What Is This Job: US expat health insurance advisor
March 4, 2018 8:17 AM Subscribe
My mom is thinking of moving back to the States after forty-plus years in the UK. She is in her sixties and understandably worried about getting healthcare there, as well as allergic to paperwork. Is there someone we can pay to give expert advice and perhaps help with paperwork and budgeting? Something like a financial advisor, but for healthcare.
More details: she has pre-existing medical conditions that require daily medication, US/UK dual citizenship, and BUPA insurance over here in the UK. California is the intended destination. My Googled understanding is that she would be eligible for Medicare in the States but would need to pay a supplement due to never paying USA income taxes, and then there is also Medigap which might or might not be useful, and the option of going fully private?
It seems that there are insurance salespeople that will do consultations, but we'd prefer to have someone unbiased. Does this role exist? How might we find someone, or do you have any recommendations? In the UK or over the phone would be best as she's not returning to the States in the near future.
More details: she has pre-existing medical conditions that require daily medication, US/UK dual citizenship, and BUPA insurance over here in the UK. California is the intended destination. My Googled understanding is that she would be eligible for Medicare in the States but would need to pay a supplement due to never paying USA income taxes, and then there is also Medigap which might or might not be useful, and the option of going fully private?
It seems that there are insurance salespeople that will do consultations, but we'd prefer to have someone unbiased. Does this role exist? How might we find someone, or do you have any recommendations? In the UK or over the phone would be best as she's not returning to the States in the near future.
If she is under age 65, she should apply through CoveredCA, just like anyone else for private insurance. For someone in their 60s it is probably going to be pretty expensive, but she may be eligible for subsidies if her adjusted gross income is less than $48,000.
Is she over age 65? If so, going full private insurance will be very expensive. She should probably apply for Medicare even if she has no work credits. If she has no U.S. work credits, then she will pay $426 per month for basic Medicare Part A. Medicare Part B is typically $134 per month. She will pay $100 to $250 for a private Medigap plan to cover what Medicare does not, depending on the deductible she chooses. She is eligible for Medicare Part D which covers prescription medications. This runs from $30 to $100 per month depending on deductible. Yes, this is expensive, about $700 a month total, but much less than for private insurance at that age. Without work credits, she will have pretty much the same coverage and premiums as any U.S. citizen, except for the extra $426 per month for Part A, which is normally free.
Pre-existing conditions are covered, but keep in mind that you only get one chance to choose a Medigap plan. If you try to change your Medigap plan later, insurance companies can charge more for pre-existing conditions.
Something else to consider. In place of the Medicare Part B, Medicare Part D, and a Medigap plan, you can alternatively enroll in the California Kaiser Medicare Advantage plan. The one premium takes the place of Part B, Part D and Medigap and is usually significantly lower cost. The downside is that you are limited to only using Kaiser facilities and doctors. A lot of people are quite satisfied with Kaiser.
posted by JackFlash at 10:10 AM on March 4, 2018
Is she over age 65? If so, going full private insurance will be very expensive. She should probably apply for Medicare even if she has no work credits. If she has no U.S. work credits, then she will pay $426 per month for basic Medicare Part A. Medicare Part B is typically $134 per month. She will pay $100 to $250 for a private Medigap plan to cover what Medicare does not, depending on the deductible she chooses. She is eligible for Medicare Part D which covers prescription medications. This runs from $30 to $100 per month depending on deductible. Yes, this is expensive, about $700 a month total, but much less than for private insurance at that age. Without work credits, she will have pretty much the same coverage and premiums as any U.S. citizen, except for the extra $426 per month for Part A, which is normally free.
Pre-existing conditions are covered, but keep in mind that you only get one chance to choose a Medigap plan. If you try to change your Medigap plan later, insurance companies can charge more for pre-existing conditions.
Something else to consider. In place of the Medicare Part B, Medicare Part D, and a Medigap plan, you can alternatively enroll in the California Kaiser Medicare Advantage plan. The one premium takes the place of Part B, Part D and Medigap and is usually significantly lower cost. The downside is that you are limited to only using Kaiser facilities and doctors. A lot of people are quite satisfied with Kaiser.
posted by JackFlash at 10:10 AM on March 4, 2018
Best answer: If she is 65, or will be soon, she should find a Medicare Consultant, not a Healthcare Navigator. There are a lot of things to look out for with Medicare - for example, if she doesn't sign up for a drug plan when first eligible, she'll pay a penalty for the rest of her life (assuming she's on Medicare), even if she signs up the next year. If she doesn't sign up for a Medigap plan right away, but does later, they can take any pre-existing conditions into account when setting her rates.
I thought I would be able to find out enough Medicare info on my own to pick what I wanted, but I'm really glad I found a consultant. They get paid by the insurance companies, so she shouldn't have to pay one.
Send me a PM if you'd like more info. I just went through this and it's really a bitch.
posted by still_wears_a_hat at 1:27 PM on March 4, 2018 [4 favorites]
I thought I would be able to find out enough Medicare info on my own to pick what I wanted, but I'm really glad I found a consultant. They get paid by the insurance companies, so she shouldn't have to pay one.
Send me a PM if you'd like more info. I just went through this and it's really a bitch.
posted by still_wears_a_hat at 1:27 PM on March 4, 2018 [4 favorites]
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posted by Stewriffic at 8:19 AM on March 4, 2018 [3 favorites]