' so don't let that codicil bite you. In our case, with a home address (for now) in Ohio, we can't use our policy within 100 miles of Columbus, so we must acquire an additional policy within that range (I know, it's nuts) or risk going uninsured.
 
The really good news about all this is that many health care systems abroad are much, much cheaper than that found in the U.S., for example, while retaining the quality found there--or exceeding it. My wife needed a full panel dental x-ray when we arrived in Medellin, and she received it in one hour, with no appointment, for about $6.00 US. (You read that right, no need to wipe your glasses.) No co-pay. No insurance interaction.
 
So one answer to the question is to acquire emergency or major medical coverage only, and pay out of pocket for the rest. Not exactly an answer to the original question about Medicare use, but an elaboration on options. Another item to consider is Tricare, if the retiree is eligible for military retirement bennies. Tricare can be used (I'm told) by paying for the expenses, then submitting paperwork to Tricare for reimbursement. Disclosure: I've not gone this route. I've only been told it's possible, so good luck.
 
(Photo: Medellin River, Christmas 2004.  Credit: By Aliman5040 - taken by Alejandra Zapata (my cousin), CC BY-SA 3.0, Wikipedia.)
Mack Jones – Best Places In The World To Retire User Account
Kuna people with tourist – Best Places In The World To Retire – International LivingWhen I moved to Panama, I figured to take care of my medical needs using local resources (I live in Coronado, but Panama City is only an hour away), because they are good and very economical.  For instance, a doctor's routine visit for a checkup or specific problem, such as diagnosing a cold, is less than ten dollars if you use your Julibilado Visa.  For more serious problems, like a knee replacement, I planned to fly to the US to use my Medicare.
 
The problem is with a medical issue that is an emergency, such as a heart attack - flying is not an option then.  Last year I had an accident swimming, and wound up in Panama City at the National Hospital.  Two days in the ICU, plus two more in a regular room, plus all the other stuff, cost me $7,500.  Without any insurance to cover that, they want cash before you leave the facility - or a credit card.  Fortunately they took American Express.  The wife of a Canadian friend of mine had to have emergency heart surgery, and his bill was in the tens of thousands.
 
Before moving to a foreign country, make plans to deal with all of your potential health needs. 
 
(The native Kuna people of Panama are distinctive because they have relatively low incident of high blood pressure, pictured.)
Kristin Wilson of Orbis Relocation – Best Places In The World To Retire User Account
world poker series, Kristin Wilson – Best Places In The World To Retire – International LivingI have an international medical insurance policy that follows me anywhere in the world that I use for emergencies. I pay out of pocket for everything else because the costs are usually so much lower.
 
You can't use your Medicare outside the US because Medicare will not pay any healthcare facility that's not in the US. What some people do (because it’s relatively inexpensive) is to maintain Medicare part A in the US if they ever need to use it so they can always come back to the US.
 
It's important to be covered anywhere you are. Any type of basic insurance you can have when you're in US is definitely ideal to have. I have never had a problem. I always had good experiences with medical facilities in different countries. I injured myself once in Czech Republic. No one spoke English in the hospital but the care was good and it all worked out and I got my insurance to cover it.
 
I've been to medical facilities and hospitals in Mexico, Nicaragua, Costa Rica, Canada, Thailand, Australia, and probably a few other places. If you don't have anything that's an expensive, ongoing serious condition, you’re in overall good health and you just need to go for a checkup, it's generally pretty affordable to pay out of pocket. My insurance has a multi-country travel and medical insurance option. It’s only US $300 to $400 a year. It includes my baggage, emergencies like life flighting, death or dismemberment. 
 
I ended up having to go to the emergency room in Costa Rica twice in a week. I had to get an IV and it cost around $1,000. In the end, because I had to get so many things done in two different days I had my insurance cover it. If I just wanted to go to a normal checkup, it would cost way less. A dental cleaning can be $20 -$50 in most places outside of the US. I was in North Carolina recently and was told that it would cost $500 for a dental cleaning. When you’re overseas, you can definitely pay out-of-pocket for anything like that.
 
When I was in Nicaragua I had an ear infection, so I went to the public clinic. I had to pay for my prescription for my infection.  However, the actual cost of going to the clinic (and they gave an itemized receipt), was the equivalent price in US dollars of around one penny.  I was there for a couple of hours. Pretty much anything that you need to get done, even if you go to the hospital when you need to see a doctor for something specific, is not usually not going be more than $40 or $50. It's usually cheaper to pay out-of-pocket and you can go to a private doctor, a private hospital, or a private clinic in places like Panama, compared to paying for some really expensive insurance that's going to cost more than going to the doctor, anyway.  
 
(Kristin Wilson, traveling for The World Series of Poker, pictured.)
Alonso Cornejo of ASA, Inc. – Best Places In The World To Retire User Account
The answer in most cases is no, Medicare will not pay for health care outside the U.S. However, if you’re in the U.S. and during a medical emergency a foreign hospital is closer than the nearest U.S. hospital, Medicare may pay for these expenses.

It is always recommended that individuals who have Medicare and live abroad secure an international policy. These policies will typically provide coverage anywhere in the world, free choice of doctors/hospitals and guarantee the renewal of the policy for life. International catastrophic policies for those 65 and older are relatively affordable and cost as little as $90 per month. It is important that retirees secure these policies before age 74; as this is the maximum age one can apply for a new international policy.
Lissy Lezcano  of Lissy Lezcano Attorney & Mediator – Best Places In The World To Retire User Account
In Panama we have “Social Security”.  if you need it you can use it but you have to pay. If you don’t have the money they will help you anyway but at some point you will have to pay for their services.
 
Private hospitals have medical insurance that most of the time will cover a percentage of the cost and you pay the difference.
 
Thanks
Catherine Burdine of American Insurance for Expats – Best Places In The World To Retire User Account
Medicare coverage is primarily designed to cover you within the U.S.  Medicare supplemental plans C, D, F, G, M and N offer 60 days of coverage outside the U.S. with a maximum benefit of $50,000.00 within that 60 days.  After 60 days outside the U.S., you are uncovered.  For this reason, ex-patriots who live half the year or more outside the U.S. purchase an international private, major medical plan.
 
An international major medical plan will allow you to be hospitalized in Panama, or any other foreign country you may visit, without worrying about the final cost.  After your deductible is met, your costs are covered.  
 
It is always recommended you keep your Medicare coverage in the U.S. 
Craig Morrissey of Hospital Nacional – Best Places In The World To Retire User Account
Retiring overseas, keeping Medicare Part A and then returning to the US to use it if you need hospitalization is a contingency plan that is used by some expatriates.  However you should be aware that there are some emergency cases, such as a heart attack or stroke, when this will not be possible because of time constraints.  It is worth noting also that Medicare does not have international benefits, so it can only be used in the US and US territories.

 
Tabitha Paddock of Greenback Expat Tax Services – Best Places In The World To Retire User Account

Unfortunately, in most cases Medicare benefits do not apply to medical care provided outside the US. I would suggest you assess your healthcare needs, and the medical costs in the country you will be retiring in. Depending on which country you plan on retiring in, you may have a public health care system available to you. You should also look into the availability and cost of a private health insurance plan for medical expenses incurred in other countries.
 
Usually, once you have moved to a foreign country, you're no longer eligible for Medicare benefits (although Medicare does cover residents of Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Northern Mariana Islands).
 
However, if you come back to the US, you will still receive Medicare Part A benefits. (Anyone who qualifies for Social Security, and is 65 or older qualifies under Part A.)
  

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